America's Hidden Stories (2019–…): Season 1, Episode 3 - Pandemic 1918 - full transcript

Narrator: 1918.

An unstoppable virus
sweeps the planet...

650,000 Americans die...

Millions more worldwide.

Man: It killed roughly

between 50
and 100 million people.

Narrator:
They call it "Spanish flu."

Woman: Spanish influenza
of 1918 was one of,

if not the most significant
disease event in history.

Narrator: And then...
It vanishes... Buried.

Man: It's a real mystery
why Americans put it away.



Narrator: Now new evidence
is emerging...

Of a possible birthplace
in the American heartland.

Woman: The term Spanish flu
is a misnomer.

It probably should have been
called the American flu.

Narrator: And the true extent
of the danger, then... And now.

Man: Civilization
could easily disappear

from the face of the earth.

That's how bad it gets.

♪

Narrator: History may be
more shocking

than we ever imagined.

Today, technology forces
the past to give up its secrets.

Newly discovered documents
turn history on its head.

And discoveries
in ancient archives



reveal startling stories
we never knew.

♪

It's like a scene
from medieval Europe...

Unnamed plague victims
dumped in mass graves.

But this isn't the plague...

It's a virus

which will kill tens of millions
in just a few months

at the dawn of the 20th century.

Shauna devine:
The influenza pandemic of 1918

was one of the worst events that
we've seen in modern history.

[Boom]

[Gunfire]

Narrator: In the spring of 1918,

as world war one
is being waged in Europe,

the Spanish flu
quietly infiltrates

cities and towns across the U.S.

Mysteriously, it targets
the young and the healthy.

John Barry: More than two-thirds
of the dead

were otherwise healthy
young adults.

Normally influenza kills
either the elderly or infants.

This was the reverse.

Narrator: But the disease
exacts a terrible toll

as the summer turns to fall.

It can strike
with murderous speed.

Barry: People could die
in less than 24 hours

after the first symptoms.

Narrator: The nation staggers
under the onslaught of death.

Jim Higgins: The hospitals
become overwhelmed,

the cemeteries
become overwhelmed,

social services
become overwhelmed.

Barry: I mean, people were
literally starving to death,

not because there was
any lack of food,

but because their friends,
their neighbors,

even in many cases their family
was afraid to bring them food.

Higgins: And there are
just bodies stacked

all over the place.

Narrator: The carnage builds
to a deadly crescendo

in the fall of 1918.

Barry: Influenza's death toll
was compiled

in a matter of weeks.

It got so bad that a guy
named Victor Vaughan...

He was head of the communicable
disease section for the army...

He said, "if the present rate
of acceleration continues"

for a few more weeks,

civilization
could easily disappear

"from the face of the earth."

Narrator: And then,
it virtually disappears.

There is little mention of it
by authorities...

And a greatly reduced death toll
in the months that follow.

Doctors are left stunned,

struggling to understand
what happened.

Where had this monster
come from?

David morens: The virus
was doing something hidden

for a short period of time
before it broke out.

Narrator: Why was the government
almost silent

as the virus wreaked havoc
across the country?

Barry: There were practically
no public statements

about the pandemic from anyone.

Woodrow Wilson
never said a word.

From the official government
view, it almost didn't exist.

Narrator: Did it shape
the 20th century

in ways we never realized?

Barry: It had a dramatic impact
certainly.

It probably affected
what happened at versailles,

which in turn led
to world war two.

Narrator: And 100 years later

scientists have
an even more urgent question:

How can we keep it
from happening again?

Barry: There could be
a virus out there already

that's circulating in humans

that will be the next
lethal pandemic virus.

[Bird squawking]

♪

Narrator: Historian Jim Higgins

has come to pennsylvania's
winfield township.

He's tracking down
an horrific local story

that victims of the flu
were once buried here

in a mass grave.

Doris herceg:
Bodies were brought here

literally in wagons to be buried

because there wasn't
adequate caskets.

Narrator: Doris herceg
has lived here for decades,

collecting the stories
second hand.

Herceg: The funeral directors
were overworked,

the doctors were overworked,

and they literally wrapped them
in sheets to Bury them.

♪

Narrator: Jim wants to determine
if the stories are true.

He's brought Matt Turner,

a ground penetrating radar
technician,

to help him survey the site.

The radar fires
electromagnetic pulses

thousands of times a second...

Giving a rough picture
of what's hidden below.

Doris believes the flu victims
were recent arrivals

from eastern Europe.

They came hopeful,
to dig the raw materials

for pittsburgh's
iron and steel mills.

