What Happened When Americans Had to Wear Masks During the 1918 Flu Pandemic

Medical professionals have had a particularly difficult time getting people in the United States to act in unison for the public good during the pandemic. This has been the case with every step that experts urge to curb the spread of COVID-19, from closing schools, churches, and other meeting places, to enforcing social distancing and wearing masks over the nose and mouth in public spaces.

The resistance may seem symptomatic of the contemporary political climate, but there is ample precedent for it during the spread of so-called Spanish Flu, which took the lives of 675,000 Americans a little over a hundred years ago. Even when forced to wear masks by law or face jail time, many Americans absolutely refused to do so.




“In 1918,” writes E. Thomas Ewing at Health Affairs, “US public health authorities recommended masks for doctors, nurses, and anyone taking care of influenza patients.” The advisory “gradually and inconsistently” spread to the general public, in a different cultural climate, in some important respects, than our own, as University of Michigan medical historian J. Alexander Navarro explains.

Nationwide, posters presented mask-wearing as a civic duty – social responsibility had been embedded into the social fabric by a massive wartime federal propaganda campaign launched in early 1917 when the U.S. entered the Great War. San Francisco Mayor James Rolph announced that “conscience, patriotism and self-protection demand immediate and rigid compliance” with mask wearing. In nearby Oakland, Mayor John Davie stated that “it is sensible and patriotic, no matter what our personal beliefs may be, to safeguard our fellow citizens by joining in this practice” of wearing a mask.

Despite the civic spirit and generalized public support for mask wearing, passing local mask ordinances was “frequently a contentious affair.” Debates that sound familiar raged in city councils in Los Angeles and Portland, both of which rejected mask orders. (One official declaring them “autocratic and unconstitutional.”) San Francisco, on the other hand, brought the police down on anyone who refused to wear a mask, imposing fines and jail time.

These measures were adopted by other cities, as well as abroad in Paris and Manchester. "Fines ranged,” Navarro writes, “from US$5 to $200,” a huge amount of money in 1918, and a good amount for many people out of work today. Even in cities that did not impose harsh penalties, “noncompliance and outright defiance quickly became a problem.” Much of the resistance to wearing masks, however, came later, after a first wave of flu infections subsided. When precautions were relaxed, cases rose once again, and new mask mandates went into effect in 1919.

San Francisco’s Anti-Mask League formed in protest, attracting somewhere between 4,000 and 5,000 unmasked attendees to a January meeting. Some of their objections rested on an early study that found scant evidence for the efficacy of compulsory mask-wearing. However, a later comprehensive 1921 study by Warren T. Vaughn, notes Ewing, found that the data was too sketchy to draw conclusions: “The problem was human behavior: Masks were used until they were filthy, worn in ways that offered little or no protection, and compulsory laws did not overcome the ‘failure of cooperation on the part of the public.’"

Vaughn concluded, "It is safe to say that the face mask as used was a failure." Many behaviors contributed to this outcome. As we see in the photograph at the top of anonymous Californians wearing masks and holding a sign that reads, “Wear a mask or go to jail,” many did not wear masks properly, leaving their nose exposed, for example, like the woman in the center of the group. Notably, instead of social distancing, the group stands shoulder to shoulder, rendering their masks mostly ineffective.

The kind of masks most people wore were made of thin gauze. (“Obey the laws and wear the gauze. Protect your jaws from septic paws,” went a jingle at the time.) The material wasn't at all effective at closer distances, where today’s quilted cotton masks, on the other hand, have been shown to stop the virus a few inches from the wearer’s face. Still, masks, when combined with other measures, were shown to be effective when compliance was high, though much of the evidence is anecdotal.

What can we learn from this history? Does it undermine the case for masks today? "We need to learn the right lessons from the failure of flu masks in 1918," Ewing argues. The overwhelming scientific consensus is that masks are some of the most effective tools for slowing the spread of the coronavirus, and that, unlike in 1918, "Masks can work if we wear them correctly, modify behavior appropriately, and apply all available tools to control the spread of infectious disease."

Related Content: 

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What Happened to U.S. Cities That Practiced–and Didn’t Practice–Social Distancing During 1918’s “Spanish Flu”

The History of the 1918 Flu Pandemic, “The Deadliest Epidemic of All Time”: Three Free Lectures from The Great Courses

Josh Jones is a writer and musician based in Durham, NC. Follow him at @jdmagness

Bill Nye Shows How Face Masks Actually Protect You–and Why You Should Wear Them

Like many Americans of my generation, I grew up having things explained to me by Bill Nye. Flight, magnets, simple machines, volcanoes: there seemed to be nothing he and his team of young lieutenants couldn't break down in a clear, humorous, and wholly non-boring manner. He didn't ask us to come to him, but met us where we already were: watching television. The zenith of the popularity of his PBS series Bill Nye the Science Guy passed a quarter-century ago, and the world has changed a bit since then. But even in the 2020s, when the spreading of scientific knowledge is no less important than it was in the 90s, Nye knows where to air his message if he wants the kids to hear it: TikTok.

