Part 3

In pursuance of this suggestion a six-page leaflet was subsequently prepared and printed in English, Italian and three other languages, and was well distributed throughout the District.

Mr. Brown also suggested that a fund be created from which money could be drawn to be used in paying some one in each sub-district to look after and report upon the sanitary and health conditions in that particular locality.

Anthony C. Campbell, Esq., Fuel Administrator for this section of the State, stated that he had received reports from various large coal-mining companies, which had enabled him to prepare a statement showing that from 28,000 to 30,000 tons of coal had been lost to the industry on account of the influenza.

On motion of Mr. W. C. Shepherd it was voted that all communities in this District be requested to organize committees on the plan endorsed or recommended by the State Board of Health. In pursuance of this motion Chairman Dougherty appointed Wm. C. Shepherd, Dr. Charles H. Miner, Dr. S. P. Mengel, Dr. E. L. Meyers, A. C. Campbell and Percy A. Brown a committee (“Ways and Means Committee”) to prepare a draft of the plan to be used for the guidance of the several communities in this matter.

In pursuance of a motion made by Dr. Walter Davis the Chairman appointed Dr. Davis, Dr. D. H. Lake, Dr. J. W. Geist and Miss Nellie G. Loftus a committee to report with respect to the systematic treatment of “flu” patients.

On motion of Wm. H. Conyngham it was voted: “(1) that an effort be made to retain here the five nurses who are now in this community, but who have been ordered to return to Washington on October 26; (2) that the Chairman of the General Committee communicate by telegraph with the proper officials at Washington, expressing our desire to have retained here, until the situation is improved, the army doctors who are now in the field, or that other doctors be sent to take their places, and that as many as can be furnished be sent.”

On October 20, at a meeting of the General and District Chairmen, in conjunction with the members of the Ways and Means Committee, the latter presented a plan for the organization of outlying communities. This plan was forthwith adopted and ordered to be printed and distributed among the officials of the various communities.[4] Fuel Conservator Campbell reported that he had telegraphed to Federal Fuel Administrator Garfield, urging him to use his influence to have the army doctors then here kept here.

Footnote 4:

This was subsequently done, in the following form:

PLAN OF COMMUNITY ORGANIZATION FOR THE EPIDEMIC EMERGENCY.

1. Community Chairman (President of Board of Health). 2. Executive Committee, consisting of: A. Board of Health. B. Burgess and member of Borough or Township Council. C. Mine Superintendent and representative of labor union. D. Principal of schools. E. Red Cross Worker. F. Member of Council of National Defense. G. Clergyman. H. Prominent Citizen. I. Local Physician—principally in advisory capacity. 3. Secretary. 4. Emergency Station. 5. Community Captains. 6. Nursing Bureau. 7. Canteen Service. 8. Automobile Service. 9. Publicity Bureau. 10. Miscellaneous.

At this time the influenza and pneumonia conditions were “appalling” in certain localities in Luzerne County. At Glen Lyon, as well as at Georgetown in the township of Wilkes-Barré, the situation was very serious. An average of about 75 new cases per day in Wilkes-Barré was being reported, while all the emergency hospitals in the District were without sufficient help.

On October 22 new cases in Wilkes-Barré to the number of 120 were reported, while conditions in Glen Lyon, Nanticoke, Wanamie and some other places in the 5th District were “desperate”. On this date Dr. Miner and the Chairman of the General Committee received the following communication, copies of which were immediately transmitted by them to the various emergency organizations in the 5th District.

“October 20, 1918.

“From: The Commissioner of Health of Pennsylvania.

“To: All concerned with Problem of Nursing during the present Epidemic of Influenza.

“Subject: Plan of Organization and Instructions. (General Order No. 2.)

“As it is not yet fully realized that the present epidemic afflicting us in these war times has caused the greatest need, and at the same time is accompanied by the greatest scarcity, of graduate nurses that has ever occurred, it is necessary to form a plan which may be adapted to any situation, as one community after another becomes involved:

“1. Graduate nurses must be used in such a way that their services be of assistance to the greatest number. This may be done by calling first upon all partially trained attendants, Red Cross workers, and then lay helpers, or any intelligent persons who are able to assist, and who will faithfully follow instructions. These latter must be instructed carefully in the essentials for treating patients, protecting themselves, and preventing the spread of infection, and be directed to make a simple record of their work each day, while the graduate nurses must move about rapidly to cover as much territory as possible if the cases are in private homes or in small groups, supervising the work of subordinates, instructing these subordinates, and following up their work. If the graduate is assigned to a hospital, the same plan should be used, _i. e._, nurses or lay helpers detailed to small groups of patients, with the graduate in charge. Thus an active graduate and subordinates who obey orders with military precision get actual results which cannot be obtained by attempts to furnish trained nurses to individual families or in quantity to hospitals.

