The bishop’s name was Antonio Álvaro y Ballano, and at thirty-eight he already had a glittering career behind him. As a student at a seminary in Guadalajara, he had shone in every subject he had turned his hand to. At twenty-three he had taken up the chair in metaphysics, and after winning a hard-fought contest for the magistral canonry of Toledo, the most important archdiocese in Spain, he had come to the attention of Cardinal Sancha, Primate of Spain. He had been named a bishop in 1913, and prior to his arrival in Zamora, had held the post of prefect of studies at the seminary in Toledo.
In his inaugural letter to his new diocese, Álvaro y Ballano wrote that men should actively seek God and truth, which were the same thing, and expressed his surprise that science seemed to advance in step with a determination to turn away from God. The light of reason was weak, and ‘modern societies mistake… contempt for God’s law for progress’. He wrote of dark forces that wished to reject God ‘or even annihilate him if that were possible’. The letter was peppered with scientific allusions, from Newton’s law of universal gravitation to Ampère’s experiments with compasses and electricity, although in his hands these became metaphors for describing the human soul’s attraction to, or rejection of, God.8
The once-great Spanish Empire was at a low ebb. The Spanish–American War of 1898, el desastre colonial, had stripped it of its last imperial jewels–Puerto Rico, the Philippines, Guam, and the deepest cut of all, Cuba. It had contributed little to the great scientific and musical advances of the nineteenth century, and the golden age of Spanish literature was long behind it. Spanish society was still essentially agricultural, living conditions in some towns and cities were not so different from those that had prevailed in Europe at the time of the Black Death, and half the population was illiterate. ‘The Madrid Spaniards are not accustomed to machinery or to industrialization,’ observed the American writer and publisher Robert McAlmon. ‘They have skyscrapers but they are rickety; they have elevators but they seldom work and then inspire one with fear of a crash; they have flush water-closets but even in the first-class hotels they are often clogged and dirty. The Spaniard is not modernized.’9
When the Naples Soldier returned to Spain in the autumn of 1918, it appeared first in the east of the country, but it soon followed the bishop along the train tracks to Zamora. September is a month of gatherings in Spain. The crops are harvested, the army takes on new recruits, and weddings and religious feasts are held–not to mention that most popular of Spanish pastimes, the bullfight. Young army recruits, some from distant provinces, converged on Zamora to take part in routine artillery exercises, and in the middle of the month, the Correo reported nonchalantly that ‘There is cholera at the frontier, flu in Spain and in this tiny corner of the peninsula, fiestas.’ Then the recruits began to fall ill.
Attempts to quarantine the sick soldiers in barracks on the site of the city’s eleventh-century castle failed, and the number of civilian casualties began to rise. As it did so, the shortage of manpower began to interfere with the harvest, exacerbating pre-existing food restrictions. The press began to sound less sanguine. On 21 September, the Heraldo de Zamora–a newspaper that was nominally independent of the church–rued the unsanitary state of the city. Zamora resembled a ‘pigsty’ in which, shamefully, people still shared living space with animals, and many houses lacked their own lavatory or water supply. The paper repeated an old hobbyhorse, that the Moors had bequeathed to Spain an aversion to cleanliness. ‘There are Spaniards who only use soap for washing their clothes,’ it noted severely.
During the first wave of the pandemic, the country’s inspector general of health, Martín Salazar, had lamented the inability of a bureaucratic and underfunded health system to prevent the disease from spreading. Though provincial health committees took their lead from his directorate, they had no powers of enforcement, and they quickly came up against what he described as the ‘terrible ignorance’ of the populace–the failure to grasp, for example, that an infected person on the move would transmit the disease. Now that the Naples Soldier had returned, one national newspaper, El Liberal, called for a sanitary dictatorship–a containment programme imposed from the top down–and as the epidemic wore on, the call was picked up and echoed by other papers.