Hugely popular among people not yet born during Bill Nye the Science Guy's original run, TikTok is a video-based social media platform that accommodates videos of up to 60 seconds — roughly half the length of the "Consider the Following" segments embedded within the episodes of Nye's original show.




This week Nye has revived the format on Tiktok in order to lay out the scientific principles behind something that had recently become a part of all of our lives: face masks. True to form, he explains not just with words but with objects, in this case a series of respiratory system-protecting anti-particle devices from a humble scarf to a homemade cloth face mask (employing that stalwart science-project component, a pipe cleaner) to the medical industry-standard N95.

"The reason we want you to wear a mask is to protect you," says Nye. "But the main reason we want you to wear a mask is to protect me from you, and the particles from your respiratory system from getting into my respiratory system!" As simple a point as this may sound, it has tended to get lost amid the fear and confusion of the ongoing coronavirus pandemic: the conflicting information initially published about the advisability of face masks for the general public, but also the ensuing controversy over the implementation and enforcement of mask-related rules. But as Nye reminds us, this is "a matter literally of life and death — and when I use the word literally, I mean literally." As we shore up our knowledge of masks, we Millennials, who throughout our lives have learned so much from Nye, would do well to internalize that point of usage while we're at it.

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Based in Seoul, Colin Marshall writes and broadcasts on cities, language, and culture. His projects include the book The Stateless City: a Walk through 21st-Century Los Angeles and the video series The City in Cinema. Follow him on Twitter at @colinmarshall, on Facebook, or on Instagram.

A Chilling Time-Lapse Video Documents Every COVID-19 Death on a Global Map: From January to June 2020

The story of the Coronavirus, at least in the US, has swung between a number of rhetorical tics now common to all of our discourse. Called a “hoax,” then given several racist nicknames and dismissed as a “nothing burger,” the pandemic—currently at around 3 million cases in the country, with a U.S. death toll over 130,000—has now become the “new normal,” a phrase that pops up everywhere you look.

“This framing is inviting,” writes Chime Asonye at the World Economic Forum. It conveys “the idea that our present is okay because normal is regular,” and we’re all supposed to be getting back to regular life, according to the powers that be, who don’t seem particularly troubled by the dead, sick, and dying or the continued threat to public health.




But pretending things are normal is simply a form of a denial, a maladaptive and unhealthy response to trauma as much as to disease. “Allowing ourselves to cope means not normalizing our situation,” writes Asonye, “but giving ourselves the time to truly process it.” We are all living in the midst of profound loss—of loved ones, livelihoods, future plans and present joys. Asonye adds:

Psychologists advise that it’s important to identify the losses we are feeling and to honour the grief surrounding us through methods like meditation, communicating our struggle, and expressing ourselves through art or by keeping a journal. In uncertain times, the 'new normal' frame reinforces an understanding that the world and our emotions should by now have settled. Surrounded by uncertainty, it’s okay to admit that things are not normal. It’s okay to allow ourselves to grieve or to be scared. It’s okay not to be comfortable with what is going on.

How do we process if we cannot admit that there is a problem—a massive problem that requires our lives to change, even if we’re feeling fatigued and worn out? Though we may have grown cynically accustomed to the callous, corrupt response of certain governments to human suffering, the “overwhelming scale” of the pandemic, as James Beckwith writes on YouTube, marks the coronavirus as decidedly not normal. It may be the kind of catastrophe the world has not witnessed in over a century.

Inspired by artist Isao Hashimoto’s “Time-Lapse Map of Every Nuclear Explosion Since 1945,” which we’ve previously featured here, Beckwith used the same visual presentation to map the over 500,000 lives lost to the virus since the first January outbreak in China. “The virus grows, continuing to work its way throughout the world until the end of June—where this piece ends but the real virus has not,” he writes. “It is likely a sequel will need to be made.” Though he admits the animation “may be upsetting to some people,” Beckwith, like Asonye, recognizes the importance of admitting the full scope.

Watching the virus spread, and kill, over the past six months hits much harder than reading the dry facts. The video is dedicated to “every person that tragically lost their lives to COVID-19.” Beckwith would like it “to be understood and seen by as many people around the world as possible,” so that we can all have a shared understanding of what we’re facing together (and maybe come to an agreement that this cannot be the "new normal"). “Sometimes there are no words for terrible events like this,” Beckwith writes, but he would like help translating the video description into other languages. You can contact him via his YouTube or Instagram channels to volunteer.