“2. It is imperative that the lives and health of physicians, nurses and lay workers be conserved for service to the vast number afflicted. Accordingly in each hospital (emergency, tent-hospital or otherwise) or in each community which has been organized against the epidemic, a system should be devised to apportion the time and labor of all workers as equally as possible, according to the character of their work. All precautions against infection must be constantly observed, _e. g._, the wearing of gowns which cover the entire body; masks made by applying eight layers of surgical gauze, or two of butter cloth, to the convex surface of a wire tea-strainer about four inches in diameter, which is molded to fit the face from above the tip of the nose to below the point of the chin and secured to the head by tapes, (gauze changed every hour and boiled half an hour, sun dried and used over again); by the use of antiseptics, including careful cleansing of the hands after handling patients, before eating, etc., and care in destroying by burning or sterilizing infected material.

“3. Strict discipline (semi-military) is essential for saving time and insuring accuracy in receiving and executing orders. All personal differences and likes and dislikes must be absolutely subordinated to the general need. Those in charge of others should exercise judgment in issuing orders to other subordinates, being careful to avoid anything which may be unnecessary or a repetition. Subordinates will observe instructions of their superiors without hesitation or argument. Courtesy at all times on the part of every one concerned will result in reaching most quickly the goal upon which our every effort is bent—the checking, if possible, of _this great public disaster_ and minimizing its crippling effect and death toll.

“4. Requests for aid from stricken communities should be made to the nearest representative of the Department of Health, who will refer it to the Physician in charge of the Emergency District. This includes calls for doctors, nurses, aids, materials and any other form of relief. The Department will make a supreme effort to satisfy all such needs as rapidly as possible. However, where these are at hand they should be obtained locally.

“5. The best emergency hospital is the tent hospital, where the patient may obtain fresh air for twenty-four hours and receive sunlight by being hauled out into the company streets during the day. Wooden shacks or lean-tos (like those used in T. B. treatment), the walls of which may be raised by hinges and pulleys to admit the air and sunlight, are excellent. Buildings without balconies or porches should not be used unless there is adequate room or window space. Open air schools are almost ideal; next to them are modern high schools with large grounds about them. Visitors should be excluded, except relatives of dying patients, who should wear gowns and masks during the visit.

“6. Encourage the people of the community who wish to do something for the sufferers but cannot nurse them, to make masks, gowns and other supplies, also broths or other forms of nourishing food. Traveling kitchens or food delivered from a community kitchen by motor cars are of great assistance to stricken families. A County Committee should be formed for the purpose of investigating and promptly relieving distress, financial or otherwise. This committee could enable wage earners to remain at their employment.

“7. All existing agencies (local government, organizations, societies, orders, etc.) should be co-ordinated so that there be no uncertainty or confusion as to what is needed and how to meet the need and no waste of personnel or repetition of instructions or starts upon unnecessary errands.

“8. In each district, which may include several Counties, there is a physician in full charge of the district, with permanent headquarters. There is also a supervising nurse of the district, whose headquarters should be the same as the District Chief’s, unless an emergency should make another arrangement desirable. All other Department officers are subordinates to these two representatives of the Medical and Nursing service respectively. Reports by wire or ’phone are required daily at 1 p.m. from Supervising Nurse, District Chief, and from each County Inspector at the Epidemic Headquarters, Harrisburg. These officers should arrange that all of their subordinates in the district report to them at a convenient hour prior to this time.

“9. It should be borne in mind that the District Chief and Supervising Nurse of each district are responsible for their entire district and cannot be spared too long in any one locality. Their movements will depend upon exigencies which may arise and orders from this office.

“B. FRANKLIN ROYER. “Acting Commissioner of Health.”

On October 23 the eighth Emergency Hospital in the 5th District was opened in the Maffet Street School building at Plains, Luzerne County, with Miss May Conlon, Graduate Nurse, as chief nurse.

On October 25 the following-named United States Army medical officers, who had been on duty in the 5th District, returned, under orders, to Camp Crane: Lieut. C. F. Bahler, Lieut. Joseph Goldstone, Lieut. G. T. Meek and Lieut. J. a.m. Aspy. Capt. E. L. Hendricks, being ill at Hotel Sterling, remained here some days longer. Upon the abovementioned date General Dougherty, Chairman of the General Committee, telegraphed to Gen. Peyton C. March, Chief of Staff, U.S.A., as follows:

“By systematic organization and effort we have been endeavoring to combat Spanish Influenza in Luzerne County, with its population of 350,000 souls. We had 300 registered physicians in the County, of whom 115 have gone into the military service. We has over 12,000 cases [of influenza] in the County, and have established, in addition to the regular hospitals, seven emergency hospitals. But three medical officers of those who were sent here from Camp Crane now remain. Six thousand mine workers are ill with the disease, thus reducing the daily output of anthracite coal 15,000 tons, or at the rate of 300,000 tons per month. We are informed that you have 4,000 medical officers in training at Camp Greenleaf. We must have twenty-five physicians sent here at once. Please give us this number of physicians, as the spread of the disease is increasing, and we must have medical assistance. Our doctors are exhausted.”