Herceg: Most of the immigrants
who came

during the 1918 flu epidemic

came to work
in the limestone mines

and the coal mines
located in west winfield.

Higgins: So these men come
from halfway around the world,

end up in this township,

and then are buried here
very soon after their arrival.

Herceg: Correct.

Narrator: Dead before the locals
even learned their names.

Herceg: They were so new,

literally there is nothing known
about them.

There was no way to contact
their ancestors back in Europe,

so they were buried here and
literally lost their identity.

Higgins: So they're anonymous.
No names. No ages.

Just men who died?

Herceg: That's correct.

Narrator: In 1918 the disease
that killed them

was called the Spanish flu.

But it almost certainly
didn't come from Spain.

One modern theory
is especially shocking.

The disease
that ravaged the globe

may have been born
on the prairies of the midwest.

Barry: There's
a distinct possibility

that it actually started
in western Kansas.

Narrator:
Historian and author John Barry

wrote a history of the flu,

recording the scars it left
on countless American families.

Barry: I remember when
I was working on the book,

my aunt told me
that it was the only time

she had ever seen her father,
my grandfather, cry.

That was because friends
across the street,

both parents died
leaving several orphans,

and they were close friends.

Narrator: In February 1918,

a doctor in haskell county,
Kansas, named loring miner

reported seeing a spike
in patients with the flu.

Barry: Loring miner noticed
a population

that he was servicing

was getting sick,
very sick with influenza,

unlike any
he had ever seen before.

He considered it so serious,
he felt the need

to alert the U.S.
public health service to this.

Narrator:
But the deaths in Kansas

may not have been the first.

In January that year,

flu targeting young adults
also hit the east coast.

Barry: There was a late winter
wave in New York City.

Conceivably somebody
from New York

carried it to haskell,

or it could have gone
the other way around.

Or neither of those things,
we just don't know.

Narrator: Loring miner's warning
from Kansas

gets little attention.

Seasonal flu is a contagious
but common illness.

Barry: It was pretty much lost.

Narrator: Besides, America
has bigger concerns.

♪

[Boom]

The previous spring,
in April 1917,

the nation had declared war
on Germany

and joined world war one.

In Washington, D.C.,

president woodrow Wilson needs
more troops as fast as possible.

John Barry believes
that one of those new soldiers

was an early carrier
of the disease,

who may have helped spread it
more widely.

His name: Albert gitchell.

Barry: The first identified
patient to report sick

was very early march 1918.

He was a cook.

Chris capozzola: Albert gitchell
is a typical American doughboy,

an ordinary enlisted man.

Every region of the country

is producing soldiers
for the war effort.

20% of the soldiers
are immigrants.

They speak probably
a hundred different languages

in the military camps.

This is real snapshot of where
America is at that moment.

Narrator:
Gitchell reports for duty

at newly created camp funston
in Kansas...

Just hours away from
the outbreak in haskell county.

He's a member
of the 164th depot brigade,

supporting other recruits.

He puts his butcher skills
to work, feeding hungry mouths.

Capozzola: His job is basically
to touch the food

that hundreds or thousands
of soldiers

might eat on any given day.

Narrator: But that march,
gitchell falls suddenly ill:

Burning throat, aching body,
fever of 103.

♪

He lands in the infirmary.

[Sneeze]

Within hours, more than
a hundred other soldiers

report identical symptoms.

Capozzola: Albert gitchell
reports for sick call,

and from there the epidemic
only expands.

Barry: Within a few days,
there were several hundred,

and a few days after that
there were several thousand.

Narrator: 46 men die.
It's a serious outbreak.

But the body count is still low.

No one has any idea

that the disease will soon steal
across the United States.

And that what is happening
on an army base in Kansas...

Is about to bring the nation,
and the rest of the globe,

to its knees.

In the winter of 1918

a powerful new strain
of influenza

terrifies Kansas doctor
loring miner.

His report gets little attention
in the United States.

But newspapers in Spain
report a similar illness.

[Sneeze]

The so-called "Spanish flu"
will eventually become

the deadliest pandemic
of the modern era.

In winfield township,
Pennsylvania, Jim Higgins

has found evidence of its toll
on the United States.

The ground penetrating radar

confirm there is not
just a grave here...

It's a mass grave.

Matt Turner: These white layers
indicate where the graves are,

going down in this direction.

This is a topogram, we're
looking down into the ground.

It shows the mass grave
or the burial pit coming down.

It looks like it's
at least 10 feet,

and in this direction
it's about 10 feet also.

