The Influenza Pandemic

Following the Great War came the extraordinarily virulent influenza pandemic which swept the world, carrying off, it has been estimated, something like 20 million people, more than died in the war itself. It is thought that the usual strain of influenza virus underwent a mutation to a highly dangerous variant. Certainly Australia had influenza in the community during 1918, but this was not severe and was nothing like what followed. 

The pandemic was raging overseas at the end of 1918 but Australia was not immediately affected.

Australia began to feel the effects of the resulting pandemic most severely in 1919. It came in 2 distinct waves: the first February – April, the second June – July. Estimates are that between 20 and 50 per cent of the population may have been affected. There were no antibiotics available at the time to treat the resulting pneumonia, which often led to a rapid death.

Among the nurses of the 25 Metropolitan hospitals that admitted influenza cases, the infection rate was 55%. This certainly happened at the Coast Hospital, but although many staff members were severely affected, no staff members died.

The dreaded complication was pneumonia which often was rapidly fatal, as there were then no antibiotics.

The effect of such a raging epidemic on the populace was to produce a state of panic. This was understandable, as little could be done to prevent its spread and there were no curative drugs.

The New South Wales Department of Public Health held a conference at which it was decided to adopt certain measures in order to limit the spread of the disease if possible; these included:

  • control of overseas and interstate travel,
  • compulsory isolation of victims and contacts,
  • poor relief,
  • restriction on the assembly of persons,
  • closing of schools,
  • free inoculation, and
  • the masking of everyone in public places.

Many people can remember the air of anxiety and helplessness that pervaded the community in those days, as none of the above measures were effective in limiting the spread of the disease. 

During 1919 there were 2,966 admissions to the Coast suffering from flu, of whom 313 died. Fortnightly admissions rose steeply from sixty-three at the outset, to 317 and then to 409; the numbers then fell off again until the epidemic died out altogether.

This involved great strain on the existing staff, although it was augmented. Additional accommodation was obtained by the temporary acquisition of the Eastern Extension Cable Company’s former cable station, Yarra House, at Yarra Bay. This was staffed and equipped with thirty-one beds and between March 1919 and August 1919, 822 male convalescent flu patients were treated there.

After the epidemic, another building at La Perouse which had been the living quarters of the staff of the cable station, was used by the hospital to house nurses on night duty, who were issued with special tram passes for the journey from these quarters to the hospital.

At the height of the epidemic, patients were admitted to the Coast Hospital from the Board of Health by motor ambulance and also in trams especially adapted to take stretchers and double coupled. These trams ran from the Bridge Street depot, along one side of which was the Board of Health building, to the hospital in the morning, and again in the afternoon.

Nurses were detailed to “tram duty” in which they cared for the victims on the journey out to the hospital, and also took down their personal particulars and a short history of each illness. On arrival at the hospital, the tram pulled up in a special shed erected for the purpose (fig. 23) and patients were then transferred to the hospital horse ambulance, and taken to the appropriate ward. Many of these patients were moribund on arrival at the hospital, and some died during the tram journey. 

Extra beds were added to the influenza wards, and the verandahs were also used. The general medical and surgical wards were emptied to make way for the influx of influenza cases.

At first the nurses were isolated and not allowed out of hospital grounds, and those working in the influenza wards were not allowed to mix with those in the other departments. Matron Watson insisted that all nurses should have a bag packed with toilet requirements sufficient for two weeks, in case they should develop influenza and be admitted themselves to hospital.

The Infectious Division (the old Sanatorium) continued to admit cases with other infectious diseases including diphtheria, of which there were 500 cases that year. 

For a time, several nurses were detailed to check travellers about to board trains at Central Railway Station to ensure if possible that they would not be likely to carry the disease to country centres, referring those with suspicious symptoms or fever for medical attention. This practice was shortly discontinued.

The influenza epidemic ended in 1920 with only eighty-three influenza admissions to the Coast Hospital, none of whom died.