As a result of the war effort, every city is flooded with people - workers, soldiers, families. The industrial areas of cities were crowded with workers. The movement of large numbers of people to urban areas not prepared to receive them meant that there were housing shortages and few city services in place. Conditions for families were squalid, with several families often sharing accommodations. Many cities had no schools, few health services and social services were nonexistent.
Cities also saw incredible industrialization; the presence of large factories pumping out products for the US war effort were common. Shipyards were huge.
Corruption was a common feature of civil politics and especially so in Philadelphia where kickbacks were common. In Philadelphia, the corruption was especially severe because the city's mayor, Republican state senator, Edwin Vare, controlled the city's councils, legislature as well as having a strong influence in the state legislature. This meant that money that should have gone to things like street sanitation did not, resulting in filthy streets. People often paid Vare's workers to influence police and other civil authorities.
When the epidemic struck Philadelphia with the same virulence as it did in Boston, nothing was done. No quarantine was imposed and public officials merely tried to reassure the public that nothing serious was happening. The flow of information to the public was strictly controlled mainly because of the war effort.
Barry goes on to explain that to understand the pandemic in the United States, the political situation in America must be taken into account. When America entered the war, it did so with an attitude of all or nothing. Everything went into the war effort. However, most importantly, control of information was paramount.
Advertising as an industry was in its infancy but already it was recognized as offering the possibility of controlling how people responded to situations, especially crises such as a war or an epidemic.
Woodrow Wilson wanted the American people to view their sacrifices for the war effort in a positive way, so there were controls on what was presented for public consumption. The last thing Wilson and other government officials wanted was a panicked public, so they downplayed the initial beginnings of the epidemic.
Barry uses the city of Philadelphia to explain how public policy related to the war effort helped spread the influenza virus and directly resulted in the deaths of thousands. An example of this was the way the Liberty Loan parade scheduled for September 28, 1918 was handled. Depsite the fact that Philadelphia was on the cusp of the influenza outbreak, despite the fact that the next scheduled draft call was cancelled due to the outbreak in the military, and despite the fact that doctors and public health officials recommended it be cancelled it was not.
None of this was known to the public.Dr. Wilmer Krusen, Director of the Philadelphia Department of Public Health denied the threat the virus posed to the city and did nothing. Even after meeting with researcher Paul Lewis and Lieutenant Commander R. W. Plummer, Krusen still did not act. On September 28, the parade went ahead as planned, with thousands upon thousands of people in attendance. Two days later, Krusen admitted that the influenza epidemic had touched the general population.
"In ten days -- ten days! -- the epidemic had exploded from a few hundred civilian cases and one or two deaths a day to hundreds of thousands ill and hundreds of deaths each day."
Bodies piled up, undertakers ran out of coffins. Gravediggers became sick and no one was able to dig the graves. Funeral homes, morgues and hospitals were overwhelmed. Bodies were stuffed on porches, fire escapes, in rooms in homes, left on beds or stuffed into corners. So many people were ill that life in the city came to a virtual standstill. Each one of Philadelphia's five medical schools dismissed it's students. There were no doctors or nurses to treat the sick.
"The city was frozen with fear, frozen quite literally into stillness."In the remaining part of Explosion, Barry tells the story of the epidemic in the army cantonments.