Narrator: For local residents
Doris herceg and Fred Cesar,

it's confirmation
that a hundred years ago

the Spanish flu had paid
a deadly visit.

Higgins: So, your community
for decades

suspected that there
were victims from the 1918 flu.

Herceg: This is so fascinating.

It's just wonderful to confirm,
to have some validity to it.

Fred Cesar:
So this is holy ground here.

Turner: According
to the gpr data, yes, it is.

Narrator:
What hit winfield township

attacked the rest
of the country, too.

♪

Capozzola: All right. Oh, wow.

Narrator:
Historian Chris capozzola

is in Massachusetts,

visiting the museum of a former
world war one army base.

Kara fossey
is executive director.

Kara fossey: We've got some
diaries, some photo albums,

a scrapbook from a nurse who was
here during the epidemic.

Narrator: The disease
hit camp devens hard

in September 1918.

Fossey: The total population
at devens was around 45,000,

and almost 15,000
had become sick.

This really goes into detail

about what was happening
to these soldiers.

Narrator: It's a letter, by
a doctor stationed at the camp.

Capozzola: "These men start
with what appears to be"

an ordinary attack
of la grippe, or influenza,

and when brought
to the hospital,

they very rapidly develop

the most viscous
type of pneumonia

"that has ever been seen."

Narrator:
The eyewitness accounts

of the doctors and nurses

read like the script
for a horror film.

[Coughing]

Capozzola:
"Two hours after admission,"

they have the mahogany spots
over the cheekbones.

And a few hours later, you can
begin to see the cyanosis

"extending from their ears and
spreading all over the face."

And cyanosis makes them
almost blue.

Fossey: Very dark.
Capozzola: Really dark,

so it must have been almost
like a zombie or something.

Really terrifying.

"Only a matter of a few hours
then until death comes,"

and then simply a struggle
for air until they suffocate.

It is horrible.

"We have been averaging
about 100 deaths per day."

Narrator: But how, exactly,
had the disease spread

from isolated outbreaks
in rural Kansas and New York

to Pennsylvania, Massachusetts
and the rest of the world?

Edmund earle: Plotted all the
data points that we received.

Narrator: Chris is visiting with
graphic artist Edmund earle.

They are plotting
hundred-year-old data

on a modern map,
looking for clues.

Earle: Where is this?

Capozzola: This is
a rural county in Kansas.

Haskell county.

So, you might think
that haskell county, Kansas,

is the middle of nowhere, right?

But even a rural place
in America

is connected to everywhere else
by these rail lines.

Narrator: During the war
millions of young men

are riding the rails,

leaving their small towns
for the first time.

Capozzola: The American army
goes from about 150,000

to ultimately 4 million men
in uniform

in the space of about two years.

Earle: So I'm going to turn on
our highlighted rails.

Narrator: Wherever the outbreak
started in 1918,

america's railroads would have
given the virus a free ride.

Earle: So what we're
looking at here

is between February
and the end of April.

Capozzola: Soldiers are moving
back and forth

from their home communities
into the military camps,

out from the camps to head
to the war in Europe.

Earle: So the flu
has all these opportunities

to spread everywhere.

Capozzola: It can go almost
anywhere that it wants.

Narrator: After training,

the soldiers head
to the front lines of France.

Capozzola: They are getting
on massive ships

that are holding thousands
of soldiers at a time.

Earle: And I have on here
the shipping routes.

This is sort of a simplified map
of them.

Capozzola: They'll be going
all the way over to Europe,

and almost all of them
would have been unloading

in the exact same place,

in the far western part
of France.

Earle: Yep.
I see around April 9th.

That must be brest right there.

Capozzola: Yep.

Earle: Oh, look at that.

Kind of just spreads from there.

Narrator: The map
reveals something else.

Earle: Here we are,
end of August,

and I can see it
beginning a little in France

and a little in the states
as well.

Narrator: What appears to be
a second wave of the virus

erupts that summer.

It shows up in France,
the United States,

and elsewhere in the world
almost simultaneously.

This is the worst killer of all.

Barry: It was not ordinary
influenza by another name.

Some of the symptoms
were horrific.

People bleeding not only
from their nose and mouth,

but from their ears
and even from their eyes.

Earle: So I'm gonna let it play.

And I see all the red
just flowing everywhere.

[Bell clanging]

Narrator: In the U.S.,
signs of this second wave

are seen
on the Boston waterfront.

Capozzola:
Some of the first cases

occurred at commonwealth pier
on August 27, 1918.

Earle: Yeah, there we are.

