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Influenza Encyclopedia

The American Influenza Epidemic of 1918-1919:

A Digital Encyclopedia

Buffalo, New York

50 U.S. Cities & Their Stories

On September 20, with reports of an influenza epidemic raging at the nearby Niagara-on-the-Lake military facility and news of the disease’s spread throughout the Northeast, Buffalo’s Acting Health Commissioner Dr. Franklin C. Gram (appointed in April when Health Commissioner Dr. Francis Fronczak was commissioned in the Army) asked city physicians to report to the Health Department any and all cases of influenza they encountered. Health Commissioner Gram’s goal was not only to get accurate statistics on the disease in his city, but also to isolate and quarantine all cases and contacts. Thus far, there were no official reports of influenza in Buffalo, but the Health Commissioner expected that to change shortly. He told the public that influenza was a serious disease, and that symptoms should not be dismissed even if mild. To drive the point home, he called influenza a disease as contagious as measles, a malady with which most families had more familiarity.1 Ten days later, Buffalo physicians had reported fifty cases in the city.2 Gram braced himself for the onslaught he knew was coming.

On October 7, as Buffalo’s epidemic began accelerating, city officials created a special sub-committee to lead the anti-influenza campaign. The committee included Health Commissioner Gram, Mayor George Buck, Chief of Police Henry Girvin, Secretary of the Chamber of Commerce George Lehman, and City Council President Henry D. Miles, and met with representatives from the school system, Fort Porter, the Buffalo Medical Society, industrial plants, retail shops, theaters, and movie houses. Together, the group decided that a sweeping closure order might be necessary in the coming days if Buffalo’s influenza situation did not improve drastically. Theater and movie house owners, not surprisingly, suggested that their venues be kept open and used for “preventative propaganda” to educate the public. A representative of Buffalo’s school system stated that schools would close only in a case of extreme necessity, but likewise offered the schools as places from which to disseminate public health information. To help limit the spread of influenza, the sub-committee recommended to the city council that outsiders be barred from attending public gatherings in Buffalo. For the time being, however, Buffalo residents were free to go about their lives uninterrupted.3

That freedom did not last long. On October 10, acting on the strong recommendation of Health Commissioner Gram and under emergency authority granted him by the city council, Mayor Buck ordered closed all schools, churches, saloons, movie houses and theaters, pool halls, five-and-ten stores (quickly removed from the list after owners protested), ice cream parlors and soda shops, and barred all indoor gatherings and meetings of any sort effective at 5:00 am the next morning.4 Buffalo’s streetcar strike precluded the need for the ventilation or passenger restrictions used in other cities. The Health Department divided the city into 21 separate districts, each with its own health inspector in charge of enforcing the order. The move came just as Buffalo was experiencing a sharp rise in new cases; nearly 700 were reported the day Mayor Buck issued the order, more than double the figure for the previous day. Residents ill with influenza were told they had to remain in their homes under isolation. Non-ill family members, however, were free to come and go as they pleased. The hope was that these measures would bring the epidemic under control and forestall the need to extend the order to include industrial plants and commercial businesses.5

Movie house and theater owners, knowing that box office returns would be down until the epidemic was brought under control, supported the closure order. Saloons owners and brewers, on the other hand, protested, claiming that saloons did not tend to draw large crowds and that the closure order would put them out of business. Health Commissioner Gram deftly responded by cutting off their main source of complaint. “I am going to appeal to your manhood and not to your pocketbooks,” he told the liquor interest, “because I know that if it came to losing a member of your family by death or your money you would give up every dollar to save life.” Saloons and brewers immediately agreed to support the closure order.6

Several other groups balked at the order as well, and sought special dispensations from the Health Department. Christian Science churches requested exemption from the closure order, which Health Commissioner Gram promptly declined. Similarly, the Erie County Medical Society asked that, as physicians, they still be allowed to hold their regular meetings. Gram rejected this request as well, stating that doctors would be given no special privileges. Medical society members could still meet, however, at the October 12 conference on influenza control in Buffalo’s factories, where all city physicians were welcome. As for Christian Scientists, technically they were still allowed to hold open-air services, as nearly every other city church and synagogue had planned for the upcoming weekend, despite Gram’s recommendation that they not. In the end, however, Buffalo’s clergy heeded the Health Commissioner’s warning and canceled their outdoor services.7