In Zamora, the two local newspapers did their best to dispel public ignorance. They tried, for example, to explain the concept of contagion. The flu ‘is always transmitted from a sick person to a healthy one’, the Correo told its readers. ‘It never develops spontaneously.’ Local doctors weighed in, but not always helpfully. One Dr Luis Ibarra suggested in print that the disease was the result of a build-up of impurities in the blood due to sexual incontinence–a variation on the medieval idea that immoderate lechery could trigger a humoral imbalance. The papers published instructions from the provincial health committee for minimising infection–notably by avoiding crowded places. Yet they seem to have shown a mental block–at least to modern, secular eyes–when it came to the activities of the church. In a single issue of the Correo, an article approving the provincial governor’s decision to prohibit large gatherings until further notice appeared alongside the times of upcoming Masses at the city’s churches.
The papers also accused the authorities of playing down the gravity of the outbreak, and of not doing enough to protect people. Of national politicians, the Correo wrote, ‘They have left us without an army, navy, bread or health… but nobody seems to resign or ask for resignation.’ Local politicians, for their part, had long ignored calls to fund an infectious-diseases hospital, and were now ignoring recommendations from the provincial committee to impose stricter hygiene on the city. When a failure at a nearby hydroelectric dam led to a blackout, the Correo remarked with heavy irony that, despite the darkness, the hunger of Zamoranos and the filth in which they lived was plain for all to see. The night was densest inside the town hall, it quipped, which continued to plough money into bullfights but not into hygiene or food for a hungry population.
On 30 September, Bishop Álvaro y Ballano defied the health authorities by ordering a novena–evening prayers on nine consecutive days–in honour of St Rocco, the patron saint of plague and pestilence, because the evil that had befallen Zamoranos was ‘due to our sins and ingratitude, for which the avenging arm of eternal justice has been brought down upon us’. On the first day of the novena, in the presence of the mayor and other notables, he dispensed Holy Communion to a large crowd at the Church of San Esteban. At another church, the congregation was asked to adore relics of St Rocco, which meant lining up to kiss them.
Also on 30 September, it was reported that Sister Dositea Andrés of the Servants of Mary had died while tending soldiers at the barracks. Sister Dositea was described as a ‘virtuous and exemplary nun’ who had accepted her martyrdom with equanimity and even enthusiasm, who had slept no more than four hours a day, and who had spent much of her time coaxing sick soldiers to eat. The Mother Superior of her order asked for a good turnout at her funeral, and the papers passed on her request. In accordance with tradition, readers were informed, the bishop would grant sixty days’ indulgence to those who complied. Apparently the turnout was not as good as the Mother Superior had hoped, because the day after the funeral the Correo lambasted the citizenry for its ingratitude. The bishop, on the other hand, was satisfied with attendance at the novena, which he described as ‘one of the most significant victories Catholicism has obtained’.
As the autumn wave neared its peak, fear and frustration threatened to spill over into unrest. Milk, which was being recommended by doctors to speed recovery, ran short and prices rocketed. Local journalists noticed that Zamoranos seemed to be dying in higher numbers than the residents of other provincial capitals, and they told their readers as much. They also returned again and again to the pitiful hygiene situation in the city. Residents simply threw their rubbish into the street, for example, and nobody seemed to care.
In October, the longed-for sanitary dictatorship came into effect. The authorities coul
d now force businesses to close if they failed to meet sanitary requirements, and fine citizens who, for example, didn’t keep their chickens cooped up. The provincial health committee threatened the city fathers with large fines for their laxity in recording flu deaths. But daily Masses continued to be held throughout that month–the worst of the epidemic–and the congregrations only grew as terrorised Zamoranos sought respite in the churches. The prayer Pro tempore pestilentia, which acknowledges that the affliction is God’s will and that only His mercy will end it, echoed around their romanesque walls.
