When Mask-Wearing Rules in the 1918 Pandemic Faced Resistance

The influenza pandemic of 1918 and 1919 was the deadliest flu epidemic in history, killing up to 50 million people worldwide. In the United States, where it ultimately killed an estimated 675,000 people, local governments have launched initiatives to try to stop its spread. These varied by region and included the closing of schools and places of public entertainment, the enforcement of "no sputum" orders, the encouragement of people to use handkerchiefs or disposable handkerchiefs and the obligation to wear masks in public.

The ordinances wearing the mask appeared mainly in the western states, and it seems that most people respect them. The nation was still fighting during the First World War, and officials devised anti-flu measures as a way to protect troops from the deadly epidemic.

WATCH: The Spanish flu was more deadly than the First World War

the the first recorded infection was seen in an American army soldier stationed at Fort Riley, Kansas, on March 4, 1918. Although the United States and other warring nations initially suppressed the news of the flu (the Neutral Spain signaled it freely, hence the improper term "Spanish flu"). There was a feeling that following these new health precautions was patriotic.

As a Red Cross public service announcement put it, "the man, woman or child who will no longer wear a mask now is a dangerous slacker." This sense of duty in wartime - and the fear of being seen as a "slacker" - may have motivated those who followed mask orders in cities like San Francisco, Seattle, Denver and Phoenix.

Yet even if compliance was high, some complained that the masks were uncomfortable, ineffective or bad for business. The officials were captured in public without a mask. And after the war ended, and there was no longer a feeling that people should wear masks to keep the troops safe, some dissidents even formed an "Anti-mask League" in San Francisco.

WATCH: World War 1 documentaries about Vault HISTORY

The masks were made of gauze or an even more porous material

Bettmann Archives / Getty Images

In 1918, the advanced masks like the N95s that health professionals use today were far away. Surgical masks were made of gauze, and many flu masks were also made of gauze. Red Cross volunteers made and distributed many, and newspapers gave instructions to those who wanted to make a mask or give it to the troops. However, not everyone used the standard surgical design or equipment.

"To encourage people to get them to wear them, [cities] were pretty lax in terms of what people could wear, "says J. Alex Navarro, deputy director of the Center for the History of Medicine at the University of Michigan and one of the editors of The American flu epidemic of 1918-1919: a digital encyclopedia.

In October 1918, the Seattle Daily Times had the headline "The veils against the flu established a new mode: the women of Seattle carrying a fine mesh with a border in muslin to distance Malady". These "fashionable" masks and others made from questionable materials were probably of little use. However, there was also a debate within the medical and scientific community about the effectiveness of multi-ply gauze masks.

For example, Detroit Health Commissioner J.W. According to Mr. Inches, the gauze masks were too porous to prevent the spread of the flu among the public. In addition, masks are most effective when worn properly, which has not always been the case. In Phoenix, where most people apparently followed the city mask order, some drilled holes in their masks for smoking, which greatly reduced their effectiveness.

Application of sanctions against maskers, punishment

Yet for the small percentage of people who have done without a mask entirely, reports suggest that their problem had less to do with the science behind them, and more to do with personal comfort.

"You regularly read about people who don't want to wear them because they're hot and stuffy," says Nancy Bristow, chair of the history department at the University of Puget Sound and author of American Pandemic: The Lost Worlds of the 1918 Flu Epidemic. "Some people complain against them because they say they create fear in the public and that we want to keep people calm; which I think is really an excuse to criticize them because someone doesn't want to wear them. "

according to to a December 1946 issue of Life magazine. & nbsp;

"data-full-height =" 1589 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcwMjI3ODA0ODY3NDA18 jpg -width = "2000" data-image-id = "ci025cc549b0002738" data-image-slug = "GettyImages-515581890" data-public-id = "MTcwMjI3ODA0ODY3NDA1NjI0" data-source-name = "Bettmann Archive / Getty Images" /> huge concern for the military forces of the First World War. Here, men are gargling salt water to prevent infection at the War Garden at Camp Dix (now Fort Dix) in New Jersey, circa 1918.

Read more: Why October 1918 was America's deadliest month

"data-full-height =" 1554 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcwMjI3ODA0ODY3M4A8NKS -width = "2000" data-image-id = "ci025cc549a0002738" data-image-slug = "GettyImages-108882878" data-public-id = "MTcwMjI3ODA0ODY3MjA4NDc4" data-source-name = "PhotoQuest / Getty Images" /> < phx-gallery-image data-caption-html = "

A woman wears a science fiction anti-flu nozzle attached to a machine circa 1919. It is unknown how it worked or whether it had any health benefits.

"data-full-height =" 1465 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcwMjI3ODA0ODY3MwQz33-2 -full-width = "2000" data-image-id = "ci025cc54980002738" data-image-slug = "GettyImages-2660331" data-public-id = "MTcwMjI3ODA0ODY3MTQzNDgw" data-source-name = "Topical press agency / Getty Images "/> Professor Bordier, from the University of Lyon, apparently claimed that this machine could cure colds in a few minutes. This photo around 1928 shows him showing his own machine.

