Australia vs the Spanish flu

Proportionally, fewer white Australians died in the 1918-20 influenza pandemic than across most places around the world. This is partly for the same reasons that Australia is currently doing better at containing the coronavirus COVID-19, with fewer fatalities than many other countries.

With some exceptions, back in 1919, Australian ports were closed and internal movement was contained by controversially closing state borders and closing down schools, theatres, shops and hotels (but not the footy). Many people were thrown out of work.

Country towns also quarantined themselves, even stopping passengers alighting from trains. Travellers needed permission to move around and even returning soldiers from First World War battlefields were soon stopped from going home. As the virus was already rampant through Europe during the last year of the war, Australian authorities had plenty of time to prepare as the troop ships starting returning in late 1918.

Quarantine relied upon honesty in disclosure and rigourous screening, which was not uniformly implemented, so the virus quickly entered Australia and spread across the country.

It is estimated that about 40% of the population got the disease. Around 15,000 people perished. Reports vary but estimates of global fatalities run from 20 to 50 million people.

Australian Aboriginal communities tried to restrict outsiders, but as is still the case today, they did not have control over keeping themselves safe. Like today, some community groups went off the grid to protect the old, young and sick. When the flu got into Aboriginal communities, the impact was devastating. A current search for mass graves underway near Cherbourg, at what was Barambah Government Reserve where, in just three weeks in 1919, nearly every one of the 600 residents contracted the disease and 90 died. This was one of the highest mortality rates in a population anywhere.

International data, patchy though it was, confirms that the mortality rate was much higher amongst colonised peoples, including across India, Africa and in New Zealand. Whilst it is often reported that the pandemic was characterised by attacking fit young adults, the reality was that children and adults who were malnourished with degraded immune systems, and living in crowded conditions with poor hygiene were much more likely to die. This described conditions in Indian and English slums, but also on battlefields and troop ships. Pregnant women and babies were particularly vulnerable.

The pandemic, which became known as the Spanish Flu, was first identified as something more than the regular bouts of influenza in early 1918. It spread rapidly throughout Europe and further afield. The origins are still debated, but it was called the Spanish flu because Spain was neutral in WWI and while censoring their own flu news amongst tanking morale of troops and civilian populations, the war's combatants eagerly reported that the Spanish king was battling the flu.

The recently federated Australia had been on war footing since late 1914, and the federal government had become well used to battling with the States over jurisdiction, adopting wide ranging powers over the movement of goods and people. These stoushes continued onto managing the influenza pandemic.

Censorship continued and push backs by the population on being ordered around also continued. However, unlike today, Australians were used to the fatal repercussions of epidemics of communicable diseases, so stern demands were also made of governments to contain outbreaks.

People knew that social distancing and isolation would prevent spread, even if they did not use those terms. This was a fairly dramatic disease, with powerful symptoms but still initially not readily distinguished from other respiratory diseases. It was spread by sneezing and coughing. Masks were popular but their efficacy debated. next page ➜

However, unlike today, Australians were used to the fatal repercussions of epidemics of communicable diseases, so stern demands were also made of governments to contain outbreaks.

Women in face masks during the Spanish flu, 1919. (National Museum of Australia)

The burden of dealing with the flu pandemic fell disproportionality on women who had to nurse at home, deal with sick returning soldiers, and feed and keep a roof over the head of families in a time of job losses and food shortages.

Quarantine camp set up at Jubilee Oval (State Library of SA)

WWI had been highly divisive in Australia with two failed conscription plebiscites, massive strikes and a very public ideological debate over empire, capitalism and warmongering. In his seminal 1976 article on the Spanish Flu pandemic in Australia, Humphrey McQueen wrote:

Longstanding grievances by seamen came to the fore as they compared their normal working and living conditions with those prescribed under the influenza precautions ashore. The Victorian Government forbade more than twenty people to be in one room, but when the Seamen’s Union complained that the owners of the Loongana expected twenty-four seamen to sleep in one room a Board of Health Inspector said that this was acceptable. ‘Dog kennel accommodation’ had been a point of dispute for years and the election of a new militant executive set the tone of the protracted shipping strike which followed.

If more than 20 out of 24 members of a crew get influenza at once, they must immediately stroll up to the owner’s office, and sneeze violently altogether at once. The owner will then immediately leave his office, and personally conduct you to his private hospital, calling at hotels en route, where you will receive every attention, and a nurse maid for each. Don’t forget that when you are dead you have to go to hell yet for asking for higher wages and more ventilation. You will find no shipowners there to argue with.

The health system was pushed to the edge, with the rate of recovery best amongst the better-off. Doctors were in short supply with some still overseas. However, this was an opportunity for nurses to come to the fore creating new nursing jobs and, critically, increasing their wages and status. The burden of dealing with the flu pandemic fell disproportionality on women who had to nurse at home, deal with sick returning soldiers, and feed and keep a roof over the head of families in a time of job losses and food shortages.

Commentators in Australia and elsewhere like to label Spanish Flu as the forgotten pandemic even though the death toll was so massive. In Australia it is very much an addendum to the WWI narrative, as the flu fatalities butted up against the 60,000 killed in the war out of a population of just over five million.

Across the world the Spanish Flu petered out. It is contended that the flu may have mutated into a less virulent strain, but with such large numbers having already been exposed immunity was widespread. Repercussions continued with people never fully recovering and remaining susceptible to pneumonia. Improved treatments and nursing as time went on helped with recovery, along with access to decent food.

Unlike Europe, Australians did not have to recover from the pandemic in a land devastated by war. But apparently the mortality rate from the influenza did not drop to the pre1919 level until 1935. •

Jeannie Rea is NTEU Immediate Past President