Narrator: The Navy records
two cases in the barracks

where more than 7,000 sailors
awaited transit.

Capozzola: But then notice
what happens.

On the following day,
eight cases were reported.

And on the succeeding day,
53, 81, 106, 59, 119, et cetera.

Earle: Oh, my goodness.

Capozzola: It explodes.

Narrator: Ships left Boston,

headed for New Orleans,
Philadelphia, and beyond.

But as the death toll
skyrockets,

public health authorities
are almost completely silent.

[Coughing]

Nancy bristow: It's very clear

that medical doctors
in the U.S. army

are aware that something
is happening.

But they simply don't get the
attention of the broader nation.

Barry: There was
no information whatsoever

coming out
of the national government,

and not much better coming out
of local governments.

♪

Narrator: The Spanish flu
strikes across the country

in 1918.

But why does the government
remain almost silent?

Barry: If the national
government and local governments

had told the truth,

I think the death toll
might have been somewhat less.

Narrator: The virus hits
as the United States

is raising an army
to fight in world war one.

Capozzola: We basically go
from zero to 60 overnight.

The American public is mobilized
as a political body,

they're mobilized as an economy,

they're mobilized, of course,

as an army to fight this war.

♪

Narrator:
Historian Nancy bristow

is visiting
Georgetown university.

Art history professor
Elizabeth prelinger

is showing her a collection

of official posters
from the period.

Bristow: It's amazing
to be standing

in front of this poster.

I mean, truly, the iconic poster
for the war.

Elizabeth prelinger:
James Montgomery flagg

was one of the important
illustrators of the day...

Bristow: Right.

Prelinger: So he was recruited

by the newly founded
committee on public information.

Narrator: The committee
on public information

was created on April 13, 1917,
by executive order,

just days after the U.S.
entered world war one.

Woodrow Wilson had promised
to keep America out of the war.

German submarine attacks
on American ships

help to change his mind.

Now his committee had to win
the battle for public opinion

and more recruits.

Bristow: I don't feel like
I'm being asked to volunteer.

I'm being told what to do.

Prelinger: Absolutely,
and I think that a softer sell

would not have worked here.

You know that he really
had to get people who had,

in many cases, voted him in...

Bristow: Keep us out of the war.

Prelinger: As "keep us
out of the war," exactly.

Narrator: By the summer of 1918,

as the flu is spreading
across the country,

the president's committee
is spreading a powerful message

of support for the war.

Capozzola: They're tapping
into the new mass media

of posters, of film,
of popular culture,

of magazines,
everywhere you turn.

The cpi also recruits
some 75,000 volunteer speakers

that would encourage people to
do their bit for the war effort.

Narrator:
While the government committee

becomes a megaphone
for the war effort,

it makes a whisper
of everything else.

Barry: The committee
was not specifically used

to combat the pandemic.

They simply didn't
comment on it.

They pretended it didn't exist.

Narrator: In some cases,

public discussion of the flu
was even prosecuted.

Bristow: People were literally
arrested for and prosecuted

for things that today we would
see as fundamentally covered

by the first amendment.

Barry: The idea that you had
to keep morale up

ended up being
very, very poisonous.

When a small-town Wisconsin
newspaper

was reporting
on the outbreaks locally,

an army general

actually referred the editors
of that newspaper

for criminal prosecution
for telling the truth.

Narrator: One European country,
however,

stayed out of the fighting.

Bristow: Spain was not at war,
it was a neutral country.

And so, their newspapers
were not facing

the kinds of restrictions

that an American newspaper
might face.

And they called it
the Spanish flu

because they were getting
the best information

as it hit Spain relative
to the other countries

that of course were also
being hit, and hit hard.

[Coughing]

Narrator: With virtually
no official information

from their own government
about the pandemic,

rumor and disinformation
also spread.

The German drug company bayer

is suspected of waging
biological warfare.

Bristow: In New York City
there's a rumor

that bayer's aspirin is where
the flu has come from.

Others suggest it's arrived
by a u-boat

off the coast
of the United States.

Narrator: Another poster
shows the importance

of the Liberty loan parades that
occurred all over the country.

Prelinger: The war cost
about $30 billion,

and two thirds of that was
raised in these Liberty loans.

Bristow: Isn't it incredible?
Prelinger: Can you imagine?

Narrator: Around the nation

misinformation and lack
of public health leadership

makes the pandemic worse.

Bristow: The one thing
they knew then

and that we obviously know now

that could have stopped
the pandemic or slowed it

was social distancing...

Keeping people away
from each other.

