Good News ?

On the evening of 11th November 1918 The Herald ‘Extraordinary Edition’ carried this news:

. . . but tucked away on page six was this portent of things to come:

The Westralia was not the first ship Quarantined at Point Nepean due to influenza. This was four days earlier on November 7th when the White Pine, also from New Zealand, was quarantined.

Why the Quarantine?

On the 17th of October 1918 the Federal Government had gazetted the proclamation – “And whereas it is desirable that influenza or any febrile toxic septicæmic condition similar to influenza to be a quarantinable disease.”

Why?

The Spanish flu

The 1918–19 influenza pandemic is often called the ‘Spanish flu’, not because it originated in Spain, but due to it first being widely reported there.
(NHS – note: This was due to Spain being neutral and therefor not having significant censorship of the press. The origins of the Flu are still disputed, and include the UK, USA, China and even Austria
From Wikipedia HERE)

This pandemic started in 1918, the last year of the First World War, and passed through soldiers in Western Europe in successively more virulent waves.

Unusually, the Spanish flu affected healthy young adults much more than its usual targets: children, the elderly or those with weakened immune systems. In Australia, the virus became known as ‘pneumonic influenza’.

The virus spread rapidly around the world as soldiers returned from active service at the end of the war. Because of its remoteness from Europe, Australia had months to make necessary preparations.

Quarantine

The first line of defence was to try to prevent the virus reaching the Australian mainland. The Australian Quarantine Service monitored the spread of the pandemic and implemented maritime quarantine on 17 October 1918 after learning of outbreaks in New Zealand and South Africa.

The first infected ship to enter Australian waters was the Mataram, from Singapore, which arrived in Darwin on 18 October 1918. Over the next six months the service intercepted 323 vessels, 174 of which carried the infection. Of the 81,510 people who were checked, 1102 were infected.

Point Nepean
NHS – note: From the White Pine on 7th Nov 1918 to 28th January 1919 there were 30 ships quarantined at Point Nepean with 13,163 passengers or crew. Of these, there were no cases of influenza detected. (This becomes an issue later) – The first ship to have cases detected was the Tasmanian steamer SS Marrawah that arrived on 30th January 1919 with one case onboard – from NHS records and trove HERE

The National Influenza Planning Conference

The federal government’s second line of defence was to establish a consistent response in handling and containing any pneumonic influenza outbreaks that might occur in Australia.

It held the National Influenza Planning Conference in Melbourne on 26 – 27 November 1918, at which state health ministers, the directors-general of their health departments and British Medical Association representatives met with Commonwealth personnel.

The conference agreed to the federal government taking responsibility for proclaiming which states were infected along with organising maritime and land quarantine. The states would arrange emergency hospitals, vaccination depots, ambulance services, medical staff and public awareness measures.
(NHS – note: this would be controversial later when things started to fall apart)

From National Museum of Australia HERE

Victoria introduces mandatory isolation and reporting
As gazetted on December 4th 1918

A World Pandemic

Meanwhile, overseas, by the end of 1918 the Times of London was reporting 6 million deaths world wide. The so called second wave. There were also reports, at this stage, that daily death rates were leveling off.

December 23rd 1918 – SS Sardinia in Quarantine at Point Nepean

The SS Sardinia was quarantined at Point Nepean from 23rd December to 27th December 1918. She had 1038 troops and 197 crew on board. There were no reported cases of influenza on board.

The Sardinia had had a difficult voyage, with cases of influenza on board and discontent amongst the returning troops. Many of them invalided. There would be an inquest into the journey in early January. See HERE . But there was general praise for the Medical Staff on board. See HERE

A False Dawn?

While the flu was still rampant around the globe, notably including South Africa and New Zealand in late 1918, the quarantine measures instigated in Australia in October appeared to work, with cases diminishing significantly towards the end of 1918. There were no reported cases in Australia outside of the Quarantine Stations at North Head, Sydney and Freemantle.
This lead Dr John Cumpston, (Bio HERE) Commonwealth Director of Quarantine, to make what might prove to be a premature statement, reported in The Age of 9th January 1919.

January 23rd – Until this . . .

The full article goes on to say that cases had been admitted since late November, but reiterates the early uncertainty among medical officials as to whether these cases were Influenza Pneumonia. It does state their belief that more recent cases were indeed Influenza Pneumonia.
Notably, there is no mention of returned servicemen.

In Sydney . . .

. . . “It is believed by the authorities that the patient is one of the Sardinia soldiers.”

So, was the origin of the disease the soldier from the Sardinia or his traveling companion?

January 28th – NSW Authorities take action

. . . and Victoria ‘follow their lead’. . .