Despondency set in. There was a feeling that the horror would never cease, that the disease had become endemic. In a letter circulated on 20 October, Bishop Álvaro y Ballano wrote that science had proved itself impotent: ‘Observing in their troubles that there is no protection or relief to be found on the earth, the people distance themselves, disenchanted, and turn their eyes instead toward heaven.’ Four days later, a procession was held in honour of the Virgin of the Transit. People flooded into the city from the surrounding countryside, and the cathedral was packed. ‘One word from the bishop was enough to fill the streets with people,’ one paper reported. When the provincial authorities tried to use their new powers to enforce the prohibition on mass gatherings, the bishop accused them of interfering in church affairs.
As in other towns and villages, a decision was taken to stop ringing the church bells in eulogy of the dead, in case the constant tolling frightened people. But in other places, funeral processions had also been banned. Not in Zamora, where mourners continued to pass through the narrow streets as the din of the bells gave way to silence. Even in normal times, coffins–white ones for children–were a luxury beyond the means of most. Now, wood for coffins was hard for anyone to come by, and the bloated, blackened remains of the deceased were transported to their final resting place draped only in a shroud. In an echo of the ritual burning of incense to purify the altar, gunpowder was sprinkled in the streets and set alight. An approaching funeral cortège could thus be perceived only dimly through choking black smoke, mixed at times with the fog that rose from the Duero in those cool autumn days. ‘The town must have looked as if it were on fire,’ one historian observed.10
By mid-November, the worst was over. The bishop wrote to his flock attributing the passing of the epidemic to God’s mercy. While expressing his sorrow for the lives that had been lost, he praised those who, through their attendance at the many novenas and Masses, had placated ‘God’s legitimate anger’, and the priests who had lost their lives in the service of others. He also wrote that he felt comforted by the docility with which even the most lukewarm believers had received the last rites.11
The epidemic was not over when the bishop wrote his letter. There would be a reprise–milder than the autumn wave–the following spring. The journalists had been right: Zamora had suffered worse than any other Spanish city. But its residents do not seem to have held their bishop responsible. Perhaps it helped that they had grown up with the legend of Atilano, the first Bishop of Zamora, who in the tenth century had made a pilgrimage to the Holy Land to repent of his sins and free his city of plague. There are even those who defend Álvaro y Ballano, claiming that he did what he could to console his flock in the face of inertia at the town hall, the real problem being an ineffectual health system and poor education in matters of hygiene. Before 1919 was out, the city had awarded him the Cross of Beneficence, in recognition of his heroic efforts to end the suffering of its citizens during the epidemic, and he remained Bishop of Zamora until his death in 1927.
PART FOUR: The Survival Instinct
Royal S. Copeland and son, Washington DC, 1924
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Chalking doors with crosses
Cordon sanitaire. Isolation. Quarantine. These are age-old concepts that human beings have been putting into practice since long before they understood the nature of the agents of contagion, long before they even considered epidemics to be acts of God. In fact, we may have had strategies for distancing ourselves from sources of infection since before we were strictly human.
Reading descriptions of the symptoms of the Spanish flu in these pages, you may have been aware of your own physical reaction of disgust. For a long time, scientists thought disgust was uniquely human, but they have come to regard it as a basic survival mechanism that occurs across the animal kingdom.1 We avoid things we find disgusting, and such avoidance reactions have been observed in many species when contagion is a threat. The Caribbean spiny lobster, Panulirus argus, is highly sociable by nature, but it refuses to share a den with another lobster that is infected with a lethal virus. Chimpanzee troops steer clear of each other in the wild, not only to avoid unneighbourly disputes, but probably also to avoid contagion, while sick badgers in captivity have been observed anticipating a disgust response–or appearing to–by retreating to their tunnels and blocking them up with earth.
