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Jane Jenkins
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Experts have long predicted the inevitable arrival of another influenza pandemic as deadly as the one that killed millions around the world in the early 20th century. While it remains to be seen whether these predictions are about to come true, one thing for sure is that New Brunswick is ready for any viral onslaught. Pharmacy shelves are stocked with anti-viral medications, people are lining up for flu shots, retired health-care workers are on alert to help out, and teachers are drilling children to be expert hand-washers and sleeve-sneezers.

Enlarge Photo

The Canadian Press

A Community Health employee cleans the door handles at the Sandy Hill Community Health centre, which opened a flu assessment clinic to help reduce the pressures on emergency rooms in Ottawa on Wednesday. Preparations for the flu today are advanced compared to what was available during the 1918 flu pandemic – yet thanks to the decisions made by its public health officials, New Brunswick emerged from the epidemic with the second-lowest death rate in the country.

The situation was a lot different in the chilly fall of 1918. Just as World War I was drawing to a close, war-weary New Brunswickers were focused on harvest dinners and getting the troops home. There were a few reports of influenza outbreaks to the south and north, but these were not considered dangerous. Besides, people were used to bouts with a seasonal flu that meant nothing more than a few miserable days in bed.

Preparations for a serious new flu amounted to newspaper editorials recommending a positive attitude and getting plenty of fresh air and sunshine. So when the influenza epidemic did sweep into New Brunswick in early October of 1918, people were stunned. It would have been hard to prepare for what they faced over the next four months. Early symptoms mimicked a bad cold, but the rapid onset and severity of the influenza were staggering. People who were healthy and active at dawn were knocked flat by afternoon, once the virulent influenza joined in a death waltz with bacterial pneumonia. As the victim's body was wracked with feverish aches, the lungs filled with a thin, bloody fluid that made breathing painful and difficult. Thrown into spasms of coughing and gasping for air, the shocked victim spewed a red, frothy liquid from mouth and nose. Death could occur within 48 hours.

Heart-wrenching tragedy struck as the province of 350,000 staggered to cope. By the middle of October 1918, thousands of people lay sick and dying in towns, villages and rural farmhouses throughout New Brunswick.

The Parks Convalescent Home in Saint John, set up originally to care for soldiers returning from war, was converted into the Parks Epidemic Hospital. In Moncton, in one day alone, church bells tolled for a shocking 13 funerals. Just outside Bouctouche, three brothers aged 22 to 26, visiting home on military leave, all caught the flu and died on the same day. Their mother died the next day. Doctors and volunteer nurses worked themselves to exhaustion. In Dorchester, 600 people were lying prostrate from influenza while the closest doctor, seven miles away, faced another 1,000 cases.

Although the situation was dire, something had happened just a few days before the first cases started appearing that would end up saving New Brunswick from the extreme suffering felt in other regions of Canada during that terrible fall.

No one could have guessed, when the province's Public Health Act of 1918 was proclaimed into law in the early days of October 1918, just how important it would be for the health of New Brunswickers. The Act was the brainchild of Dr. William F. Roberts, a prominent Saint John doctor who had run for election with the explicit goal of establishing a provincial Department of Health. It had been an uphill battle.

Critics complained that government-controlled oversight of public health would cost too much, bring in no revenue and give autocratic powers to the Minister of Health to regulate public and private buildings and businesses. Even after the bill passed, Roberts worried that his victory was a precarious one and that critics would make short work of dismantling the new department. He didn't have long to worry about this, though, since his focus was quickly turned to the deadly strain of influenza sweeping into the province. Little did he know that it would be this disease attack that would prove the merits of the Department of Health and provide the impetus for continued public health reform in New Brunswick.

Dr. Roberts, along with his Chief Medical Health Officer, Dr. George C. Melvin, were the only health officials with province-wide jurisdiction when the flu hit New Brunswick, but Roberts acted swiftly and decisively. He used the sweeping powers given to him in the Public Health Act to shut the province down.

On Oct. 9, 1918, government proclamations ordered the closure of all schools, theatres and churches in New Brunswick until further notice. All public gatherings, even ones planned to take place at the Saint John Natural History Museum to make sphagnum-moss bandages for the war effort, were prohibited. Although shops and businesses could remain open, their proprietors were implored to prevent overcrowding and loitering. Roberts and Melvin co-ordinated the efforts of a range of volunteer organizations to help people too sick to move.

Closure orders maintained the quarantine for all but essential businesses and relief efforts, but people still complained about them. Church leaders, especially, appealed to Dr. Roberts for exemptions, but in every case he did not relent and the closures held for over six weeks.

Hitting its peak in November 1918, the epidemic slowly faded away by the end of January 1919. Also dissipated was the criticism that had been hurled at the government's centralized control of public health. New Brunswick's death rate from the 1918 influenza epidemic turned out to be the second-lowest in Canada, and Roberts' quick action to quarantine was credited. He reported later that the attack of influenza had been the department's baptism of fire.

It had been a baptism that had legitimized government oversight of public health matters. The new Public Health Act had made it possible for only two health officials to make a dramatic impact, which, no doubt, saved lives.

The devastation of the 1918 influenza epidemic is often invoked by public health authorities today to rally support for preparations for the next pandemic. If the past can offer any insight, it might be to heed the advice of today's public health officials as we anxiously await another influenza.

Jane Jenkins is Associate Professor and Director of Science and Technology Studies at St. Thomas University in Fredericton.