Meanwhile, Buffalo’s epidemic had grown severe. Over 1,700 new cases were reported on the first day of the closure order, with 53 new deaths. Casket makers could not keep up with demand; their usual capacity was thirty per day, but the number of epidemic deaths alone far surpassed that. Hospitals similarly were overwhelmed with patients and in desperate need for physicians and nurses. Gram did his best to alleviate the situation. He ordered the department of sanitation to begin producing caskets. These would be sold to families that could afford them and given to the poor for free. He sent word to the adjutant general at Albany asking that physicians serving on state draft boards be sent to Buffalo to help. He asked city physicians to volunteer to care for patients free of charge and to be reimbursed by the Health Department. He requested Red Cross nurses serving at Fort Niagara return to Buffalo, and for all retired and practical nurses to lend their services. The old Central High School building was quickly converted into a 1,000-bed emergency hospital. Last but not least, Gram announced that no one exposed to influenza or showing symptoms of the disease would be allowed to leave Buffalo or to enter the city from outside, especially from Canada. Along with recommending that residents use influenza masks while in public and enforcing the closure order, it was all Gram could do.8

Over the course of the next two weeks, Buffalo’s epidemic crested, with over 22,000 cases and nearly 1,800 deaths reported for October.9 But the city was finally on the road to recovery. By the end of the month, new case tallies began to drop. On October 28, Gram announced that he was anxious to lift the closure order and gathering ban, but would wait to see how the how the end of streetcar strike and the resumption of service would affect the epidemic.10 After waiting a few days to make sure that the epidemic would not spike again, Mayor Buck issued a proclamation to rescind Buffalo’s closure orders effective at 5:00 am on Friday, November 1. Schools remained closed until Wednesday, November 6 in order to give teachers–many of whom had volunteered for the city’s door-to-door influenza canvassing efforts–a few days break and to disinfect and ventilate classrooms.11

On November 3, the influenza advisory panel officially declared that Buffalo’s epidemic had ended. For the first time since the start of the crisis, Municipal and City hospitals were clear of influenza and pneumonia cases, having moved their patients to the Central High emergency hospital.12 Some argued for keeping Central High as an emergency hospital even after the last of the influenza victims had convalesced and been discharged. Opponents noted that the building was located between two sets of streetcar tracks, making it a rather noisy and unpleasant place to recuperate. Besides, the building was owned by the Board of Education, not the Health Department, and was needed for schooling Buffalo’s teenagers. Even Gram, who had advocated for its use as an emergency hospital, believed that the Central High building better served the city as a school than as a health care facility.13 After reviewing the situation and considering the future needs of Buffalo, the city council decided to allow Central High to return to duty as a school building when the last of the influenza patients had recovered.14

By the time Thanksgiving rolled around, Buffalo was in the clear, despite new influenza cases still being reported each day. December, however, saw a small surge in the epidemic, with as many as 138 new cases being reported on a single day (December 21).15 The situation continued to grow more severe by mid-January, when upwards of 300 new cases per day were being reported by city physicians.16 Suddenly, Health Commissioner Gram fell ill. Immediately his temporary replacement, Dr. George Staniland, ordered the clerk in charge of calling in the daily influenza case tallies to the newspapers to stop doing so; from now on, newspapers would have to call the Health Department for that information. Staniland claimed the reason for the change in policy was because the case numbers were so low that it would be of “no use to ask you [newspapers] to publish them any longer.” The Secretary of the Board of Health had a different take: Staniland did not want to panic the public with the spike in cases, and so ordered that the daily count not be revealed until after 11:00 pm, when the morning edition papers went to press.17

Over the course of the next few weeks, the epidemic subsided completely and life in Buffalo returned to normal. The epidemic had been costly, both in lives and in dollars. The city spent approximately $75,000 in its battle with influenza, most of which went to hospital patient care. Between the start of the epidemic in September 1918 and the end of the year, 28,398 official cases of influenza were reported in Buffalo. Of this, nine percent (some 2,561) died of pneumonia or other influenza complications.18 The total excess death rate attributed to the epidemic was 530 deaths per 100,000 people, a figure similar to that of other Eastern cities.

Notes

1 “City Girds Self to Fight Dread Spanish Grippe,” Buffalo Courier, 21 Sept. 1918, 5.