At a meeting of the General Committee held October 26 Chairman Dougherty reported that the Commissioners of Luzerne County had appropriated $25,000. to be used in defraying the expenses incurred in combating the epidemic in Luzerne County.[5] It was the general opinion of the members of the committee present that this money should not be distributed among the various communities entitled to it until the end of the epidemic. It was pointed out, however, that several communities had already made applications for needed funds. It was finally decided that a committee composed of the Chairman and three other members of the General Committee should prepare, and report at a subsequent meeting, a plan for the proper expenditure of the County appropriation.

Footnote 5:

About this time the City Council of Wilkes-Barré made a special appropriation of $5,000. to be used in fighting the “flu” in the city. This sum was in addition to the regular annual appropriation for the city’s Bureau of Health.

Colonel Eyer reported on conditions at the Armory Emergency Hospital, and stated that many of the patients who had died there were practically in a dying condition when received into the hospital. At 9:20 o’clock p.m. the Committee adjourned and proceeded to the Lehigh Valley Railroad station, where the following-named United States Army medical officers were met upon their arrival from Camp Crane, Allentown, Pennsylvania, for epidemic work in Luzerne County, and were assigned to duty as herein noted.

Capt. H. W. Dessaussure (in command) and Lieuts. E. J. Burke, E. Z. Brunner, L. H. Hills and J. B. McGuinness, to report to Dr. J. W. Leckie at the Hazleton Emergency Hospital; Capts. E. B. Chenowith and Evan S. Evans, U.S.M.C., to the Wilkes-Barré Armory Hospital; Lieuts. Robert Funston and A. C. Hall to report to Dr. Stricker at Nanticoke; Lieut. Frank F. Davis to report to Dr. Stricker for service at Glen Lyon; Lieut. Leroy Fredericks to report to Dr. Stricker for service at the Wanamie Emergency Hospital; Lieut. H. R. Lipscomb to be physician in charge at the Plains Emergency Hospital.

On this date, according to a report submitted by the County Medical Inspector to the State department of Health, the number of influenza and pneumonia patients undergoing treatment in the various hospitals in the 5th District were as follows: Hazleton Emergency, 22; Exeter Emergency, 70; Dupont Emergency, 9; Wanamie Emergency, 55; Wilkes-Barré Armory Emergency, 46; Catawissa Emergency, 8; Plains Emergency, 19; Nanticoke Emergency, ?; Hazleton State, 75; Nesbitt West Side, 14; Wyoming Valley Homœopathic, 15; Nanticoke State, 13; Mercy, 30; Wilkes-Barré City, 64; Bloomsburg, 19; Berwick, 26. (Riverside Hospital, Wilkes-Barré, had received no “flu” patients.)

On October 28 new cases in Luzerne County were reported as follows: Edwardsville, 40; Wilkes-Barré City, 98; Wilkes-Barré Township, 16; Larksville, 19; Plymouth Borough, 50; Plymouth Township, 12; Laflin, 10; Miners Mills, 29; Parsons, 18; Plains Township, 109; Ashley, 13; Hanover Township, 35; Laurel Run, 2; Sugar Notch, 2; Warrior Run, 19; Courtdale, 6; Dallas, 2; Dorranceton, 16; Forty Fort, 18; Luzerne, 31; Swoyerville, 16; Wyoming, 14; West Wyoming, 8; Avoca, 5; Duryea, 4; Dupont, 1; Exeter Borough, 1; Hughestown, 11; Pittston, 20; West Pittston, 4; Pittston Township, 4; Dorrance, 3; Kingston, 32; Hazleton, 27; Weston, 48; Conyngham Borough, 3; Freeland,18; Lattimer,11; St. John’s,1; Sandy Run,11; Upper Lehigh,6; West Hazleton,72; Seybertsville,2; Neuremburg,22; Nanticoke, 64; Nescopeck,3—making a total of 956 new cases in Luzerne County.

On October 28 a joint-meeting of the General and Coöperation Committees was held in the rooms of the Wilkes-Barré Chamber of Commerce.

Chairman Brown stated that the biggest problem with which the Coöperation Committee had to deal was that respecting nurses. He further stated that something should be done immediately to establish organizations in those communities. He advocated more pay for nurses, and said he believed that a sufficient number of nurses could be secured, whereby better progress would be made in combating the scourge.

After some discussion it was voted that in Luzerne County the pay of graduate nurses should be fixed at $120 per month, and that of practical nurses at $75 per month. It was also voted that all nurses should be under the control of Miss Loftus and the General Committee.

