In 1918, California Confronted a Growing Pandemic with Much Less Uniformity

Two responses that produced two very different outcomes.

Much like the current COVID-19 epidemic, Californians wore masks and endured public closures amid the 1918 Spanish Flu outbreak. But unlike 2020, where San Francisco led the charge as the first U.S. city to enforce stay-at-home orders, the City by the Bay waited a week longer than Los Angeles to shut down “all places of public amusement” during the 1918 epidemic. While both cities would witness a severe outbreak, San Francisco’s delayed action likely produced more infections, especially during the deadly “second wave.” And while our biggest cities look starkly different than they did a century ago, early, coordinated social distancing efforts statewide likely saved lives this time around.

According to the Los Angeles Times, “San Francisco had suffered more than all other major American cities, with a death rate from the Spanish flu approaching 30 per 1,000 people. The later CDC review showed that both of California’s landmark cities suffered “second humps” of infection, though San Francisco’s was more severe.

“The researchers examined ‘excess’ death rates in 50 cities, the number who died of influenza above the normal yearly expectation. L.A.’s rate was 494 excess deaths per 100,000 residents, lower than that of many other American cities. With its shortened public distancing requirements and preoccupation with masks, San Francisco suffered 673 excess deaths per 100,000.”

You can read more about California’s response to the 1918 Spanish Flu epidemic here.

Featured image: People gather for mass and pray on the steps of the Cathedral of Saint Mary of the Assumption in San Francisco during the 1918 epidemic.

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