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.
Chairman Dougherty, referring to the work of the various committees in
this locality during the epidemic, stated that, while talking at
Harrisburg a few days previously with Dr. Royer, the Acting Commissioner
of Health, the latter informed him that the epidemic organization in
Luzerne County was “_the finest in the country, and the people of this
County deserve great credit for the work done_.” General Dougherty then
read a letter which he had just received from the Acting Commissioner,
in part as follows:
“I am very greatly indebted to you for the splendid story of the
Emergency hospitals, and to note what a tremendous amount of
public interest your committee has aroused. It is only by such
community service that it has been possible to save the number
of lives of miners that we have saved during this public health
drive. Too much credit cannot be given to your local committee,
and I shall see to it that the press gives the local people a
great share of credit.”
Wm. C. Shepherd expressed the opinion that the General Committee should
communicate to the various communities in the County the suggestions of
the State Department of Health with reference to the lifting of the
quarantine ban wherever it had been imposed.
Percy A. Brown, Chairman of the Coöperation Committee, reported that
while the latest reports received showed there had been a general
falling off of the disease, the daily average of new cases was about
seven per district, compared with a recent average of ten per district.
He stated that he expected to send out on the ensuing day, to every
community chairman in Luzerne County, a questionnaire asking for certain
information regarding the total number of cases and of deaths that had
occurred since the beginning of the epidemic, together with a complete
record of all workers, paid and volunteer. Later on, he said, he hoped
to have a meeting of the various chairmen, with a view to forming an
organization to prevent a recurrence of dangerous conditions during
future epidemics.