The Spanish Influenza epidemic of 1918-1920 struck Newcastle and the lower Hunter between March and September, 1919.
During that time the disease claimed 494 lives in the district.
Planning for the necessity of responding to the epidemic began before the disease’s arrival. An Influenza Committee was set up, and when the first cases appeared in Sydney, the Newcastle and Northumberland Benevolent Society’s hospital and asylum at Waratah (later the Western Suburbs Hospital) was requisitioned as an 188-bed Isolation Hospital. This was done at the beginning of February; consequently, when the first Newcastle cases of the influenza appeared, the premises were already available to receive them. This, of course, caused considerable disruption to the work of the Benevolent Society, which had to find temporary premises in Darby Street, with a capacity of about 30, until their building was returned to them at the end of September. Their Annual Report for that year complains that “The Government took over the Benevolent Home at Waratah … forgetting that the aged and infirm of the District required a home and a place of refuge … and the result was a number of the inmates were scattered over the State.”
Newcastle Hospital agreed that its Dr Banks-Smith should become the Medical Superintendent of the new Influenza Hospital. The Deputy Matron at the Newcastle Hospital, Sister Skelton, was appointed as Matron, and the whole of the Newcastle Hospital nursing staff volunteered to nurse influenza patients; most were sent to the Isolation Hospital as they could be spared, and, although several contracted the disease, all who did so recovered.
Other measures were taken. The Health Department set up an inoculation station at St Philip’s Hall in Watt Street; in one day, the 3rd of February, 1,774 inoculations were given there. Other stations operated at Newcastle South Public School (for children) and Wickham Council Chambers. From the 3rd of February, all travellers by train were required to wear masks, and masks were distributed to all railway staff; however, the Newcastle Herald reported on the 4th that “While every member of the staff at the Newcastle railway station yesterday was wearing a mask, numbers of the passengers were not masked.” From that evening, however, passengers without masks were refused tickets.
The first influenza case in Newcastle was a young sailor, Frederick McAlister, who arrived from Melbourne on the steamship “Ooma” on the 25th of February, was taken, already ill, to Newcastle Hospital, in the belief that he had typhoid, and died on the 2nd of March, at which time it was confirmed that his illness was the influenza. Unfortunately, he had infected five nurses, two wardsmen and one other patient during his short time at the Hospital (Newcastle Herald, 4th March, 1919). These became the first eight patients at the Isolation Hospital, where they were admitted on the 4th. One of the doctors was diagnosed shortly afterwards; within a week, thirty-five patients had been sent to the hospital at Waratah, and the Deaf and Dumb Institution in that municipality had decided to prohibit visitors (Newcastle Herald, 11th March, 1919).
According to the final report of the Board of Health Medical Officer for the Hunter, Dr Robert Dick:
“The disease showed itself in two waves, the crest of the first being felt during the period 6th to 19th April, and the second more pronounced wave extended over the period May 25th to June 28th. After this there was a very rapid decline and disappearance of the disease. The outlying mining town at Catherine Hill Bay was the last centre attacked. That town and one or two others in the Maitland mining district experienced only one wave in the epidemic, but during its prevalence a very high percentage of the populations of these towns was attacked.” (Newcastle Herald, 16th October, 1919)
The second wave was particularly challenging for the establishment at Waratah. During June, Dr Banks-Smith, his assistant Dr Taylor, and Matron Skelton all contracted the infection, as did several other members of the staff (Newcastle Herald, 12th June, 1919). On the fifteenth of that month, 17 new patients were admitted, 15 discharged, and three died, leaving a total of 166 cases under care (Sunday Times, 15th June, 1919). Two days later, twenty cases were admitted; on the same day, over thirty members of the Newcastle Post Office staff were reported to be absent through sickness (Singleton Argus, 19th June, 1919).
During the course of the epidemic in Newcastle, 1,442 patients were admitted to the Isolation Hospital, of whom 157 died. A further 256 were taken by Wallsend Hospital, 23 of whom died there. Other deaths occurred at Maitland, Cessnock and Kurri Kurri Hospitals. Of the 494 lives claimed by the epidemic in the Hunter, 290 died in hospitals, and 204 at home.
In retrospect, Dr Dick had some thoughts about the measures taken:
“The methods adopted, beginning with maritime quarantine, preventive inoculation of the population, masking, closure of theatres, picture shows, and all other similar places where crowds congregate, the control of train and other traffic, etc., all failed to prevent the entrance of the disease to the State, and when once introduced, they had practically no appreciable effect in limiting its spread. … I think it will be judged that the enforcements of all these restrictions had no compensating advantages. No one will deny that it is very unwise to frequent crowded places during the prevalence of any infectious diseases, but to compulsorily prohibit any and every form of meeting and to restrict travel unnecessarily is a different matter. One serious effect resulting from the adoption of the restrictions referred to was that the public was led to regard the disease as a very fearsome thing…”
Dr Edward Bridle
University of Newcastle
4 thoughts on “Spanish Flu and Newcastle 1919: What can we learn today?”
Newcastle South Public School (1872) is now known as The Junction Public School. The school was extensively damaged during the 1989 Newcastle earthquake resulting in only the survival of its original earliest schoolrooms. In 1919 it was a very large school making it a central point for assembly.
Interesting comments from Dr Dick. To paraphrase, ‘of course discouraging large gatherings is essential, but prohibition frightened people.’
There was no reassuring doctor on the telegraph to calm the public, I suppose.
In retrospect, there is good reason to believe that Frederick McAlister did not die of influenza, or if he did, he caught it at the hospital. As noted, McAlister became sick on board the ‘Ooma’, and two medical practitioners travelling on the same ship diagnosed him with typhoid fever. Their diagnosis was reviewed by Dr Zions, the Hospital Superintendent, and an admired clinician, who agreed with the diagnosis prior to McAlister being admitted to the Newcastle Hospital. McAlister did not have any respiratory symptoms until the terminal phase of his life, and the diagnosis of influenza was made at autopsy. However, the test for typhoid available at the time was never undertaken, and it’s likely the autopsy examination was conducted by a junior (inexperienced) resident. Even if we accept that the resident found evidence of ‘pneumonic consolidation’, there was no way for anyone at that time to distinguish between terminal pneumonia complicating typhoid from pneumonic consolidation secondary to influenza infection. The most compelling argument against McAlister having influenza when he was admitted to the hospital was that no further cases occurred on the ‘Ooma’, which was declared a ‘clean ship’ when it later docked in New Zealand. This would have been very unusual if McAlister had had the (highly infectious) influenza virus, but had failed to infect anyone else on board. (It should be noted that other influenza patients had been treated at Newcastle Hospital prior to McAlister’s admission, so the alternative explanation is that one (or more) of these patients were actually responsible for infecting the hospital staff).
It may seem pedantic to argue about a diagnosis made more than 100 years ago, but Dr Zions was (in my opinion falsely) blamed for the explosion of influenza cases in Newcastle, and forced to resign. While he subsequently became a leading London physician, and prospered, his case is a reminder of the harm that can be done by jumping to conclusions with limited, or inadequate information.
Very interesting David. My Grandfather returned from WW1 a complete mess with “shell shock” , malaria and a host of other ailments. I got his repat file from the national archive recently and saw this entry. ” I began as a driver of the influenza car on 1/5/19 and after eight days had to knock off as I had the flu and another bout of Malaria” Regard Peter Cave