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Josh Jones is a writer and musician based in Durham, NC. Follow him at @jdmagness

Vintage Science Face Masks: Conquer the Pandemic with Science, Courtesy of Maria Popova’s BrainPickings

If you don’t floss or brush your teeth, they will rot and fall out. If you don’t eat fruits and vegetables, you will get scurvy or some other horrible disease. If you don’t use protection… well, you know the rest. These are facts of life we mostly accept if we care about ourselves and others because they are beyond disputing. But the idea of wearing a cloth mask when in public during a viral pandemic spread through droplets from the nose and mouth—a practice endorsed by the CDC, the World Health Organization, scientists at Stanford, Johns Hopkins, and pretty much every other research university—has become some kind of bizarre culture war.

Maybe some walk around mask-less because they’ve internalized the idea that the coronavirus is “over,” despite the fact it’s spreading at around 50,000 new cases per day in the US, and potentially heading toward double that number. Maybe some feel it won’t affect them because they aren’t elderly or immunocompromised, never mind that viruses mutate, and that the novel (meaning “new”) coronavirus has already demonstrated that it is far less discriminating (in purely biological terms) than previously thought. (In Florida, the median age for COVID-19 has dropped from 65 to 37 years old.) Never mind that spreading the virus, even if one is not personally at high risk, compromises everybody else.

Are masks uncomfortable, especially in hot, humid weather? Do they muffle speech and make it hard to have satisfying face-to-face interactions? Well, yes. But consider your hourlong masked trip to the grocery store against the 12 or 24 or 48 or whatever hour-long shifts medical personnel are pulling in emergency departments across the country.




It really is the least we can do. And we can do it in style—masks went from scarce, with armies of homebound neighbors sewing homely stacks of them, to truly overabundant and fashionable, on the rack of every grocery, pharmacy, and convenience store. It couldn’t be easier.

If you’re concerned about looking like every other masked weirdo out there, consider these masks created by Maria Popova of Brain Pickings, which she introduces with references to Rebecca Elson’s poem, “Antidotes to Fear of Death.” The science of public health may demand that we are grimly practical at the moment, but Popova wants to remind us that scientific thinking is equally invested in the experience of awe and the love of life. By wearing these masks, we can communicate to others, those who may be feeling despondent over the sea of masked faces in public places, that there is beauty in the world and we can fully experience if we get through this. Popova’s masks, printed and sold by Society6, illustrate the wonders of scientific curiosity with “wondrous centuries-old astronomical art and natural history illustrations.”

These include “treasures like the Solar System quilt Ella Harding Baker spent seven years crafting… gorgeous 18th-century illustrations from the world’s first encyclopedia of medicinal plantsastonishing drawings of celestial objects and phenomena…trailblazing 18th-century artist Sarah Stone’s stunning illustrations of exotic, endangered, and now-extinct animals; some graphically spectacular depictions of how nature works from a 19th-century French physics textbook; Ernst Haeckel’s heartbreak-fomented drawings of the otherworldly beauty of jellyfish...William Saville Kent’s pioneering artistic-scientific effort to bring the world’s awareness and awe to the creatures of the Great Barrier Reef; and art from the German marine biologist Carl Chun’s epoch-making Cephalopod Atlas — the world’s first encyclopedia of creatures of the deep.”

Society6 is donating a portion of its proceeds to World Center Kitchen, and Popova is donating to The Nature Conservancy. You can purchase your own vintage science illustration mask here and see some of these illustrations in their original context at the links further down.

Antidotes to Fear of Death

Sometimes as an antidote
To fear of death,
I eat the stars.

Those nights, lying on my back,
I suck them from the quenching dark
Til they are all, all inside me,
Pepper hot and sharp.

Sometimes, instead, I stir myself
Into a universe still young,
Still warm as blood:

No outer space, just space,
The light of all the not yet stars
Drifting like a bright mist,
And all of us, and everything
Already there
But unconstrained by form.

And sometime it’s enough
To lie down here on earth
Beside our long ancestral bones:

To walk across the cobble fields
Of our discarded skulls,
Each like a treasure, like a chrysalis,
Thinking: whatever left these husks
Flew off on bright wings.

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The Brilliant Colors of the Great Barrier Revealed in a Historic Illustrated Book from 1893

Josh Jones is a writer and musician based in Durham, NC. Follow him at @jdmagness

How Fast Can a Vaccine Be Made?: An Animated Introduction

From Ted-Ed comes a video that answers a timely question: How fast can a vaccine be made?

They write: "When a new pathogen emerges, our bodies and healthcare systems are left vulnerable. And when this pathogen causes the outbreak of a pandemic, there’s an urgent need for a vaccine to create widespread immunity with minimal loss of life. So how quickly can we develop vaccines when we need them most? Dan Kwartler describes the three phases of vaccine development." Exploratory research, clinical testing, and manufacturing.

When you're done, you can watch their related video: When is a pandemic over?