2 “Much Sickness in Buffalo Now Just Plain Grip,” Buffalo Courier, 30 Sept. 1918, 5.

3 “Spanish Flu Gaining Here, Officials Talk of Closing Schools, Theaters, Churches,” Buffalo Courier, 8 Oct. 1918, 4.

4 Annual Report of the Department of Health, Buffalo, NY, for the Year Ending December 31, 1918 (Buffalo: 1919), 19-21. The closure order and gathering ban were actually issued as two separate, back-to-back orders when it became clear that clarification and extension of the original closure order would be necessary to enforce further social distancing measures.

5 “City Closes Today to Fight Influenza which is Spreading,” Buffalo Courier, 11 Oct. 1918, 1; “1,237 New Flu Cases; Close More Places; Urge Masks on All,” Buffalo Courier, 12 Oct. 1918, 5.

6 “Proclamation,” Buffalo Courier, 11 Oct. 1918, 1.

7 “1,237 New Flu Cases; Close More Places; Urge Masks on All,” Buffalo Courier, 12 Oct. 1918, 5; “Church Plan Open-Air Services for Tomorrow,” Buffalo Courier, 12 Oct. 1918, 4.

8 “1,726 New Cases, 53 Deaths in 24 Hours; Not Enough Doctors,” Buffalo Courier, 13 Oct. 1918, 43; “1,237 New Flu Cases; Close More Places; Urge Masks on All,” Buffalo Courier, 12 Oct. 1918, 5; “83 Die in Day; 1,717 New Cases,” Buffalo Courier, 17 Oct. 1918, 1.

9 “New Flu Cases Drop to 569 for Day; 1010 Deaths,” Buffalo Courier, 26 Oct. 1918, 5.

10 “Only 66 Deaths and 268 New Flu Cases Yesterday,” Buffalo Courier, 28 Oct. 1918, 4.

11 “Buffalo Free of Flu Ban Today,” Buffalo Courier, 1 Nov. 1918, 15.

12 “Committee Calls Flu Epidemic at End in Buffalo,” Buffalo Courier, 4 Nov. 1918, 5; “Remove All Flu Cases to Central High Hospital,” Buffalo Courier, 3 Nov. 1918, 5.

13 “Health Dept. Wants to Retain Old High School as Hospital,” Buffalo Courier, 21 Nov. 1918, 6; “Hartwell Opposes Using Old Central High as Hospital,” Buffalo Courier, 24 Nov. 1918, 53; “Dr. Gram Would Give up Hospital in ‘Old Central,’” Buffalo Courier, 25 Nov. 1918, 4.

14 “Old C.H.S. Returns to School Dept. at End of Flu Danger,” Buffalo Courier, 29 Nov. 1918, 4.

15 “Influenza Shows Increase; 138 New Cases in 24 Hours,” Buffalo Courier, 22 Dec. 1918, 3.

16 See, for example, “288 Flu Cases in 24 Hours, Record Since Epidemic,” Buffalo Courier, 14 Jan. 1919, 12; “Flu Jumps to 319 Cases in 24 Hours,” Buffalo Courier, 15 Jan. 1919, 12.

17 “128 New Flu Cases, 17 Deaths, in Day,” Buffalo Courier, 18 Jan. 1919, 10.

18 Annual Report of the Department of Health, Buffalo, NY, for the Year Ending December 31, 1918 (Buffalo: 1919), 18.

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Main Street, Buffalo. Click on image for gallery. Main Street, Buffalo.
Niagara Square, with the old Central High School on the left, used as an emergency hospital during the epidemic. Click on image for gallery. Niagara Square, with the old Central High School on the left, used as an emergency hospital during the epidemic.
Map of Buffalo. Click on image for gallery. Map of Buffalo.
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Buffalo, New York

Timeline of Events

Excess Death Rate (per 100,000) Daily EventsClick day to view details. Selected Event
graphNational
200Excess Death Rate (per 100,000)
180 
160 
140 
120 
100 
80 
60 
40 
20 
0 
Total Excess Death Rate 530
Total Deaths per 100,000 population over duration of epidemic (roughly 1918 September 14 through 1919 February 22).
 19181919
 AugustSeptemberOctoberNovemberDecemberJanuaryFebruaryMarchApril
Sa273101724317142128512192629162330714212841118251815221815222951219
Fr2629162330613202741118251815222961320273101724317142128714212841118
Th2518152229512192631017243171421285121926291623306132027613202731017
We243171421284111825291623306132027411182518152229512192651219262916
Tu2330613202731017241815222951219263101724317142128411182541118251815
Mo2229512192629162330714212841118252916233061320273101724310162431714
Su21284111825181522296132027310172418152229512192629162329152330613