Narrator: Perhaps
the most tragic example

comes in Philadelphia that fall.

On September 28, 1918,
a crowd of nearly 200,000

floods the streets
for a Liberty loan parade.

Barry: There were numerous
doctors urging the cancellation,

but the local
public health director

insisted that the parade
go forward.

Narrator:
It's a public health disaster

as the flu spreads
to thousands in the city.

Higgins:
Philadelphia falls apart.

The hospitals
become overwhelmed,

the graves become overwhelmed,

the cemeteries
become overwhelmed.

Barry: There were over 15,000
people killed in Philadelphia

from the pandemic.

There were hundreds...
Literally hundreds...

Of people dying
every single day.

Narrator: Young seminarians
from the catholic archdiocese

are the unsung heroes
of the city of brotherly love.

Higgins: They remove hundreds
of bodies from homes.

Some of them have been dead
for a week or ten days.

And it's October.
This is not the dead of winter.

In one cemetery,
we've got almost 3,400 bodies

that go into the ground,
many of them in mass graves.

Narrator: Even when the
Philadelphia health authorities

change course and close
public meeting places,

the newspapers still
don't tell the truth.

Barry: When they finally,
after all this, closed schools,

banned all public gatherings,

one of the newspapers even said

this was not
a public health measure.

You know, how stupid did they
think the people were?

Narrator: Secretly, the flu
also plays a key role

on the front lines.

In the spring of 1918
the Germans have the advantage

and launch a massive offensive...

To win the war before
American soldiers arrive.

♪

[Artillery fire]

[Gunfire]

They break through allied lines
and are 90 miles from Paris,

before a hidden foe
helps stops them.

[Coughing]

As many as half a million
German soldiers

are sickened by the flu
that summer,

which the German high command
blame for stalling the advance.

Capozzola: The flu epidemic was
devastating for the German army,

and it made it almost impossible

for them to wage their
sort of last, final campaign.

♪

Narrator: By September,
it's the allies' turn to attack.

Up to a million
American soldiers

launch the meuse-argonne
offensive...

One of the most ambitious
military efforts in history.

But behind the scenes, flu is
crippling American forces, too...

On both sides of the Atlantic.

In October 1918,

200,000 Americans die
of the Spanish flu.

Secretly, the virus
is even threatening

america's ability
to fight world war one.

Barry: The army camps themselves
became so dangerous,

and they couldn't function, they
couldn't train soldiers either,

that the draft
was actually canceled

in late September 1918

to prevent huge influxes
of new people arriving

at the army camps.

Narrator: Around the country,

health authorities
and newspapers

continue to hide the truth.

Camp pike in Arkansas
houses 52,000 soldiers.

In late September and October,
the Spanish flu strikes.

Almost 12,000 fall sick.

Barry: It got so bad that the
camp admitted 8,000 soldiers

in four days to the hospital,

then stopped admitting soldiers,

and there are thousands more in
barracks, many of them dying.

And the doctor went on to say,

"there's nothing
but death and destruction,"

while seven miles away
the Arkansas gazette is saying,

"this is ordinary influenza
by another name."

Narrator: In France,
general pershing

cables woodrow Wilson
from the front lines,

demanding more men.

Secretly, wilson's chief
physician, Dr. Cary Grayson,

warns against sending
the soldiers.

He knows that sending soldiers
on transport ships

is a potential death sentence.

Barry: You can imagine
a transport.

Very, very crowded.

They became floating coffins.

His own personal physician
advised him not to do that.

Narrator: But army
chief of staff Peyton march

takes a hard line:

He insists the troop ships
must continue.

Capozzola: And this is one
of the only times

in the historical record

that we see Wilson
agonizing over the flu.

Wilson sort of listens
and makes the decision

that yes, the troop ships
will continue.

Narrator: Wilson's decision
had a direct consequence.

By early November, 200,000
U.S. soldiers in France

were sick with the Spanish flu.

Many were almost certainly
infected on the troop ships.

The war needed to be won,

but sending sick or vulnerable
soldiers was unnecessary,

says John Barry.

Barry: There were soldiers
in camps

who had already experienced
the pandemic,

so they were not going
to get sick a second time.

You could have taken
those soldiers

and put them on the transports.

But the army
didn't even do that much.

Narrator:
To soldiers and civilians,

it's obvious that what's
attacking America

in the fall of 1918
is no ordinary influenza.

But they struggle for answers.

Capozzola: Those explanations
that are coming

from science and medicine

are just not enough to most
people to explain why this flu,

which is a disease that they've
lived with their entire lives,

is creating the devastation at
the level that they are seeing.

