The Parade That Knew No Fear

The machinery had been set in motion. Wilmer Krusen had signed no cancellation order, and so the population assembled. At 1:15 p.m. on September 28, 1918, the First Regiment of the Naval Reserve stepped off from the intersection of South Broad Street and Oregon Avenue. Their boots struck the cobblestones in measured cadence, and the crowd that pressed against the police sawhorses took up the rhythm, a human surf of more than 200, 000 Philadelphians stretching north toward City Hall and beyond. The sailors carried rifles at port arms.

Their faces were young, tanned, recently inspected by medical officers who had found nothing to prevent their participation. Behind them came the Marine Band, then the First Regiment of Marines, then the cadets of Girard College in their gray uniforms, then the floats—fifteen of them, each representing some stage of the war, each surrounded by children who had been released from school for the occasion.

The temperature held at sixty-five degrees. The sky over Center City carried the high thin clouds of early autumn, the kind of weather that brings people out of doors without making them hurry.

Spectators had begun arriving before noon, carrying sandwiches wrapped in wax paper, folding chairs, small American flags on sticks. The Inquirer’s special edition that morning had announced the parade as the greatest demonstration in the history of the city, and the newspaper’s estimate of attendance would later prove conservative. People filled the sidewalks from building line to curb. They leaned from second-story windows. They packed the roof of the Union League and the balcony of the Bellevue-Stratford Hotel, where the Liberty Loan committee had its headquarters.

The police department, already short of men due to the draft, had detailed every available officer to crowd control; at the 11th Street precinct, the sergeant on duty noted in his log that two patrolmen had called in sick with what he termed bad colds, a phrase he wrote without emphasis, one entry among many.

The parade moved north on Broad Street at a pace designed to let the crowds see everything. At Washington Avenue, the Second Regiment of Marines passed the reviewing stand where the mayor sat with the director of public health and the assistant secretary of the Treasury, who had come from Washington to promote the Fourth Liberty Loan. The city was responsible for raising $259 million in subscriptions, a quota assigned by the Treasury Department as part of the national campaign for $6 billion in bonds at 4.25 percent interest. The parade was the mechanism for that raising, a moving advertisement for civic duty cast in military spectacle. The Treasury official would speak at the conclusion, but for now he sat under the bunting, watching the procession with the satisfied expression of a man who had seen such demonstrations before and found them good.

At Walnut Street, the crowds were eight and ten deep. Children sat on their fathers’ shoulders. Women held infants wrapped in blankets against the afternoon chill. The virus moved among them invisibly, riding the respiratory droplets that speech and laughter and cheering expelled into the air. The incubation period was one to three days. The infectious period began before symptoms appeared. Every person shouting for the Marines, every child waving a flag, every sailor marching with his rifle, was participating in a transmission event that the municipal authorities had chosen not to prevent. The confidence loop held: the absence of visible crisis justified the decision to proceed, and the decision to proceed ensured that the crisis would remain invisible until it was too late.

The floats moved slowly enough that their mechanical details could be appreciated. One depicted the sinking of the Lusitania, with painted waves and cardboard smoke. Another showed American soldiers distributing food to French refugees. The children riding these constructions had been selected from Liberty Loan poster contests; their parents walked alongside, ready to lift them down if the horses pulling the floats showed nervousness in the press of people. No horse bolted. The police horses, stationed at every intersection, stood with their ears forward, accustomed to noise. At Chestnut Street, a detachment of Yeomen (F), the women’s naval reserve, marched in formation, their uniforms still novel enough to draw special cheers from the female spectators. The Inquirer’s reporter, moving through the crowd with his notebook, recorded wild enthusiasm at this sight, describing the spirit of patriotism as having run riot.

By 2:30 p.m. The head of the parade had reached City Hall, where the statue of William Penn looked down on a plaza so packed with people that movement became difficult. The temperature had risen to seventy degrees. The combination of sunlight and body heat created the conditions that respiratory viruses favor: warm, humid air that keeps droplets suspended, close proximity that reduces the distance they must travel.

The parade did not pause at City Hall; the route continued north on Broad to Girard Avenue, then east to the reviewing stand at Franklin Field, where the university’s football stadium had been prepared for the mass meeting that would conclude the day’s events. But many spectators did not follow. They had seen what they came to see, and they began dispersing into the side streets, into the trolley cars that ran on every north-south and east-west line, into the shops and restaurants where the crush of business overwhelmed any thought of ventilation or spacing.

The hospitals began receiving calls before the parade ended. At Pennsylvania Hospital, on Spruce Street, the switchboard operator logged the first inquiry at 3:47 p.m.