September 21, 1918

Health Commissioner Dr. Franklin C. Gram asks all physicians to report cases of influenza to the Health Department. These cases will then be quarantined in the hopes preventing the disease’s entry into the city. While no cases have been reported in the city, an outbreak is underway at Camp Niagara, some 30 miles north of Buffalo.

United States Marine Hospital head surgeon meets with Health Commissioner Gram to talk about how to begin a “preventive campaign against the malady.”

September 23, 1918

Health Commissioner Gram has been consulting “scientific sources,” such as the Rockefeller Institute, about the illness, and has also requested information from the public health service in Washington. He warns the public that flu-like symptoms, which seem mild, should not be viewed as “trivial.”

The state of Massachusetts requests nurses from Buffalo to help with Boston’s influenza outbreak. Health Commissioner Gram says that he does not think it is reasonable for the nurses to go there, since influenza is “short-lived if treated properly from the start and also provided that pneumonia does not set in. If properly cared for the patient should not get pneumonia.”

September 24, 1918

Several cases of influenza are reported at the Chenango Street barracks, forcing a quarantine of the approximately 400 men stationed there. Six or seven of the men are sent to the Homeopathic Hospital for treatment. Health Commissioner Gram says he only knows of three cases in the city: one each in the northern, central, and eastern sections of the city. He calls for doctors to let him know of all cases, believing prompt action can prevent an epidemic.

September 27, 1918

Health Commissioner Gram has met with physicians cooperating with the Health Department to control the spread of influenza. Physicians included Dr. William G. Bissell, director of laboratories; Dr. W.S. Goodale, Superintendent of hospitals and dispensaries; Dr. Dewitt Sherman, special diagnostician for the department and responsible for positive diagnoses; Dr. George S. Staniland, of the board of hospitals; and Dr. F.B. Willard, medical sanitary inspector of the department. Following the meeting the group releases a statement detailing the salient features of what is known about the disease, including how to recognize potential signs and symptoms, and how to safeguard against contracting the illness.

September 30, 1918

Health Commissioner Gram announces there are now 50 cases in the city. He requests for all physicians to contact the city laboratory for help related to the lab work on known cases.

Later in the evening, Gram announces the discovery of 6 new cases.

October 1, 1918

Health Commissioner Gram announces that the bureau of laboratories of the Buffalo Health Department has “designed an outfit” for any doctor or medical authority to use “on suspicious cases of influenza, or even where the diagnosis does not seem to be in doubt.” When pneumonia is present, the pneumonia outfit should be used, and sputum samples should be taken.

October 7, 1918

Health Commissioner Gram calls a meeting to discuss reports showing New York, Philadelphia, Boston, Washington, Albany, and Syracuse to be hit by the influenza epidemic.

October 8, 1918

A special sub-committee is formed to work with the Health Department to prevent an epidemic and finds closures of schools, theaters, churches, factories, and public places may be necessary. After meeting with representatives of theaters, industry, and churches it is decided that a one-week educational campaign will encourage people toward voluntary quarantine.

Health Commissioner Gram announces that 500–1,000 people have influenza or a related sickness.

The hospital at Fort Porter reports 44 cases of influenza.

President of the Department of Hospitals Board of Managers Dr. Edward J. Meyer and Superintendent of city hospitals Dr. Walter S. Goodale arrange for the Municipal hospital to accommodate 100 influenza patients.

October 9, 1918

The Health Department receives $25,000 to finance a preventative campaign.

The newly formed sub-committee adopts a resolution that “outsiders” especially from areas with influenza, will not be allowed to attend public gatherings.

All doctors will be required to report influenza, bronchopneumonia, pneumonia, and lobar pneumonia cases, as well as combination cases of influenza and bronchopneumonia.

At a meeting of the big industries at the Larkin Men’s club it is decided to form an organization to work with the Health Department, called the Industrial Physicians and Surgeons Association of Buffalo. Elected President is Dr. Chester T. Stewart of the Curtiss Aeroplane and Motor Corporation.

