The ‘Spanish’ Influenza Epidemic of 1918 – 1920 and its impact on Wales

Given the present circumstances it is perhaps inevitable that historians, and in particular those who spend their career studying the Great War, would look for similarities between the Covid-19 virus and the influenza epidemic that caused such havoc across the world between 1918-1920. However, such an exercise is problematic; there are similarities, but to get an accurate picture of the nature of the influenza epidemic, you need to be fully aware of the context in which it took place.

Dr Lester Mason, Lecturer in History at UWTSD.

The influenza epidemic (influenza A virus subtype H1N1, to give its full name) lasted from January 1918 to December 1920, and reached a deadly peak in Wales during October and November 1918. The label ‘Spanish’ is misleading. True, Spain suffered the full force of the epidemic, like many other European countries; however, the fact that the country was not at war, and was not compelled to impose wartime news restrictions, meant that early reporting on the virus tended to concentrate on Spain, coupled with the added attention given to the fate of the monarch, King Alphonso XIII, who had been struck down with the virus. The presence of wartime restrictions would have a lasting impact on how the virus was tackled and indeed on its legacy.

There have been a number of theories put forward about the true origins of the virus, many of which speculate about the impact of the War and the increase in the number of army camps and barracks across the world, with further speculation connecting meat and poultry preparation and the army camps in Kansas USA (teeming with soldiers about to cross the Atlantic to fight in Western Europe). Some suggest the extensive Allied military training camp and medical facilities at Etaples on the French coast was a breeding ground for the virus. Whatever the true source, it cannot be denied that the massing together and movement of so many young men helped spread H1N1. In his 2006 publication The War of the World, Neil Ferguson claims ‘one in every hundred American males between the ages of 25 and 34 ‘fell victim to the Spanish flu lady’ (pp.144-5). Other factors that were linked at the time to the spread of influenza included poverty, poor hygiene, and overcrowding. These factors would have an impact on Wales, particularly in the working class communities of the south Wales coalfields.

The symptoms were alarming, particularly during the virulent second-wave in the autumn of 1918 – the skin turned blue, the lungs filled with suffocating fluids, and there was bleeding from the nose and ears.  It struck quickly and quietly, and death could occur within days, and in some cases, hours. Counter to expectations, and supporting Ferguson’s comments above, it was most virulent among young adults, taking a fearful toll on servicemen, many of which had survived combat, only to succumb to H1N1. It is believed that a lifetime of acquiring immunities to such viruses had given more protection to the elderly.

This period, of course, predates the NHS, and there were no vaccines or anti-viral drugs to turn to, so any response to the virus did lack the medical sophistication we tend to take for granted today (at the time it was judged a bacterial infection, and not a virus); but there are some parallels between then and reactions today to Covid 19.  Restrictions on movement were imposed in 1918, including advice on the need to avoid sneezing and coughing in public, the boiling of handkerchiefs, the ventilation of bedrooms, and the avoidance of crowds. Some schools, cinemas and theatres were closed. At the heart of the response to the Spanish flu virus was the role of the Medical Officer of Health under the control of the local Councils, a far cry from the more centralised government response of today. However, in the early stages its full impact was not realised because of poor communication, wartime restriction on the sharing of information and news gathering, and the simple fact that, at a time when the death of young men in battle had become the norm, the toll taken by the H1N1 went unnoticed.

The impact in Wales was profound. According to the BBC website:  ‘How Spanish flu epidemic devastated Wales in 1918’ (available at: www.bbc.co.uk/news/uk-wales-45577611) it is estimated that between 8750 and 11400 people died in Wales from the virus. The worst impact came during the second wave in the autumn of 1918, clearly indicated by the graph below (see fig 1 below), showing the spike in cases of over 20,000 in October/ November. The spike came earlier in the Rhondda, when 144 deaths were recorded in July 1918. The close-knit mining communities of south Wales, known for their neighbourliness, suffered disproportionately, as did the more deprived areas of Cardiff. However, rural Wales did not escape; the highest death rate in Wales occurred in Caernarfonshire, where some communities were overwhelmed, hampered by a shortage of Doctors, as many from this profession were in uniform and serving abroad.  This is clearly evident in figure 2 below, which maps the death rate per thousand in Wales by county (both fig 1 and 2 are available at:www.bbc.co.uk/news/uk-wales-45577611).