It was decided to recommend the placarding of all homes in which influenza existed in all cities, boroughs and first-class townships in Luzerne County. Also, that all matters of publicity concerning the “flu” in Luzerne County should be handled by the Chairman of the Coöperation Committee.

Following the adjournment of this meeting the following “Publicity Bulletin” was issued.

“A meeting of all District Chairmen and members of the Ways and Means Committee was held this morning in the auditorium of the Chamber of Commerce. Reports received showed that in certain outlying boroughs and townships officials charged with the protection of the lives of their constituents, as well as the general health of their respective communities, are placing the lives of their people below their selfish aims by playing politics. It was decided that, unless the said officials take immediate steps to bring about proper organization and protection of their respective communities, action will be taken at once to have them removed and their places filled by people with a sense of honor, and who will give to their communities the protection to which they are entitled.

“It was also decided that there is a great need for field nurses, and that the sooner a sufficient number of such nurses can be secured, the sooner the epidemic will be checked in our community. It was decided to pay graduate nurses $120. per month and practical nurses $75. per month. All nurses will be in charge of Miss Nellie G. Loftus, who is stationed at the Wyoming Valley Dispensary, 184, South Washington Street, Wilkes-Barré.

“It was also brought to the attention of the meeting that newspaper reports secured from people in boroughs and townships are not accurate, and that the same are an injustice to the said communities. In one community, where it was reported that thirteen deaths had occurred, correct figures show that the deaths numbered only three. Therefore, it was decided that the General Committee should be responsible for publicity given out only by the Chairman of the Coöperation Committee, to whom are sent all official reports from communities.

“It was also decided to recommend to the officials of all cities, boroughs and first-class townships in Luzerne County the placarding of homes in which influenza exists.

[Signed] “PERCY A. BROWN, “Chairman of the Coöperation Committee.”

Reports to the Coöperation Committee on October 31 showed 709 new cases of influenza and 67 deaths theretofore unreported in forty-eight communities of Luzerne County—indicating a decrease in the number of new cases, but no decrease in the number of deaths.

On November 4 only seventy-three new cases in Wilkes-Barré were reported, and there were very gratifying indications that the scourge was subsiding in most parts of Luzerne County. It was estimated that 10,000 coal miners in the County were idle because of the “flu.”

A well-attended meeting of the General Committee was held in the auditorium of the Wilkes-Barré Chamber of Commerce in the evening of November 6, with Chairman Dougherty presiding and Hayden Williams as Secretary. The County Medical Inspector, in reporting on conditions in his District, stated that Berwick in Columbia County and Plains in Luzerne County were still having a serious time with the epidemic. Nanticoke, he said, had also been hard hit. He stated that in Newport Township, Luzerne County, 249 people had died from the influenza. He declared that, while conditions in general were improved, new cases and deaths would likely continue to occur during the next three or four weeks.

The County Medical Inspector took advantage of this occasion to declare that too much could not be said about the good work accomplished by the general organization in Luzerne County, which had been the salvation of the entire County. Without it the loss of life would have been considerably greater, and many communities would have felt the full force of the epidemic. He then read a communication from the Acting Commissioner of Health, which he had received a short time previously, in part as follows:

“Where churches and schools have been closed during the epidemic of influenza, great care should be practised at the time of removing restrictions. Many children have been kept completely out of danger during this dangerous period, and to open too soon and run the chance of bringing them into contact with persons who have recently recovered, and who may perhaps be carriers, may again bring fresh outbreaks of the disease, particularly among school children.

“Then, too, thousands of public, private and parochial school teachers have been actively engaged in nursing, and these teachers should have a few days of rest—preferably a week—and ought to be absent from work at the bedsides of the sick for that period of time before returning to the schools or to crowded services.

“I would urge that you take these things into consideration, and in conference with the School Boards arrange for resuming sessions, so far as possible, when two-thirds of the children in any school district are ready to return from homes where no one has suffered with influenza for a period of seven days. Where possible, medical or nursing supervision would be advisable—especially for a few days after opening the schools.

“I would suggest that, so far as practicable, the resumption of school work should take place about midweek, and of Churches and Sunday Schools on the Sunday following. This will bring children gradually together, and will avoid the overcrowding apt to occur in Sunday Schools if these schools were first opened. It is not necessary to tell you that fifty per cent. of the Sunday Schools are conducted in buildings not as well ventilated as are the public schools.”

It was stated, in this connection, that over 2,000 school teachers throughout the State had been active in helping to fight the epidemic.

Upon motion of Percy A. Brown it was voted to publish the letter of the Acting Commissioner of Health, and to urge all school boards and Sunday Schools not to reopen their schools without first consulting the Boards of Health of their respective localities, to learn whether or not the resumption of school sessions would cause a further spread of the epidemic.