This post, by Megan Huang in the National Archives History Office, was originally published in 2018 marking the centenary of the 1918 influenza. It has been updated with additional images.
Masks as protection against influenza. Street cleaner wearing the influenza mask, 10/16/1918. (National Archives Identifier 45499357)
The 1918 influenza pandemic was a pandemic in the truest sense possible, affecting not just major population centers but also the most remote communities in the Pacific Islands and among Inuits in the far north.
About 500 million people may have been infected at some point, with 675,000 deaths in the United States alone. Globally, more people were killed by the influenza than by World War I, a concurrent, global conflict that lasted twice as long as the pandemic.
The war, however, contributed to the disease’s rapid spread. Crowded wartime conditions and troop movements across the Atlantic and throughout the war zones carried the flu worldwide.
The initial appearance of the disease in the United States was in the spring of 1918, but its effects were mostly benign and not much more severe than the seasonal norm.
Influenza hospital ward in France, 12/28/1918. (National Archives Identifier 86697895)
It was not until autumn that the sickness made its most fatal strike—most of the estimated 20 to 100 million total deaths took place in a span of just several weeks in October and November.
Red Cross workers of Boston, Massachusetts, removing bundles of masks for American soldiers from a table where other women made them, 1918. (National Archives Identifier 45499363)
Although medicine had made great strides since the end of the 19th century with the discovery of germ theory, doctors and scientists seemed to have been powerless against the flu, owing to the rapidly mutating nature of its virus. Responses instead focused on containing its spread. One of the most commonly promoted pieces of advice was to wear a mask.
The scale of the disease created mass panic. Churches and schools were closed, while local businesses and services that remained opened struggled with staff shortages. Too frightened to go out in public, people isolated themselves in their homes, leaving the streets nearly empty.
At work in the Red Cross rooms in Seattle, Washington, with influenza masks on faces, 1918. (National Archives Identifier 45499309) 
Precautions taken in Seattle, Washington, during the Spanish Influenza epidemic would not permit any one to ride on the street cars without wearing a mask, 1918. (National Archives Identifier 45499311) 
Masks for protection against influenza. Traffic “cop” in New York City wearing gauze mask, 1918. (National Archives Identifier 45499301) 
Gauze masks to help prevent spreading of influenza. At the Red Cross Headquarters workers are busily engaged in turning out gauze masks to prevent Spanish Influenza Soldiers in many army camps wore them, 1919. (National Archives Identifier 45499393) 
Masks for protection against influenza. 1700 of these masks were distributed by policemen to all police stations, to be used whenever duty calls, 1918. (National Archives Identifier 45499349)
A medical student in normally bustling Philadelphia recalled, after driving 12 miles without passing a single other car, that “the life of the city had almost stopped.”
Yet the severe isolation was lamented by a strained medical community. The head of Philadelphia’s Emergency Aid turned bitter when desperate pleas for more volunteers went unanswered: “There are families in which the children are actually starving because there is no one to give them food. The death rate is so high and they still hold back.”
Among the people who stayed home were shipbuilders who were essential to the war effort. At L.H. Shattuck Co. in New Hampshire, only 54 percent of its workers showed up, and 41 percent at Connecticut’s Groton Iron Works.
The overexertion of the medical community during the height of the pandemic is evident in this call for more vehicles by the Washington, DC, Red Cross. (National Archives Identifier 20802392)
Men on the front and would-be soldiers were also affected. One of the most alarming aspects of the 1918 flu was its penchant for targeting previously healthy young adults. Past flu outbreaks had killed more of the elderly and very young, but the 1918 strain targeted those who were in the prime of their life, who might have been on the battlefield if not for the illness.
The third wave began in early 1919 and ran through spring, which wasn’t as devastating as the fall but still caused significant illness and death. The outbreak finally ended in the summer of 1919. Scientists now know it was caused by an H1N1 virus, which continued as a seasonal virus for the next 38 years.
To learn more visit the National Archives online exhibit concerning the pandemic and its impact in the United States.
Pandemic repeated in 2020. Sad.
Polio survivor myself from that epidemic in 1952 in Ireland.
Many of the methods Americans used in 1918 to try to prevent the spread of the flu are similar to what people began doing during the COVID-19 pandemic: Close schools. Wear masks. Don t cough or sneeze in someone s face. Avoid large events and hold them outside when possible. And no spitting.
Many of the methods Americans used in 1918 to try to prevent the spread of the flu are similar to what people began doing during the COVID-19 pandemic: Close schools. Wear masks. Don t cough or sneeze in someone s face. Avoid large events and hold them outside when possible. And no spitting.
In western states, some cities adopted mask ordinances, and officials argued wearing one was a patriotic duty. In October 1918, the
Ah, how history repeats itself. They were smarter back then and most people did wear masks! In 1918, My father, Sam, was thirteen when the swine flu hit the United States. There were nine children at the time and he was the fourth oldest. He was most kind and patient.
They called him “the Saint.” He was in charge of five of the younger children. Then the swine flu hit in Europe and the soldiers there from the United states in 1918 began to contract it. The “swine flu” was the common name for the Covid-19 virus back then. At the time, the army was eating pork raised there on local farms for food. The flu spread all over the world eventually killing He was devastated when he lost his favorite sweet little brother, Jack. He had loved him so much that when he and my mother married in 1930, twelve years later, they named their first born son “Jack.” Indeed, my brother Jack was the kindest person. He took after our father. I am the last one left of that whole brood descended from those eight surviving children. And now another Covid-19 epidemic is raging.