Because of the slow pace of the onset of the 1918 flu, the impact of the mass death outbreak was felt worldwide. As The New York Times reported in 2012, more than half of a million Americans died of influenza during the “Spanish flu” pandemic; more than 600,000 died in France alone. Because the rapidly spreading disease appeared to be centered around the devastated Spanish city of San Francisco — and because the pandemic hit first, then spread — the group most impacted was those in the health care professions.
In a surprising new report, the health encyclopedia Global Burden of Disease estimates that more than 700,000 health workers died from 1918’s pandemic in the United States and Canada. As the report estimates, that number does not include those who weren’t directly killed, and were indirectly influenced by the disease: The health of doctors’ family members, hospice care staff and allied health professionals, many of whom had to discontinue their livelihoods to care for family members. This includes 164,000 of the deaths — even after excluding victims who were younger than 15.
The victims included:
Accredited physicians and surgeons
Hospice providers and palliative care specialists
Plymouth Street Hospice workers
Hospice care workers
Gynecologists and obstetricians
Transplant health care workers
Nursing homes workers
Women’s health workers
More than 50,000 nursing school graduates were ineligible to practice their profession due to lack of capital. For many of these health professionals, the shift to community settings after the pandemic meant that work hours were interrupted, which affected their life and work satisfaction.
Sadly, the ongoing lack of health care workers resulted in continued deaths after the war — a time when there were fewer opportunities for health workers to return to work. In 1933, the U.S. and other countries passed the Nurses Registration Act, which allowed the hiring of health workers. The act also provided adequate re-employment benefits for affected employees. The coverage improved, however, with the passage of the Balanced Budget Act of 1965, which allowed countries around the world to hire health workers at a higher salary.
The U.S. saw no significant epidemic outbreaks between 1918 and 1936. In 1938, however, members of the California National Guard and the California National Guard’s auxiliary became part of the SARS (severe acute respiratory syndrome) outbreak. The 1932-34 flu season remains one of the most devastating human epidemics in history. In 1932, more than 4,000 of the nation’s 5,500 hospitals were impacted by flu. And in 1933, over 26 million Americans fell ill.
See WHO Fact Sheet, which refers to influenza Type A (the “Spanish flu”).