. . .and the border between Victoria and South Australia is closed.

Under the agreements made in November this would have meant, as Victoria and NSW were declared infected, that movement between them would be unrestricted.
However . . . By January 30th NSW have had enough of Victoria’s dithering and closed the border:

January 30 – At last, the Victorians concede that they actually have Spanish Flu.

January 31 – With no cases reported there, Queensland closes border with NSW.

At this point the National Influenza Planning Conference appeared to be in some disarray.

So by the end of January, the first tranche of regulations was in place.

And the authorities were preparing for the unknown.

Quarantine Station Jan 30th – First ‘possible’ case

How do you identify Pneumonic Influenza?

January – 62 deaths nationally

February 1 – Western Australia closes its border with South Australia

February 4 – After a couple of days of ‘indecision’ South Australia recognise they have cases.

. . . and they blame Victoria

Nationally, Sport continues, under some restrictions.

But on February 13th the Pubs are closed!

The closure did not apply to licensed grocers.

February 16th – First Deaths at The Quarantine Station – SS Ooma

The SS Ooma was a steamer owned by the Pacific Phosphates Line, trading between Australia, Nauru and Ocean Island (Banaba). With six crew deaths, this was both the first and worst case at The Quarantine Station over the course of the epidemic.

February – USA – The Pandemic appears to be easing after approximately 675,000 deaths.
From CDC timeline HERE

February – 465 deaths

In March some restrictions are eased.

But was this optimism justified?

March – 280 deaths

Meanwhile at The Quarantine Station

April 16th – Contracts were issued to build twelve wooden huts of 32 bunks each, based on the drawing below. The first hut was to be delivered within 10 working days with completion of all within 5 weeks.

. . . the huts remain in place today.

April 19th

April – 1,845 deaths

May 3rd – Football Season opens with large crowds.

But on the same day – May 3rd

Not a cure but a treatment

May – 1,491 deaths

June – With Queensland now in the grip of the epidemic, despite moves to quarantine them, the ‘Aboriginal Settlements’ are hard hit.

June – 2,129 deaths

July – and ‘another wave’ looks imminent

While death rates are high overall, they are mixed between states.

July – 2,339 deaths

August – and Tasmania joins the journey

Meanwhile, back in Victoria . . .

August – 1,074 deaths

September 16th

By the end of September this was tucked away on Page 8 of The Age

September – 494 deaths

October 11th – VFL Grand Final
Collingwood 11.12 (78) defeat Richmond 7.11 (53) in front of a crowd of 45,413 from AFL & Trove HERE

But still there were sporadic outbreaks around the country.

October – 202 deaths

By November, despite deaths continuing, albeit in much reduced numbers, the epidemic was less newsworthy and a tired country was in the process of moving on.

November – 84 deaths

December saw a Federal Election that saw the Nationalist Party under Billy Hughes win 37 of the 75 lower house seats. This despite him not being in the country from May 1918 to August 1919. A feature of the otherwise lacklustre election was the emergence of the Country Party.
See details HERE
It would seem the country just wanted this year to end.

December – 28 deaths

1919 Total – 10,493 deaths from Pneumonic Influenza

Lies, damn lies and statistics
Perhaps the best analysis of the statistics comes after the event. These two tables are part of the 1920 Year Book, that had a special ‘Section 34’ dealing with the epidemic in Australia.

The report also notes that the periods of maximum death rates differed in each of the states

	Feb	Mar	Apr	May	Jun	Jul	Aug	Sep
Vic	X			X		X
NSW			X			X
Qld					X
SA				X			X
WA							X
Tas								X

It includes a detailed analysis of the variation of death rates over the epidemic compared to base line death rates in normal years.
It suggests that, after allowing for population growth, the number of expected deaths from all causes in 1919 should have been 51,891. The actual deaths were 65,930 or 14,039 in excess.
For more info you can get Section 34 of the report HERE

Around the World

The 1918-19 Spanish Flu pandemic is thought to have infected over 500 million people and killed between 50 and 100 million. While details are hard to find, here are some indications of numbers of deaths:
New Zealand 4,000
Britain 228,000
Japan 390,000
France over 400,000
Germany 400,000 (civilians only)
Russia 450,000
USA 675,000
Dutch East Indies (Indonesia) 1,500,000
China 1-2 million
India over 12 million

In Conclusion

The 1919 epidemic was a tragedy on top of four years of a World War that had already taken 62,000 Australian lives.
It is apparent that Australia did better than many other countries and that our isolation and border controls played a majour part in delaying the epidemic.
Thankfully with the rapid development of medicine in the 20th and early 21st centuries this sort of thing could never happen again. . .

. . . or could it?