October 10, 1918

Precautions against public funerals are issued, and burials of influenza cases are to be carried out within 24 hours of death.

Dr. William G. Bissell, City Bacteriologist, and Dr. Meyer, President of the Board of Managers of the Hospital Department call for the closing of Buffalo schools.

Health Commissioner Gram instructs hospitals to open their wards to influenza patients. One hospital refuses.

On the recommendation of the Health Commissioner, Mayor George S. Buck may issue a closing ban against public gatherings when he feels it is appropriate.

October 11, 1918

Upon the recommendation of the Health Department and the sub-committee on influenza, at 5 pm Mayor Buck closes schools, churches, show places, saloons, and indoor gatherings of every sort until further notice.

Furthermore, those infected with influenza will remain quarantined in their homes, but healthy family members may leave the house. Public library reading rooms are also to be closed. Books may still be checked out, but must be held for 48 hours before being lent out again. A new anti-spitting ordinance is enacted, and will be enforced “rigidly” by Police Chief Henry J. Girvin.

October 12, 1918

Health Commissioner Gram forbids meetings of more than ten persons and urges people to wear protective masks. Members of the Health Department begin publicly wearing masks to set a good example. Police, firefighters, and postal workers are requested to follow suit, and Major Brownrigg of Fort Porter requires medical staff there to do the same.

Mayor Buck extends the closing order to department stores, five-and-dime stores, poolrooms, bowling alleys, ice cream fountains, and swimming pools. Exceptions to the closing order include governmental meetings, military gatherings, and meetings related to the Liberty Loan campaign. The council of the University of Buffalo decides to halt instruction.

After casket dealers inform Health Commissioner Gram of a casket shortage, Gram announces that the Health Department will manufacture coffins. Gram indicates that these coffins will be sold at cost to those able to afford it, and given freely to the poor.

Sneezing becomes a misdemeanor in New York state, punishable by a $500 fine, one year in jail, or both.

A conference of all industrial physicians of Buffalo is held at 8:30 pm at the Larkin Men’s Club. The goal is to “arrive at uniform and cooperating methods of controlling the epidemic through factories.” All physicians are requested to attend. City bacteriologist, Dr. William G. Bissell, will talk about prevention/treatment of influenza.

540 beds are available in city hospitals for influenza cases.

October 13, 1918

Superintendent of the Medical and Dispensary Departments of the city hospitals Dr. John F. Ryan succumbs to influenza. He is the first member of the hospital staff to die, and contracted the disease while taking care of patients.

Health Commissioner Gram instructs school and tuberculosis nurses to help out at local hospitals. Red Cross nurses at Fort Niagara are called back to Buffalo. All retired or otherwise not working nurses are asked to lend a hand. Nine city doctors are organized to care for patients, compliments of the city. Gram issues instructions to hospitals including the following: no visitors, unless the condition of a patient is critical; only emergency operations should be performed; nurses should wear masks and spray their noses/throats with oil solution; hospitals should set aside space for influenza cases.

Gram advocates against outdoor church services scheduled to take place today, and many churches cancel their outdoor services.

The Liberty Loan parade and all Columbus Day celebrations are cancelled. All playgrounds are closed.

Police Chief Girvin orders all police to wear masks.

October 14

Adjutant General Hutchinson acquiesces to Health Commissioner Gram’s request for draft board physicians to stop physical exams in order to help with the epidemic.

Gram closes public baths, including swimming pools and public tub baths. He also declares: “no one is allowed to leave Buffalo or to come here who has been exposed to epidemic influenza, or who shows any signs of having it.”

The Health Department begins giving away thousands of masks to the public.

49 out of 910 men in the police department and 30 out of around 940 men in the fire department are reported sick with influenza.

October 15, 1918

Major A. E. Brownrigg of Fort Porter says that Buffalo’s numbers of cases and deaths were much better than elsewhere in the country. Dr. Edward Clark from the State Department of Health commends Health Commissioner Gram on his handling of the epidemic.

The Health Department issues the following statement regarding masks: “Persons failing to mask who contract influenza can lay blame on their own careless or stupidity. It is an effective means of prevention. New cases soon would cease if all wore masks.” One Buffalo plant is producing masks at a rate of 20,000/day. Many factories, businesses, and hospitals are requiring their employees to wear masks.