Fig1: Register General’s graph of Influenza cases in Wales, June 1918 to May 1919. 

Fig 2: Register General’s map of Influenza cases in Wales 1918-1919. 

The west of Wales did not escape. An article in the Cambrian Daily News from 28th June 1918 covers events in Swansea:

‘THE SPANISH FLU: Cases Multiplying in and Around Swansea. The Spanish influenza runs its giddy course in and around Swansea. It is no respecter of busy and leisured people, rich and poor, young and old, are down with it.’

While in The Carmarthen Journal on 17^th January 1919 this appeared:

‘Flu in Carmarthenshire – 349 deaths’: 174 males and 175 females, made up of 111 deaths in the urban districts and 238 in the rural districts. The number of deaths…appeared to be over 100% more in the rural districts. The period (sic) showing the highest death rate was between 25-65 years, and that next to that came the period (sic) between 15 and 25.  The disease appears to be more fatal in rural districts…this could be accounted for to some extent to the greater exposure to inclement weather by pursuing agricultural work. Sanitary conditions in rural areas were also more defective than in the towns’.

Both these newspaper extracts are available at the National Library website.

The Wales newspapers on-line website is a rich source of information and holds a variety of Welsh newspapers dating from 1804-1919. A simple entry into the search engine will display numerous articles on the epidemic from all parts of the country.

The legacy of the flu epidemic is a complex subject matter. As discussed above the initial response was muted because of wartime restrictions, and ever since it has been viewed as the ‘forgotten epidemic’ (however a number of studies on the epidemic have appeared in recent years – see the further reading list below).

In his social history of Wales, entitled People, Places, and Passions, Russell Davies aptly states:

‘this contagion, which caused panic and fear on a scale not seen since the ravages of cholera in the mid-nineteenth century, killed more than 9000 people in Wales. Yet there is almost no echo of a cough in the history books’ (2015, p.15).

Limited news coverage during World War One, coupled with the close proximity to the conflict and the carnage of trench warfare and the war at sea, meant that the disease was deemed less significant, even if it claimed so many young citizens of all nations. This has also meant that, over the years, the epidemic has not been given the attention it deserves. Perhaps the present Covid-19 crisis will lead historians to think again, and re-assess the significance of the Spanish Influenza crisis a century ago. Whether we can learn anything about the 1918 virus that can help in our response to the challenge today, is questionable, but there are similarities, including how epidemics appear in peaks and waves. Whatever the similarities, the epidemic of 1918-1920 was an event of historical significance and it surely deserves our full attention at this time.

About Lester Mason

Dr Lester Mason is a lecturer in History at the University of Wales Trinity Saint David in Lampeter.  His expertise primarily relates to The Great War and west Wales, and in particular war commemoration and memorialisation. During his post-graduate research, and indeed since, he’s acquired an extensive knowledge of the commemoration process in west Wales, and indeed of the plethora of memorials that remain with us today. This includes the decision-making process behind their instigation and the changing nature and meaning around the language and iconography associated with such sites. Dr Mason also possess an extensive knowledge of the impact of fighting the war had on the communities of west Wales, both on the home front, and on those who left their homes to fight. More generally, my interest in war and conflict has led to an extensive knowledge of World War One, its history and indeed its rich and evolving historiography.  

Note to Editor

Further Reading:

• Catherine Arnold, Pandemic 1918 (Michael O’Mara, 2018)
• Russell Davies, People, Places, and Passions: A social history of Wales and the Welsh (Cardiff: UWP, 2015)
• Charles Rivers Editors, The 1918 Spanish Flu Epidemic (Create space, 2014)
• Niall Ferguson, The War of the World (London: Allen Lane, 2005)
• Lauren Spinney, Pale Rider: The Spanish Flu of 1918 and how it changed the World (Vintage, 2018)
• Aberystwyth, National Library of Wales, ‘Welsh Newspapers on line’: available at https://newspapers.library.wales/.  [Accessed 26 April 2020]
• BBC website:  ‘How Spanish flu epidemic devastated Wales in 1918’ available at: www.bbc.co.uk/news/uk-wales-45577611) [Accessed 27 April 2020]

Further Information

For further information, please contact Sian-Elin Davies, Principal Communications and PR Officer on 01267 676908 / 07449 998476 sian-elin.davies@uwtsd.ac.uk