"data-full-height =" 1448 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcwMjI3ODA0ODY3Mjc0DE34 -width = "2000" data-image-id = "ci025cc549c000251e" data-image-slug = "GettyImages-517387234" data-public-id = "MTcwMjI3ODA0ODY3Mjc0MDE0" data-source-name = "Bettmann Archive / Getty Images" /> In England, people wear different-looking masks to prevent the flu around 1932.

"data-full-height =" 1441 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcwMjI3ODA0ODY3M4QwM full -width = "2000" data-image-id = "ci025cc5499000251e" data-image-slug = "GettyImages-82090912" data-public-id = "MTcwMjI3ODA0ODY3MzQwMDg4" data-source-name = "Imagno / Getty Images" /> < phx-gallery-image data-caption-html = "

The parents of this baby had the right idea in this photo around 1939. The flu can spread between people up to six feet apartand because babies have high risk develop serious complications from the flu, it is best that people who have not received the flu vaccine stay away.

Read more: Pandemics that have changed history

"data-full-height =" 1462 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcwMjI3ODA0ODY3Mjc085Images -width = "2000" data-image-id = "ci025cc5498000251e" data-image-slug = "GettyImages-3312859" data-public-id = "MTcwMjI3ODA0ODY3Mjc0NTUy" data-source-name = "Harry Shepherd / Fox Photos / Getty Images "/>

PICTURES: Innovative ways to try to protect yourself from the flu

Some companies were concerned that customers would buy less if they had to wear a mask when they went out, and some people said that the mask orders were a violation of civil liberties. Still, "more important in terms of criticism," says Bristow, "is this idea that we also heard today that gives people a false sense of security." As she points out, wearing a mask is less effective when people do not follow other health guidelines (and especially if some people make holes in their mask for smoking).

The cities that adopted masking orders in the fall of 1918 found it difficult to enforce them among the small group of people who rebelled. The most common sanctions were fines, prison terms, and publishing your name in the newspaper. In a horrific incident in San Francisco, a special health board officer shot dead a man who refused to wear a mask and two passers-by.

It was very different from the treatment that San Francisco leaders received when they failed to comply. During a boxing match, a police photographer captured images of several supervisors, a member of Congress, a judge, a naval rear admiral, the town's health official and even the mayor, all without a mask. The health worker paid a fine of $ 5 and the mayor subsequently paid a fine of $ 50, but unlike other "mask slackers", they were not imprisoned (not to mention anyone who shot them).

The decline in the wearing of masks after the war

Chicago Sun-Times / Chicago Daily News Collection / Chicago History Museum / Getty Images

The first masking order for San Francisco began in October and ended in November after the First World War armistice. In January, when flu cases started to rise again in San Francisco, the city placed a second mask order. This time the resistance was much more intense. A group of dissidents, which included a few doctors and a member of the supervisory board, formed the "Anti-mask League", which held a public meeting with more than 2,000 participants.

Navarro speculates that resistance to the second order of masks from San Francisco may have been more intense because the country was no longer at war, and some residents did not feel the same sense of patriotic duty as before. In any case, the city was an outlier. It does not appear that there have been leagues or similar demonstrations in other cities.

Nancy Tomes, distinguished professor of history at Stony Brook University, who wrote on public health measures during the 1918-19 flu pandemic, said there were pockets of resistance to the wearing of face masks. 1918 and 1919, but that it was not very widespread.

And, unlike handkerchiefs and handkerchiefs, which Tomes says people started using more regularly because of the pandemic, the use of masks did not increase in the United States after the end of the prescriptions. It is still difficult to say how effective the mask was in 1918 and 1919. What is clear is that the communities which implemented more solid health measures were generally more successful than those which did not. haven't.

"Today we can look back and see that they have flattened the curve and that the communities that applied much tighter regulations and for a longer period and started earlier had lower mortality rates" says Bristow. "But they didn't have that data yet, so I think afterwards it wasn't as clear that what they had done had been effective."

Read more: Why the second wave of the Spanish flu in 1918 was so deadly Spanish Flu - Symptoms, Start and End In the midst of the 1918 flu pandemic, America struggled to bury the dead Why October 1918 was America's deadliest month Pandemics That Changed History: Chronology

Middle Ages. & nbsp; A slow-growing bacterial disease that causes sores and deformities, leprosy was considered a punishment from God who ran in families. & nbsp;

"data-full-height =" 1594 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcxNDE0NTQyNzEyMypr -1150947013.jpg "data-full-width =" 2000 "data-image-id =" ci0260fc9f700027ee "data-image-slug =" 11-Century-Leprosy-GettyImages-1150947013 "data-public-id =" MTcxNDE0NTQyNzE3Mjk4MzU1 "data -source-name = "From Agostini / Getty Images" data-title = "Leprosy, 11th Century" /> Social distancing and quarantine were used in medieval times to fight against the black plague