: a woman reporting that her husband, who had attended the parade with their two children, had developed a fever of 103 degrees and was having trouble breathing. The operator transferred the call to the admitting desk, where the clerk noted the symptoms without alarm. Influenza was not a reportable disease in Philadelphia; the health department required notification only for typhoid, smallpox, tuberculosis, and a short list of others. The clerk told the woman to bring her husband to the outpatient department in the morning if the fever persisted. This was standard advice. The hospital’s wards were already near capacity with surgical cases and the chronic illnesses of autumn; there was no protocol for admitting a man with fever and cough, no ward designated for respiratory isolation, no stock of tents or cots for emergency expansion.

At the Episcopal Hospital in Kensington, the story repeated with variations. A mother arrived on foot, carrying a boy of six who had marched with his school group near the head of the parade. His temperature was 104 degrees. His skin showed the cyanosis that would become the epidemic’s signature: not the pink of ordinary fever, but a dusky blue-purple that suggested oxygen starvation. The house physician, a resident in his second year, examined the child and diagnosed pneumonia following influenza. He had seen such cases before, though never so acute. The boy was admitted to a general medical ward, where his bed was separated from others by a curtain that did not reach the ceiling. His mother was sent home with instructions to return in the morning. She would not see him alive again.

The parade continued to its terminus. At Franklin Field, the stands held 30, 000 people, and thousands more packed the field itself, standing on the grass where the Penn Quakers would play their next football game. The Marine Band played “The Star-Spangled Banner.” The mayor spoke of Philadelphia’s duty to the war effort, of the $259 million that must be raised, of the city’s pride in its naval establishment and its industrial production. The Treasury official followed with a technical explanation of the fourth Liberty Loan’s terms: $6 billion nationally, 4.25 percent interest, convertible at the holder’s option into the higher-yielding bonds of future issues. The crowd listened with the patience of people who had come for spectacle and stayed for obligation. When the speeches ended, the band played again, and the crowd dispersed into the falling darkness.

The evening bulletin of The Philadelphia Inquirer, published at 6 p.m., described the parade as the first premonition of victory and as a great day in Philadelphia. The paper’s account filled three columns: the precision of the military units, the beauty of the floats, the size of the crowds, the enthusiasm of the spectators. There was no mention of illness. The health department had issued no statement. The city’s other newspapers—the Evening Public Ledger, the North American, the Record—carried similar accounts, competing in their estimates of attendance and their praise for the civic spirit displayed. The Record noted that no accident had marred the day’s proceedings, a conventional formula that happened, in this case, to be false.

The first deaths occurred overnight. At the Navy Yard, where the epidemic had begun nine days earlier on September 19, the sickbay log recorded three deaths from pneumonia complicating influenza between midnight and 6 a.m. The victims were seamen aged nineteen, twenty-two, and twenty-four. Their bodies were removed to the base morgue, a brick building near the water that had been designed for the occasional casualties of industrial accident and the rare suicide. The morgue’s capacity was twelve. By morning it held nine.

In the city proper, the mortality returns for September 29 would show a normal number of deaths from all causes: 31 for the day, well within the seasonal range. The epidemic’s explosion was still hidden in the incubation periods of the thousands who had breathed shared air on Broad Street. But the hospital switchboards continued to light up. At St. Agnes Hospital in South Philadelphia, the night supervisor counted seventeen calls between 8 p.m. And midnight, all describing the same sudden onset: fever, headache, back pain, the rapid progression to respiratory distress. She logged them as influenza inquiries and noted in her report that several callers mentioned attendance at the Liberty Loan parade.

At the Bureau of Health offices on South Penn Square, the night watchman made his rounds at 10 p.m., checking that doors were locked and windows secured. He found the director’s office dark, the desk clear of papers. Wilmer Krusen had gone home to his house in Germantown, where his wife and children awaited him. He had spent the afternoon at the reviewing stand, had shaken hands with Treasury officials, had spoken with reporters about the city’s excellent health record. The watchman did not enter the office; there was no reason to. The files on the desk held the reports from the Navy Yard, the telegrams from Washington, the laboratory results from Dr. Paul Lewis at the Phipps Institute confirming the presence of Pfeiffer’s bacillus in the sputum of sailors. These documents had not prevented the parade. They would not prevent what followed.

The morning of September 29 brought the first visible strain on the city’s institutions. At the 11th Street police precinct, the sergeant who had logged two sick officers the previous day now found himself with seven absent, three of them admitted to hospitals with diagnosed influenza. The remaining men worked double shifts, their patrol routes extended to cover the gaps. At the central police garage, where the department’s automobiles and motorcycles were maintained, three mechanics called in sick; the vehicles scheduled for patrol would sit idle for want of drivers. The police commissioner received a preliminary report at 9 a.m. And filed it without comment. His department had no medical officer, no liaison with the health bureau, no procedure for responding to an epidemic among uniformed personnel.