[Coughing]

Narrator: The questions
then, and now, are simple.

Why is the flu of 1918
so lethal?

And why are certain populations
especially hard hit?

Jim Higgins is in Pittsburgh,

where the Spanish flu killed
4,500 and sickened 22,000.

Mortality here was
twice the national average.

An old steel mill
called the Carrie furnaces

might hold clues as to why.

Ron baraff: At its height,
there are seven blast furnaces

working here producing the steel

that won the first
and second world war.

Narrator: 4,000 men toiled here
around the clock.

Baraff: Really what you're
looking at is a manmade volcano

that every 4 to 6 hours

these men were tasked
with controlling.

The iron's coming out
at 2800 degrees.

These are men that are being
exposed to extreme heat.

It's sulfury, it's smokey,

it's this
all-sensory experience,

it's completely overwhelming.

Narrator: The entire region
becomes the central cog

in president wilson's
war machine.

The factory here produced
a thousand tons of iron per day.

Higgins: Pittsburgh is the
greatest single armament center

in the United States.

It's not just Pittsburgh;

It's allegheny county
and the surrounding counties

that produce just about anything

an army or Navy
would need to fight.

Narrator: But productivity
comes at a price.

No city in America
has a higher death rate.

Higgins: And the neighborhoods
these workers lived in,

what were they like?

Baraff: Oftentimes
the unskilled guys,

especially,
are living in squalor.

I mean, there's open sewage,
common privy,

two-up, two-down little houses,
sharing beds.

Sleeping in shifts.

They're working in shifts,
and they're sleeping in shifts.

It's rough, and it's
disease ridden.

Add to that this massive
amount of coal burning

that's providing
this black soot.

You're surrounded
by these mills.

You can't get away from them.

Higgins: So it's
just compounded.

Baraff: Just compounded.

Narrator: In 1918, Pittsburgh
has one of the highest rates

of lung disease in the country,

leaving it virtually defenseless
once the virus arrives.

Devine: Spanish influenza tended
to kill by secondary infection.

And this is when you see
the severe symptoms:

Bronchial pneumonia,

the purplish-bluish marks
on the face,

and it was essentially
patients suffocating,

their lungs filling with fluid.

Narrator: At the university
of Pittsburgh,

archivist David grinnell is
showing Jim coroner's reports.

They are for sudden deaths
in 1918.

In many of them,

Jim suspects the fingerprints
of influenza's lethal grip.

Higgins: Who do we have here?

Otto haberland.

David grinnell:
Living up on mount Washington.

Higgins: Okay. 49 years of age.
Found dead on the street

with cardiac exhaustion
and chronic bronchitis.

Interesting.

He's dying of
chronic bronchitis,

which you're just not
going to die of.

Something else
is probably at work here.

Narrator: The dead man's
grieving wife tells police

he'd left the house,
despite being sick for a week.

Higgins: "I was informed
by a police officer"

that my husband was found dead,
laying on Wyoming street."

So, we have a man who wanders
out of his house

and is found dead on the street
just 20 minutes later.

Narrator: Sudden death
from bronchitis

and evidence of confusion

are telltale signs
of the hidden killer

stalking Pittsburgh in 1918.

Higgins: People are exhibiting
very, very weird symptoms.

Nosebleeds, gouts of blood.

It really is a disease
that some doctors find so unique

that they hesitate to actually
call it influenza in 1918

until they realize, "no,
I am dealing with influenza."

Narrator: Poisoned air
and Spanish flu

had dealt Pittsburgh
a lethal one-two punch.

Higgins: Once a virus began,
it's almost guaranteed

that in a place like Pittsburgh,
with their lung health,

with their lack of
public health organization,

you're probably going to have
a much more severe epidemic

than you would have
otherwise had.

Narrator:
More than half the deaths

were in people who were
between 15 and 40.

Why had the Spanish flu targeted
the young and the healthy

in Pittsburgh
and around the world?

It's a mystery
still being investigated

at the national institutes
of health.

Medical historian shauna devine

is meeting
with Dr. David morens,

who was at the CDC

when the swine flu
panicked the country in 1976.

Morens: Oh, yes, I was.
We thought, initially,

that it was the 1918 virus
coming back,

and that there'd be
a horrible deadly pandemic

with tens or hundreds
of millions of deaths.

It was not
on the radar screen...

Narrator: After that scare,
a team of scientists

reconstructed the 1918 virus
to study its genetics.

Devine: With this genetically
reconstructed strain,

what did it reveal
about this particular virus?

