A century after this piece of advice was offered during the Spanish flu outbreak, we’re still struggling with mask-wearing and other protection methods when a pandemic happens. Exploring the history of global outbreaks that have affected Canada shows that many of the solutions and public reactions over the past two centuries are, for better or for worse, still relevant.
As European colonization in North America grew, so did fear that ships carrying goods and migrants would also bring disease and pandemics. By 1721 New France had legislated a quarantine act to prepare for any outbreak. European illnesses which Indigenous peoples had no immunity to, such as smallpox, devastated their population during the 17th and 18th centuries.
Between 1832 and 1854, Canada experienced at least five major outbreaks of cholera. It initially arrived via crowded ships filled with British immigrants. With scarce supplies of food and drinking water, poor sanitation, and dirty bedding, passengers in steerage (the lowest class deck) had little resistance to the disease, which caused severe dehydration. Quarantine stations were set up, the most prominent being Grosse Ile in the St. Lawrence River near Quebec City. While medical inspectors removed those who were visibly ill, many slipped through the cracks, spreading illness to subsequent stops—within two months of its first appearance in 1832, cholera spread from Grosse Ile to York (modern day Toronto). Communities set up emergency quarantine sheds, where conditions weren’t much better than on ships, as the dead and the living lay side by side. Author Susanna Moodie compared the scenes she saw in quarantined areas to “cattle pens.” Overall, at least 20,000 people died from cholera.
Quarantines were debated by health officials and politicians during the Spanish Flu pandemic in fall 1918, which killed over 50,000 Canadians. Much of the advice provided sounds familiar as we cope with COVID-19: frequent hand washing, self-isolation at home if sick, closing non-essential businesses, wearing masks in public. Officials initially downplayed the seriousness of situation, hoping to avoid public panic, but drug stores soon experienced shortages of cold medications and lozenges. The few outlets allowed to sell alcohol saw long lines. In Toronto, Medical Officer of Health Dr. Charles Hastings recommended that anyone who lived within a mile of their work should walk in order to ease overcrowded streetcars and enjoy fresh air. Schools were closed, and teachers with nursing training were asked to fill in for sick nurses. The nature of the flu allowed it to cross class and income lines, uniting people in their suffering.
The respect normally given to the dead has often been another victim of pandemics. Mass graves were filled during cholera outbreak, especially by paupers—in some cases, historians are still determining exactly where bodies may be buried. During the Spanish Flu, undertakers were overwhelmed, having to find temporary storage space such as garages and vaults. Funerals became rushed affairs, as funeral homes and cemeteries tried to schedule services. These added to the mental health affects to families already dealing with the loss of relatives who fought in the First World War.
Pandemics offered a great opportunity to push useless remedies onto the public, a tradition echoed in some of Donald Trump’s questionable COVID-19 recommendations. Many were alcohol-based, which one supposes might provide temporary drunken relief if consumed in large quantities. Others were bizarre: during the 1832 cholera pandemic, newspapers published the claims of a man who showed up in Montreal promising “treatment” via a barely edible mixture of charcoal, lard, and maple sugar that usually induced vomiting. During the Spanish Flu, The Globe reported that Hastings advised the public “not to tamper with a healthy body, and leave all nostrums, gargles and washes alone, except under the direction of a qualified medical officer.” Newspapers were filled with ads ranging from cure-all tonics to useless air purification units.
Travel and large gatherings have also come into question. During the Spanish Flu, many health officials gave into demands to hold large public rallies for the Victory Loan campaign, or celebrations when the armistice ending the First World War was declared. In 2003, the World Health Organization issued an advisory recommending that non-essential travel to Toronto be avoided due to SARS.
Outbreaks also increase our fear of others, raising levels of racism and xenophobia. Residents of York refused to go to hospitals set up for cholera treatment due to wild rumours they heard about the criminal behaviour of attendants and people who were nearly buried alive. During the Spanish flu, there were reports in Toronto of female volunteer nurses whose landlords who refused to let them use communal telephones, even if their call was to request more supplies and assistance. During the 1980s, HIV/AIDS further stigmatized the queer community, as people imagined ways the virus could spread, making them afraid to touch victims. SARS increased racism against the Asian community, as the media described the illness in exotic terms, focused on the ethnicity of patients, and fixated on images of people wearing surgical masks, even if some of those images didn’t originate in Canada. The result was a rise in anti-Asian discrimination, from personal taunts to avoiding Asian-owned businesses.
Yet pandemics have also spurred governments to enact permanent public health measures, in order to prepare for future outbreaks. Cholera led to the formation of the first public health boards. The Spanish Flu was a key factor in the establishment of the federal health department. SARS prompted hospitals to improve their methods of infection control and led to the creation of the Public Health Agency of Canada. We are seeing signs that COVID-19 may lead to the improvement of conditions in senior care homes, and opened discussions concerning the health of low-income workers and minority communities.
The Silent Enemy
By Eileen Pettigrew
156 Pages. Western Producer Prairie Books, 1983.
By Susan Goldenberg
Pandemics in Canada
The Canadian Encyclopedia