Churches are closed for the first time in the city’s history.

After cemetery associations inform Gram that graves cannot be dug fast enough to keep up with demand, Gram looks into getting help from prisoners.

October 16, 1918

Health Commissioner Gram and his subordinates in the Health Department test a new vaccine produced at the army camp on themselves.

The Brewers’ exchange is notified of 68 saloonkeepers that may be violating the order; the exchange sets about trying to contact those individuals. Several arrests of those violating the saloon closing order have been made throughout the city.

October 17, 1918

Hospitals report they are at capacity, and there is a shortage of nurses and doctors. Plans are announced to turn the old Central High school building into an emergency hospital by tomorrow morning. The senior medical class at the University of Buffalo is assigned to hospital work.

The Health Department declares that Buffalo will be mapped by schools, with the principal of each school heading up a campaign to survey influenza conditions. Teachers will go house-to-house to the homes of their students, and list ill household members. After the Health Department receives these lists, they will assign the necessary number of doctors/nurses to each area.

A Home Relief corps, led by Mrs. Anna Fox of the Red Cross, is given the green light to organize. This corps will look for homes where parents have become ill and children are alone or only with one parent, and send them to temporary homes, as well as monitor the status of these sick parents.

Health Commissioner Gram issues orders to barber shops, hotels, and restaurants to mask employees under penalty of closure.

October 18, 1918

Health Commissioner Gram gives Dr. DeWitt H. Sherman responsibility for all children sick with influenza, and also for children who are healthy, but homeless. The Truant school building will be made a home for these children.

Mayor George S. Buck and city councilmen, meeting with Gram, give him “full authority to deal with the epidemic.”

Following the senior class, the junior, and sophomore classes at the University of Buffalo are drafted to work in the hospitals. New wards are opened in the Children’s hospital, though by night they are nearly full.

Judge Noonan, in city court, convicts three saloonkeepers of violating the closing order.

October 19, 1918

The Truant school will no longer be used for healthy, homeless children; instead, the Watson house is offered. The Children’s Aid Society building will be used for children who have been exposed to influenza, but whose parents are dead or sick, so that they can be taken care of until they recover.

Health Commissioner Gram issues an order for sick individuals to be removed from homes and taken to hospitals.

According to City Bacteriologist Dr. William G. Bissell there will be vaccine available by Monday, and it will be provided for free to doctors who would like to use it.

The teachers’ citywide survey is presented to the Health Department. It shows “that the disease is not going beyond all bounds as it has in other cities.”

Judge Hazel extends the postponement of trials for another week. The court will be open, however, for motions, arraignments, and orders.

October 20, 1918

This is the second 24-hour period in a row where there has been a decrease in the number of new cases.

Aside from Liberty Loan meetings, virtually nothing else is open, and practically no outside activities are going on.

Dr. Sherman, in charge of children’s cases, informs the control committee that Harrington Hospital is preparing a ward for convalescent cases. The Sisters’ Hospital opens a new ward for women and children.

The request for schoolteachers’ assistance with the influenza census becomes mandatory.

October 21, 1918

Unsanitary conditions in food stores are being reported by customers; in response, inspectors check all stores to make sure they are sanitary otherwise they will be closed.

By tomorrow the Central High School hospital will be able to accommodate 400 patients, and by the end of the week, 1,000. Ferry Street and City hospitals are at capacity. Mayor Buck sends a request to the Red Cross in Charleston, West Virginia for twenty nurses.

City Bacteriologist Dr. Bissell reports that there is enough vaccine to distribute, thanks to the delivery of a large supply sent from New York. The vaccine is freely distributed to physicians to be used as a prophylactic, not a cure.

Superintendent of education E. C. Hartwell contracts influenza.

October 22, 1918

The Jewish community building and Neighborhood house are made available for convalescents. The Red Cross announces they will take care of convalescents who cannot cook for themselves. The Charity Organization Society will have volunteers do housework in homes where women are ill or recovering from the flu. Pastor of Holy Family church, Reverend John J. Nash, along with Mother Helena of Mount Mercy Academy, begin a parish first aid service.

October 23, 1918

Officials at Fort Porter announce a clearing up of cases. It can now release nurses to help elsewhere.