Morens: It's hard to identify

single genetic
virulence properties,

because the eight genes
have to work together.

It's like a football team.

It doesn't do a lot of good
to have a good quarterback

if the rest of the team
isn't good.

They have to fit together
and be able to play together.

Narrator: The scientists found
that the genes

in the Spanish flu
were all-stars...

They had combined to make
a perfect killer.

Morens: The genes in the
original h1n1 virus from 1918

appear to have been
working together in concert

very well indeed,
very efficiently.

Narrator: Dr. Morens says
we may never know

exactly where the Spanish flu
entered the human population.

Morens: We know that the virus
shortly before 1918

came from wild birds, waterfowl,
or shore birds,

or things like that.

The exact event in which it
shifted out of the reservoir,

the wild birds, into people,
we'll never know.

But it sort of doesn't matter,
because we know it happened.

Narrator: Why had those
in their twenties and thirties

been hit so hard?

Not all scientists agree,
but one theory

is that some of these victims
had been exposed to flu before,

as children.

In 1918 their immune systems
fought back.

But the Spanish flu
was different,

so their immune systems
were fighting the wrong enemy.

Morens: Some people
have raised the possibility

that some of
the severe pneumonias

and deaths and excess mortality

was due to the fact
that the immune response

was harmful instead of helpful.

Narrator: The result:
A violent, destructive war

inside their own bodies.

On November 11, 1918,

the other war, in Europe,
finally ends.

Germany agrees to an armistice.

As the guns fall silent,
the prayers of much of Europe

are directed
at the new political power

on the world stage

and its leader.

Capozzola: The people of Europe
are putting onto Wilson

all of their hopes for what
a post-war world can look like.

Narrator:
Woodrow Wilson had promised

to make the world safe
for democracy.

He's the first sitting American
president to visit Europe.

Paris had never seen
anything quite like it.

William hazelgrove: Millions
and millions of men had died.

Here comes woodrow Wilson,
the man who won the war.

They couldn't get enough of him.

The only thing I can think of

is maybe the frenzy when
the Beatles came to America.

You know, it's that kind
of frenzy.

Narrator: But the Spanish flu
of 1918 is not finished,

with the world, nor with
president woodrow Wilson.

By the spring of 1919,

the Spanish flu
has circled the earth.

An incredible
500 million people...

One third of
the world's population...

Have been infected.

In India, 20 million lie dead.

In the United States, 650,000.

A world more connected
than ever before

allowed a deadly virus to move
with unprecedented speed.

Devine: This disease
was highly contagious

and spread widely
all over the world.

So it wasn't just the war that
aided the spread of disease,

it was lines of communication,
ships, trains, transport.

[Cheering]

Narrator: The war had helped
carry the Spanish flu

around the planet.

But behind closed doors,

the pandemic may be
about to shape the peace.

That march,
the victorious leaders

of France, britain, Italy
and the United States

gather at the palace
of versailles

to hammer out a peace treaty

and bring about
a league of nations.

Hazelgrove: What is
the league of nations?

It's basically an organization
to stop war for all time.

Woodrow Wilson felt

he could not look at the mothers
who had lost their boys

and tell them this war
wasn't the final war,

the war to end all wars.

Narrator: The French and British
want Germany punished.

Wilson wants
a more balanced treaty.

[Cough]

But on April 3rd,

the American president
falls sick.

Devine: Woodrow Wilson,
in the midst of his peace talks,

was very, very, very ill,
and took to his bed on April 3rd

and was extremely ill
for five days.

They did not think
he was going to survive.

Narrator: Paris is struck

with a third wave
of Spanish flu that spring.

There has long been speculation

that president Wilson
may have caught the disease.

Barry: He had a 103-degree
temperature,

he was vomiting, had diarrhea.

These are not
necessarily typical

of seasonal influenza today,

but they were extremely typical
of influenza in 1918.

♪

Narrator: At the Wilson
presidential library

in staunton, Virginia,

Nancy bristow and
archivist Mark Peterson

are digging through the records
of wilson's doctor,

Cary Grayson.

He was with the president
in Paris.

His papers were donated in 2008.

Bristow: Fever of 103,
a cough he can't quell,

and body aches
that are really painful.

Those three are
such classic symptoms

of, in particular,
this pandemic influenza.

Narrator: The next morning,
Grayson agonizes

about what to tell
the newspapers.

Mark Peterson: "The president
had no objection"

to my announcing
that he was sick in bed.

In fact, he advised that I do
so, because, as he pointed out,

he did not want anyone
to attribute to him

"any indication of quitting."