A sense of disgust, in this very basic sense of the term, may also be what drives animals to dispose hygienically of their dead. Honeybees scrupulously drag dead co-workers out of the hive, and elephants won’t pass by a deceased one of their kind without covering it in branches and earth. Elephant-watcher Cynthia Moss tells how, after a cull in a park in Uganda, wardens collected the animals’ lopped-off ears and feet in a shed, with the intention of selling them later for handbags and umbrella stands. One night, some elephants broke into the shed and buried the feet and ears.2 The consensus among scholars is that humans started burying their dead systematically when they came together in the first settlements. Before that, they had left them exposed to the elements, and moved on.
Like chimps, human groups have probably been avoiding each other’s germs for millennia, but as they became more sedentary, they were forced to come up with new strategies for keeping infection out. The much-feared sanitary cordon, in which a line is drawn around an infected area and no one is allowed out–sometimes on pain of death–is effective but brutal. In the seventeenth century, the English village of Eyam in Derbyshire erected a cordon around itself, once it knew it was infected with plague. By the time it was lifted, half the villagers were dead, but the infection had not spread. In the next century, the Habsburgs erected a cordon from the Danube to the Balkans, to keep infected easterners out of western Europe. Complete with watchtowers and checkpoints, it was patrolled by armed peasants who directed those suspected of infection to quarantine stations built along its length. Sanitary cordons fell out of favour in the twentieth century, but the concept was revived in 2014, during the Ebola epidemic in West Africa, when three affected countries erected one around the region where their borders met, believing this to be the source of the infection.
Another approach to containing disease is to forcibly isolate the sick or individuals suspected of infection in their own homes. This can work, but it is costly in terms of policing. More efficient, logistically speaking, is to round those individuals up in a designated space and keep them there for longer than the period of infectivity. Quarantine was invented by the Venetians in the fifteenth century, when they forced ships arriving from the Levant to sit at anchor for forty days–a quarantena–before they allowed those on board to land. The concept is much older, though. ‘If the shiny spot on the skin is white but does not appear to be more than skin deep and the hair in it has not turned white, the priest is to isolate the affected person for seven days,’ states the Bible (Leviticus 13:4–5). ‘On the seventh day the priest is to examine them, and if he sees that the sore is unchanged and has not spread in the skin, he is to isolate them for another seven days.’
In the days before trains and planes, when most long-distance voyages were completed by sea, ports were the usual entry points for disease, and ‘lazarettos’ or quarantine hospitals were built either close to the docks or on offshore islands. They often resembled prisons, both in their architecture and in the way they treated their ‘inmates’, but by the nineteenth century enterprising merchants had realised that those inmates represented a
captive market, and in some cities, they negotiated with the authorities to lay on restaurants, casinos and other forms of entertainment–all, of course, at elevated prices (today, many former lazarettos have become high-class hotels, so arguably not much has changed).
By the twentieth century, the problem of disease containment had become more complex. Infection didn’t always arrive by sea, and the populations of the largest cities numbered in the millions. Their inhabitants not only did not know each other, beyond their own limited social networks, but they did not necessarily speak the same language or share the same beliefs either. In these modern cities, anti-infection measures had to be imposed from the top down, by a central authority. To pull this off, the authority required three things: the ability to identify cases in a timely fashion, and so determine the infection’s direction of travel; an understanding of how the disease spread (by water? air? insect vector?), and hence the measures that were likely to block it; and some means of ensuring compliance with those measures.
When all three of these ingredients–which we’ll describe in more detail in the following sections–were in place, containment could be extremely effective, but a hat-trick was rare. Often one or more were missing, meaning that an authority’s efforts were only partially effective or ineffective. During the 1918 flu pandemic, all possible permutations were observed. We’ll go on to explore two in particular–in New York City, and in the city of Mashed in Persia. In neither place was flu reportable at the beginning of the pandemic, but that is where the resemblance between them ends. Though more factors shaped their experiences of the flu besides their efforts to contain it, the contrast in the impact the epidemic had in the two cities was striking: the death rate from flu in Mashed was approximately ten times that in New York City.
Pale Rider: The Spanish Flu of 1918 and How It Changed the World Page 8