"data-full-height =" 1241 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcxMzkxMTIwMzgxNjUpg15 "data-full-width =" 1920 "data-image-id =" ci0260e751200027ee "data-image-slug =" Black-Death-GettyImages-515359722 "data-public-id =" MTcxMzkxMTIwMzgxNjUwNjEx "data- source-name =" Bettmann Archive / Getty Images "data-title =" Black Death, 1350 "/> Great London fire. & nbsp;

Learn more: & nbsp;When London faced a pandemic - and a devastating fire& nbsp;

"data-full-height =" 1417 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTYyMjk2ODg3MTA0MjUpgMxxx -width = "2000" data-image-id = "ci0240982900002579" data-image-slug = "GettyImages-51241529" data-public-id = "MTYyMjk2ODg3MTA0MjUxMjU3" data-source-name = "Hulton Archive / Getty Images" data- title = "The Great Plague in London, 1665" /> cholera Pandemics Over the next 150 years, this wave of small intestine infection started in Russia, where one million people died. Spread in fecal-infected water and food, the bacteria was transmitted to British soldiers who brought it to India where millions more died. & Nbsp;

Learn more: & nbsp;How 5 of the worst pandemics in history finally ended& nbsp;

"data-full-height =" 1312 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcxNDE0NTQyNzE8M815-348. jpg "data-full-width =" 1535 "data-image-id =" ci0260fc9e700027ee "data-image-slug =" 1817-Cholera-GettyImages-959158348 "data-public-id =" MTcxNDE0NTQyNzE3Mjk4Njcw "source-name =" Photo 12 / Universal Images Group / Getty Images "data-title =" Choléra, 1817 "/> The Russian flu of 1889: the deadly pandemic that few Americans have taken seriously

"data-full-height =" 1200 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcxMzQ0MjM5NDcxMcc mapj.pg -full-width = "1766" data-image-id = "ci0260bcadb00026b3" data-image-slug = "Russian flu map" data-public-id = "MTcxMzQ0MjM5NDcxMzcxOTU1" data-source-name = "National Library of Medicine "data-title =" Russian flu, 1889 "/> 1918 flu was first observed in Europe, the United States and parts of Asia before spreading worldwide. At the time, there was no effective drug or vaccine to treat this killer flu strain. & Nbsp;

Learn more: & nbsp;How American cities tried to stop the spread of the 1918 Spanish flu

"data-full-height =" 1080 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcwNDE4NjYzNTUwMTY8 flu -32images .jpg "data-full-width =" 1920 "data-image-id =" ci025d72df3000271c "data-image-slug =" 1918-Spanish-Flu-GettyImages-520830329 "data-public-id =" MTcwNDE4NjYzNTUwMTY2NzE4 "data-source -name = "Universal History Archive / Universal Images Group / Getty Images" data-title = "Spanish Flu, 1918" /> How the 1957 flu pandemic was stopped early on its way

"data-full-height =" 1920 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcxMjA2MzAzOTEyMz4377 Images "data-full-width =" 1486 "data-image-id =" ci02603f3a300026b3 "data-image-slug =" Flu-Virus-GettyImages-500437723 "data-public-id =" MTcxMjA2MzAzOTEyMzA2MzU1 "data source-name =" Ed Clark / The LIFE Picture Collection / Getty Images "data-title =" Asiatic flu, 1957 "/> AIDS destroys a person's immune system, resulting in the possible death of diseases that the body would usually fight. & nbsp; AIDS was first observed in American gay communities, but it is believed to have developed from a West African chimpanzee virus in the 1920s. & Nbsp; Treatments have been developed to slow the progression of the disease, but 35 million people have died of AIDS since its discovery

Read more: The story of AIDS

"data-full-height =" 1330 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcxNDE0NTQyNzE3M2Y2A2M2Y2 .jpg "data-full-width =" 2000 "data-image-id =" ci0260fca0300126b3 "data-image-slug =" 1982-HIV-AIDS-GettyImages-50468679 "data-public-id =" MTcxNDE0NTQyNzE3MzY0MjA2 "data-source -name = "Acey Harper / The LIFE Images Collection / Getty Images" data-title = "HIV / AIDS, 1981" /> SARS pandemic: how the virus spread around the world in 2003

"data-full-height =" 1080 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcwMTE1ODMyMzg1ND30sjs.jpg -full-width = "1920" data-image-id = "ci025c5f731000251e" data-image-slug = "SARS-GettyImages-144530355" data-public-id = "MTcwMTE1ODMyMzg1NDQ3NzM2" data-source-name = "Peter Parks / AFP / Getty Images "data-title =" SARS, 2003 "/> 12 times people have faced a crisis with kindness

"data-full-height =" 1080 "data-full-src =" https://www.history.com/.image/c_limit%2Ccs_srgb%2Cfl_progressive%2Ch_2000%2Cq_auto:good%2Cw_2000/MTcxMjY5OTc2MjY1NTk4c1551515.jpg -full-width = "1920" data-image-id = "ci02607923000026b3" data-image-slug = "COVID19-GettyImages-1201569875" data-public-id = "MTcxMjY5OTc2MjY1NTk4NjQz" data-source-name = "STR / AFP / Getty Images "data-title =" COVID-19, 2020 "/>