The hospitals felt the pressure differently. At the Hospital of the University of Pennsylvania, the morning ward rounds revealed six new admissions with influenza symptoms, all of them young adults, three of them parade attendees who had developed fever overnight. The chief of medicine recognized the pattern from his reading of reports from Massachusetts and from Europe. He ordered the conversion of a surgical ward to respiratory isolation, a process that required moving twelve post-operative patients to other floors and improvising barrier nursing procedures that the nursing staff had never practiced. The hospital’s supply of face masks, intended for use in the operating theater, was exhausted by noon.

At Jefferson Hospital, the situation repeated with less preparation. The house staff, already reduced by the military draft, found themselves admitting patients faster than they could examine them. The hospital’s admitting clerk, a man who had held his position since 1903, began keeping a separate ledger for influenza cases, though no such category existed in the hospital’s formal records. His handwriting, usually precise, grew hurried as the morning progressed. By 11 a.m. He had filled two pages; by 2 p.m., four.

The Bureau of Health opened at 8 a.m. On September 29. Krusen arrived at 9:15, having stopped first at the Mayor’s office to discuss the success of the previous day’s demonstration. The Liberty Loan committee reported subscriptions of $3 million from the Franklin Field meeting alone, with more expected as the campaign continued. The director was in good spirits when he reached his desk. The morning mail held the usual accumulation: requests for permits, complaints about sanitary conditions, a report from the city chemist on the purity of the milk supply. The telephone rang at 10:30: Dr. Lewis calling from the Phipps Institute to report that his laboratory had isolated the influenza bacillus from seven additional Navy Yard cases, confirming the epidemic’s continued spread.

Krusen listened. He asked about mortality. Lewis reported three deaths overnight, with more expected. The conversation lasted perhaps five minutes. When it ended, Krusen sat at his desk with his hands flat on the surface, a posture that would be described later by his secretary, who entered with papers to be signed and found him motionless. Then he reached for the telephone and called the mayor’s office to request an emergency meeting of the Board of Health.

The board met at 2 p.m. That afternoon, a Sunday session without precedent in the city’s recent history. The five members gathered in the small conference room adjoining Krusen’s office: a physician in private practice who served as president; a surgeon; a pharmacist; a soap manufacturer; and a lawyer. Krusen presented the Navy Yard figures and the reports from Lewis’s laboratory. He noted the hospital admissions of the past twenty-four hours, the police department’s absenteeism, the calls to the Bureau from physicians seeking guidance. The board’s minutes, recorded by the clerk, describe the discussion in formal terms: after due consideration, a motion was made and seconded that the Director of Public Health be authorized to take such measures as he may deem necessary for the protection of the public health.

The motion passed unanimously. The meeting adjourned at 3:17 p.m. Krusen returned to his office and began drafting the closure orders that would be issued on October 3, four days later. The delay was not recorded in the minutes; nor was any discussion of why immediate action was not taken. The confidence loop held its shape: the parade had succeeded, the city had demonstrated its vitality, the health director had been authorized to act if necessary. The gap between authorization and action was fatal, but it was invisible to the men who created it, their vision still adjusted to the normalcy they had worked to preserve. Twenty-four hours after the parade had ended, 118 Philadelphians would be reported as coming down with “a mysterious, deadly influenza.”

That evening, the first medical casualty fell. She was twenty-three years old, a graduate of the Philadelphia General Hospital Training School for Nurses, assigned to the medical ward at Pennsylvania Hospital where the parade attendees were being admitted. She had worked a double shift on September 28, covering for a colleague who had attended the parade and developed symptoms. Her own fever began at 8 p.m., rising rapidly to 105 degrees. She was admitted to the hospital’s staff sickroom at 11 p.m., delirious, her breathing already labored. The house physician who examined her noted in his record that a nurse had been taken ill while on duty, that the probable diagnosis was influenza, that her condition was serious.

She was the first medical casualty of the parade, the first concrete evidence that the transmission event of September 28 had seeded the virus in the very institutions that would be required to fight it. The hospital’s nursing staff, already reduced by the war, would lose six more members in the following week. The sickroom where she lay would overflow; the staff quarters would be converted to patient wards; the nurses who remained on duty would work until they collapsed, then rise and work again. The city had not yet recognized what was happening. The records existed, the names were written down, the temperature charts showed the fever’s rise.

But the structure of comprehension lagged behind the fact of infection, and the gap between what was known and what was understood would widen in the days to come, until the streets themselves became unrecognizable and the dead accumulated faster than the living could bury them.

The parade had been the deadliest in American history, a transmission event that would lead to one of the largest outbreaks of the influenza epidemic in the United States. In the days to come, the gap between what was known and what was understood would widen until the streets themselves became unrecognizable and the dead accumulated faster than the living could bury them.