Bristow: And he's worrying
about how it appears

in terms of this
international crisis

of trying to figure out

what a peaceful world
could, would look like.

Narrator: The public is told
Wilson has a bad cold.

Privately,
Dr. Grayson tells a friend

what had really happened.

"The president was suddenly
taken violently sick"

with the influenza at a time

"when the whole of civilization
seemed to be in the balance."

When Wilson returns
to the negotiations,

he's a different man.

Devine: His aide said,
and his personal secretary said

he was never quite the same.

He was not as quick-witted,
he was not as tenacious,

he was tired,

he was suffering from some kind
of depression and malaise.

He never really came out of it.

Narrator:
Wilson's confusion suggests

he has been stricken
with the Spanish flu.

Barry: In 1918, one of the most
common complications

was psychological impacts.

In fact, there was
a scientific assessment

that said second only
to, you know, pneumonia

was mental disturbances.

There's no doubt that Wilson
was thrown off.

Mentally, he just stopped
making sense.

Narrator: On June 28, 1919,

the treaty of versailles
is signed.

Instead of a balanced treaty,

Germany is ordered to pay
crippling reparations.

Capozzola: So you can see
where the treaty of versailles

is going to take you, right,
if you're Germany.

There's going to be
unemployment, inflation,

debt, economic crisis,

a sense that the other powers
of Europe have sort of combined

to put all of the burdens
of the war onto your country.

Barry: Wilson abandoned
his principles.

Versailles was a significant
contributing factor

to the rise of Hitler
and eventually world war two.

Narrator: In October 1919

the president suffers
a massive stroke,

which leaves him paralyzed
on his left side.

Historians have long blamed
wilson's blood pressure.

John Barry also suspects
the hidden hand

of the Spanish flu.

Barry: One of the best-known
complications of influenza

are cardiovascular problems.

It's very reasonable to say

that the pretty severe
influenza attack

that Wilson suffered during
the versailles peace conference

was a contributing factor

to the stroke that he suffered
months later.

Narrator: Though kept
a tightly guarded secret,

Wilson is essentially
incapacitated

during his final year in office.

An estimated 17 million soldiers
and civilians

died in world war one.

The Spanish flu was much worse.

Barry: It killed roughly between
50 and 100 million people.

If you adjust that
for population,

that would be between
a little over 200 million

to about 450 million
in today's world.

Narrator: New research suggests
the virus may have been carried

from China to Europe
by wartime laborers.

In 2003 the world trembled

when another virus from China
threatened.

Sudden acute respiratory
syndrome, or "SARS,"

also had lethal,
pneumonia-like symptoms.

Morens:
The scary part of the story

is that if that SARS virus

had been just a little bit
more transmissible,

it probably would have
overwhelmed public health,

and we would have had a disaster

probably worse
than the 1918 flu.

Narrator: A coordinated
global response to SARS,

and identifying the virus
that caused the Spanish flu,

have given scientists hope

they can avert
the next influenza pandemic.

Morens: 20 years ago,
there were very few people

doing influenza research;

Now that's changed.

We have the technical knowledge,
to, in the next 5 or 10 years,

make much more
universal vaccines,

meaning vaccines
that are more effective

and their protection more
durable and more long-lasting.

Narrator: There is
no national monument

commemorating the 1918 flu.

Only fading markers
in forgotten fields

for the unnamed dead.

The president had sold
the nation a war,

but then sold the people short

on vital public health
information

about a far greater threat.

Barry: Had people known
things to do...

Things as simple
as washing your hands,

things as simple as not going
to work if you're sick...

Those things would actually
have, I think,

made a difference
in the death toll.

I think in most disasters the
best of humanity shows itself.

People risk their lives,
they help each other.

That did not happen in 1918.

It became alienated, and it was
every person for themselves.

Narrator: The war had made
America a global superpower.

As the American century dawned,
few wanted to look back.

Bristow: They want
to remember a victory.

They've got one.

It's called world war one.

And so the pandemic

really is quickly subsumed
under the war,

and the war is the right story
for Americans

at that historical moment.

Narrator: The lucky moved on.

Soldier Albert gitchell,

who had been one of the first
to fall ill,

marries and opens a restaurant.

He dies at the age of 78,
in south Dakota.

For countless thousands
of other families,

there are only hard memories
and bitter lessons.

Bristow: To suggest, though,

that Americans
forget the pandemic

is actually not true.

People are orphaned, they lose
spouses, they lose children.

This is a devastating event

that's remembered at the level
of an individual.