Because influenza tended to strike cities very hard, Pennsylvania was one of the hardest hit states in the country.

In late September, state officials were optimistic about the situation. At the time, there were “comparatively few cases" among the state's residents. A few cases had occurred at Hog Island and some had occurred in Pittsburgh but officials saw no need for concern at that point. Within a week, however, state officials were forced to adopt a different tack. Influenza now raced through the state's large cities, reaching epidemic proportions in Philadelphia and Pittsburgh by October 4th. On October 11th, the Public Health Service reported that “the disease is said to be especially prevalent in the industrial districts of Philadelphia and vicinity, in the Lehigh Valley anthracite region and in scattering sections of the bituminous coal fields.” On October 18th, state officials reported that “6,081 deaths from influenza and 2,651 deaths from pneumonia had been registered in Pennsylvania. The greater number of these deaths occurred in Philadelphia.” Grim as these numbers were, they were probably inaccurate: overwhelmed by record numbers of deaths, state officials often under-reported the death toll.

By October 25th, official estimates claimed that there were 350,000 cases in the state, 150,000 of which were in Philadelphia alone. By November 1st, state officials resumed some of their former optimism, noting that “a rapid decline in the number of deaths has taken place in Philadelphia.” The disease probably have peaked in the state during the week of October 16th. In Philadelphia, over seven hundred city residents had died on that day alone. This was more than had died on any previous day in the city’s history; even the infamous yellow fever epidemic of 1793 had caused fewer deaths.

c1910. The entrance to Forbes Field, Pittsburgh, Pennsylvania. At the height of the pandemic, public gatherings were limited or banned altogether in many cities. [Credit: The Library of Congress]

In Pittsburgh, the crest of the pandemic lagged three weeks behind Philadelphia and the rest of the state. Faced with a mounting death toll, the city suffered from a shortage of coffins. The situation was not helped when the Washington DC Health Officer seized two railways cars as they passed through his city. The cars were loaded with coffins intended for Pittsburgh. Sarah McCollough Cowles, the great aunt of writer David McCollough was one of the approximately 50,000 cases in Pittsburgh. She died of influenza.

In Wilkes-Barre, the city's armory became an emergency hospital. Gertrude Williamson, who was placed in charge of a Red Cross Emergency hospital, worked at the armory “sending out food, broths mostly, to over 150 families daily who, because of the flu had no one well enough to prepare their meals.”

In Philadelphia, Dr. Wilmer Krusen, Director of the Department of Health and Charities warned against “fright or panic.” On October 3rd city officials closed all schools, churches, theaters and places of amusement. As the situation worsened, an emergency telephone switchboard was established at Strawbridge and Clothier Department Store, one of the city's largest stores. Firemen, garbage collectors, policemen, and city administrators all fell ill. The city’s only morgue overflowed. Designed to handle thirty-six bodies, it had over five hundred. Stacked in the hallways of the morgue, bodies rotted. To ease the pressure on the city's morgue, convicts were ordered to dig graves. But even this failed to solve the problem, and desperate city officials opened five supplementary morgues.

Days after Philadelphia’s Liberty Loan parade in September 1918, which was attended by 200,000 people, hundreds of cases of influenza were reported. [Credit: Naval Historical Center]

Selma Epp, who was a child during the pandemic, remembered that her family “made up their own remedies, like castor oil [and] laxatives...everyone in our house grew weaker and weaker. Then my brother Daniel died. My aunt saw the horse-drawn wagon coming down the street. The strongest person in our family carried Daniel’s body to the sidewalk. Everyone was too weak to protest. There were no coffins in the wagon, just bodies piled on top of each other. Daniel was two; he was just a little boy. They put his body on the wagon and took him away.”

Harriet Ferrel, another Philadephian, remembered how she, her father, brother, sister, aunt, uncle, and cousin were all ill with influenza. The only healthy member of the family was her mother who nursed them all. Ferrel's life was in danger: “Our family doctor...told my mother she didn’t need to feed me anymore, because I wasn’t going to live. He said if I did live, I would be blind.” Ferrel recovered.

On October 27th, the health authorities lifted the ban on public gatherings. According to The Philadelphia Inquirer, “we have passed through a most dismal period, the gloom of which will be lifted by the reopening of places of amusement.”

Financially, the city and its businesses had suffered tremendously from the ban. The city's streetcar company had lost $250,000 when they were forced to close. Overall, city officials estimated that the ban on “places of amusement” had resulted in a net loss of $2.5 million in potential revenue.

While the situation improved after October, influenza did not disappear from the state until the summer of 1919.