Health Commissioner Gram says the request for women to do housework and nursing work in the homes of people with influenza has not been answered to a great extent. Women who can help with this should report to the Health Department.

October 24, 1918

Health Commissioner Gram acquires the use of Elmwood Music Hall for housing of convalescent adults and children.

October 25, 1918

Reverend Nelson H. Baker, administrator of the Catholic diocese of Buffalo, announces that Catholic churches will not open for another week. Democratic and Republican organizations also postpone their meetings.

The third floor of the Central High School temporary hospital is now able to accommodate an additional 200 convalescent patients. Superintendent of Hospitals Dr. Walter S. Goodale says that there are enough facilities to take care of all patients, and says hospitals are in their best condition since the start of the epidemic, and no more volunteers are needed.

October 26, 1918

The sub-committee on influenza discusses the possibility of resuming streetcar service, as long as certain rules are applied to prevent crowding and unsanitary conditions.

October 27, 1918

The streetcar company hires experts from disinfecting companies to help with disinfecting the cars.

October 29, 1918

Health Commissioner Gram sends a letter to Superintendent E. C. Hartwell of the Department of Education requesting that the schools be cleaned, ventilated, disinfected, and readied for use.

Gram is said to be overworked, and it is later announced that he has suffered a heart attack. Dr. George S. Staniland, Gram’s volunteer assistant during the epidemic, becomes Acting Health Commissioner.

October 30, 1918

Open-air political meetings are now allowed.

Teachers are called to conduct one last survey today. Depending on the results, there may or may not be measures taken to reopen the city.

A report surfaces of a father having to dig the grave of his own child for lack of undertakers. Reverend Alexander Pitass of St. Stanislaus parish, president of the cemetery association, says that they had acquired a trench-digging machine, and were not being lazy in burying bodies. He claims there are only 30 unburied bodies, and they would be buried today.

October 31, 1918

The sub-committee on influenza adopts a resolution stating tomorrow morning should be a safe time to end the ban on indoor meetings and gatherings. Health Commissioner Gram concurs, but is not present as he was at home in bed, resting.

Mayor Buck rescinds the quarantine of the city.

Superintendent E. C. Hartwell announces that the Board of Education does not intend to make up class time that was lost during the epidemic by extending school into summer. Schools are being fumigated and prepared for the return of students.

November 1, 1918

At 5 am the ban on indoor gatherings is lifted. Churches hold All Saints Day services. Saloons, dance halls, theaters, and moving picture houses open for business. Schools will re-open next Wednesday (11/6).

November 2, 1918

The departments of the main building of the Public Library reopen.

City Health Department resumes routine work, though “a sufficient force” remains on task for the epidemic. The Superintendent of Hospitals, Dr. Walter S. Goodale, is handling most of this work.

Health Commissioner Gram will rest for a week from work, on the orders of his doctor.

In November, all new cases of influenza will be taken to the city hospital on Groder Street.

The ban on church and public funerals of individuals with non-communicable diseases is lifted. If individuals die of influenza or other communicable diseases, the funeral must be held within 24 hours and be private.

November 3, 1918

The sub-committee on influenza declares that the epidemic has ended in Buffalo.

Influenza cases are transferred from Municipal and City Hospital to the improvised hospital at Central High School. A total of 250 influenza patients are now housed there, under the care of Dr. H. D. White.

November 4, 1918

The University of Buffalo holds classes. There will not be a holiday for election day tomorrow. Superintendent Hartwell holds a conference with all teachers, instructing them to report any suspected illness in students to school doctors.

Acting Health Commissioner Staniland quarantines ten men from the steamer Glenshee, which docked at the Donner Steel plant. Martin H. Stearns, the head of the steel department’s safety plan, informs Staniland there was an epidemic on the boat. The men are sent to the City Hospital annex on Court Street. Three cases are found amongst the crew. Following this, an order is issued for a group of Health Department doctors to be assigned to checking on incoming ships for cases of influenza.

November 5, 1918

Superintendent Hartwell recommends lengthening schooldays by thirty minutes to recoup time lost to influenza-epidemic closings. All involved parties agree.

November 10, 1918

Health Commissioner Gram returns from his period of rest.

Watson House will be empty of all recovering children this week. Children left without parents will be taken care of as would normally occur. The emergency hospital at Central High School is still treating 150 cases of influenza.