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Sir Isaac Newton’s Cure for the Plague: Powdered Toad Vomit Lozenges (1669)

Nearly 300 years after his death, Isaac Newton lives on as a byword for genius. As a polymath whose domain encompassed astronomy, physics, and mathematics, he mastered and expanded the domain of scientific knowledge available to 17th-century Europe. But if we remember him as a one-man engine of the scientific revolution, we should also bear in mind his contrasting intellectual frailties: Newton was no financial genius, as evidenced by his loss of $3 million in the South Sea Bubble of 1720, and though his inquiries into alchemy may be fun to re-enact today, we wonder now why he didn't see them as a dead end even then. And then we have his forays into medicine, one of which involves toad vomit.

"Two unpublished pages of Newton’s notes on Jan Baptist van Helmont’s 1667 book on plague, De Peste, are to be auctioned online by Bonham’s this week," reported The Guardian's Alison Flood earlier this month. "Newton had been a student at Trinity College, Cambridge, when the university closed as a precaution against the bubonic plague, which killed 100,000 people in London in 1665 and 1666. When the polymath returned to Cambridge in 1667, he began to study the work of Van Helmont," a famous Belgian physician. While some of the conclusions Newton drew from his study of Van Helmont's work remain practical today — "places infected with the plague are to be avoided," for instance — his suggested cures may not hold up to scrutiny.

In the "best" plague treatment observed by Newton, "a toad suspended by the legs in a chimney for three days, which at last vomited up earth with various insects in it, on to a dish of yellow wax, and shortly after died. Combining powdered toad with the excretions and serum made into lozenges and worn about the affected area drove away the contagion and drew out the poison." Learning how, exactly, Newton found his way to such a procedure will inspire enthusiastic collectors to bid on these papers, which remain on the Bonham's online auction block until June 10th. Newton may, as we recently noted here on Open Culture, have had some of his most groundbreaking ideas during the era of the plague, but even a mind as formidable as his by its very nature missed a few times, sometimes wildly, for every hit. Yet as the world's scientific-industrial complex races to develop a vaccine for COVID-19, we might consider what unorthodox solutions have gone overlooked in our Newton-less era.

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Based in Seoul, Colin Marshall writes and broadcasts on cities, language, and culture. His projects include the book The Stateless City: a Walk through 21st-Century Los Angeles and the video series The City in Cinema. Follow him on Twitter at @colinmarshall, on Facebook, or on Instagram.

The History of the 1918 Flu Pandemic, “The Deadliest Epidemic of All Time”: Three Free Lectures from The Great Courses

In one cascade of events after another, people are finding out the normal they once knew doesn’t exist anymore. Instead it feels as if we’re living through several past crises at once, trying to cram as much historical knowledge as we can to make sense of the moment. 2020 especially feels like an echo of 1918-1919, when the “deadliest epidemic of all time,” as The Great Courses calls the “Spanish flu,” killed millions (then the U.S. devolved into a wave of racist violence.) By offering examples of both negative and positive responses, the history, sociology, and epidemiology of the 1918 flu can guide decision-making as we prepare for a second wave of COVID-19 infections.

The Great Courses started offering free resources on the coronavirus outbreak back in March, with a brief “What You Need to Know” explainer and a free lecture course on infectious diseases. After catching up on the history of epidemics, we’ll find ourselves naturally wondering why we learned little to nothing about the Spanish flu.




The three-part lecture series here, excerpted from the larger course Mysteries of the Microscopic World (available with a Free Trial to the Great Courses Plus), begins by boldly calling this historical lacuna “A Conspiracy of Silence.” Tulane professor Bruce E. Fleury quotes Alfred Crosby, who writes in America’s Forgotten Pandemic, “the important and almost incomprehensible fact about the Spanish influenza, is that it killed millions upon millions of people in a year or less… and yet, it has never inspired awe, not in 1918 and not since.”

Epidemic diseases that have had tremendous impact in the past have become the subject of literary epics. Few epidemics have accomplished mass death “through sheer brute force” like the 1918 flu. The numbers are truly staggering, in the tens to hundreds of millions worldwide, with U.S. deaths dwarfing the combined casualties of all the country's major wars. Yet there are only a few mentions of the flu in American literature from the time. Fleury mentions some reasons for the amnesia: WWI “took center stage,” survivors were too traumatized to want to remember. We may still wonder why we should look back over 100 years ago and learn about the past when current events are so all-consuming.

“History compels us not to look away,” professor Fleury says, “lest we fail to learn the lessons paid for by our parents and our grandparents.” Faulkner, it seems, was right that the past is never past. But we need not respond in the same failed ways each time. The ability to study and learn from history gives us critical perspective in perilous, uncertain times.

Sign up here for a free trial to the Great Courses Plus.

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Josh Jones is a writer and musician based in Durham, NC. Follow him at @jdmagness

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