November 13, 1918

Health Commissioner Gram is working to ensure that coffin supplies are ample. He explains that his authority ends at that, and his office never intended to fix coffin prices to prevent mortuary and manufacturer profiteering during the influenza epidemic.

November 17, 1918

The Health Department issues statistics comparing influenza’s effect on Buffalo with other cities.

November 21, 1918

The Health Department asks the City Council to permanently keep the hospital at Central High School as an emergency hospital. No immediate decision is made.

November 23, 1918

Superintendent Hartwell comes out in opposition of using Central High School as a hospital, declaring that the building is desperately needed for schooling purposes.

November 25, 1918

The number of influenza cases has increased for several days, and during the previous 24 hours there are 71 cases and six deaths (four influenza, two pneumonia). Mayor Buck meets with Health Commissioner Gram to discuss the increase in cases. Gram declares, “we are not out of the woods yet.”

November 27, 1918

Health Commissioner Gram confers with school superintendents, asking them to tell teachers and principals to continue stressing precautions. Gram also speaks with President Dickson of the International Railway Streetcar Company, and Dickson says that the company will ventilate and clean street cars. More cars will also be used to prevent overcrowding.

November 29, 1918

Superintendent Hartwell announces that when the influenza epidemic is over, Central High School will be used for educational purposes by the school department, not as a hospital.

December 1, 1918

Health Commissioner Gram announces the formation of a committee to be in charge of a survey to determine if there are any “secondary ills,” such as tuberculosis. City and private hospitals are being asked to report patients treated and discharged as they are cured, and the inspection force will then monitor the patients to see if they have any other sicknesses.

Acting Superintendent of the Buffalo State Hospital Dr. William W. Wright is told by Dr. Gram that he should keep the quarantine there for awhile, despite low case numbers. At the Buffalo State Hospital, there have only been 75 cases and 5 deaths from influenza. The quarantine will also be continued because there are visitors to the hospital from a large number of areas, and in some of them, the epidemic has not yet passed.

December 5, 1918

The quarantine of Buffalo State Hospital is lifted.

January 3, 1919

Dr. Gram denies allegations by Dr. Cott, President of the Erie County Medical Association, that a large number of influenza cases went unrecorded. Gram requests proof of allegations and explains that any doctor who failed to report cases will be prosecuted.

Mayor Buck requests a $10,000 appropriation for the Health Department to fight influenza.

January 7, 1919

State transfer tax appraiser’s report shows that this past quarter “was the busiest in the history of the surrogate’s office.” 900 estates have passed through the office, 30% greater than total for any other quarter. Increased deaths from the influenza epidemic are thought to be responsible for this.

January 8, 1919

Frank M. Stage, Superintendent of the Poor for the county, is informed that the county will have care of 63 more influenza orphans.

January 13, 1919

288 new influenza cases are reported throughout the day, the largest number since the epidemic was pronounced on the wane.

January 14, 1919

Mayor Buck once again appoints Dr. George S. Staniland as Acting Health Commissioner during Health Commissioner Gram’s illness.

January 15, 1919

Health authorities begin to re-stress preventive measures due to an increase in cases. Physicians and public health officials have claimed the War Exposition, where large numbers of people have been gathering, may be related to the jump in numbers.

January 18, 1919

Acting Health Commissioner Dr. George S. Staniland orders his subordinates to stop “giving to the newspapers information as to the number of new influenza cases and pneumonia and the number of deaths.” His reasoning for this is that “the cases are getting so few that I thought it would be no use to ask you to publish them any longer.”

January 30, 1919

The Health Department will report each month to the Commissioner of Finance and Accounts until the council determines how much has to be appropriated.

February 6, 1919

Health Commissioner Gram returns to his post after recovering from an undisclosed illness.

February 14, 1919

The Health Department is granted an additional $1,000 to aid in the fight against the epidemic. When it is spent, the Department may then request more.

An ordinance is passed giving the Health Commissioner the authority to take cultures from sick individuals that may be “contagious disease carriers.” If the cultures come back positive, the individuals will be sent to the Municipal Hospital.

February 22, 1919

Christian Scientists, chiropractors, and osteopaths protest as “Un-American” the Health Department’s new powers to quarantine, take cultures, and order sick individuals to be taken to hospitals. Health Commissioner Gram argues that the Health Department must have the authority to impose quarantines.