In the Aftermath of the “Lost” Pandemic: Philadelphia, 1919-1922

Bethany Johnson

Bethany Johnson is the 2022-2023 Albert M. Greenfield Research Fellow and Ph.D. Candidate at the University of South Carolina.


My dissertation tells the story of Philadelphia following the influenza outbreak in the fall of 1918. I explore the experiences of individuals, families, communities, and institutions in the aftermath of the epidemic from 1919-1923, including during the influenza wave in the winter of 1920.  The project troubles claims that communities moved on with the armistice celebrations of November 1918 and that influenza’s impact is hard to find. My research at member institutions of the Consortium of the History of Medicine, Science, and Technology revealed that the pandemic interrupted local economies and neighborhood dynamics and complicated the efforts of New Negro activists resisting the erosion of civil rights and increasing segregation in the post-war period. The disease also left thousands of survivors permanently disabled or debilitated with ongoing familial responsibilities and scant financial support. Conversely, the pandemic supplied campaign material for local suffragettes seeking support for ratification of the 19th amendment. The influenza crisis also prompted a bevy of new relief programs, including hourly public health nursing, temporary income, and rental assistance, and the creation of the state-level clearing house for charitable donations known as the Welfare Federation.


College of the Physicians of Philadelphia

In October 2022, I worked with the College of Physicians of Philadelphia to review digital materials. I examined the case files of Dr. Charles Frazier, a neurologist and well-known surgeon at the University of Pennsylvania School of Medicine. His work with influenza survivors was innovative but ultimately unsuccessful. Frazier’s observations and treatments underscore the burdensome and sometimes shocking results of virgin-soil epidemic survival, including brain swelling, which can result in neurological and mood disorders, personality changes, and long-term impairment. Commentary by leading physicians such as Dr. John Deaver and reports by the Pneumonia Commission of the City of Philadelphia in the months and years following the outbreak further demonstrate the medium and long-term health consequences of survival. Alongside reports, patient files, and personal papers, I reviewed research monographs from the period, such as Edwin Jordan’s Epidemic Influenza: A Survey from 1927. These materials answered my questions about local responses to post-pandemic health outcomes and shaped my approach to materials at the University of Pennsylvania.


University of Pennsylvania: Kislak Center and Barbara Bates Center

In January of 2023, I visited the Barbara Bates Center for the Study of the History of Nursing and the Kislak Center at the University of Pennsylvania. At the Barbara Bates Center, I viewed the executive, alum, and housing committee reports and the attendance registries from various nursing schools. In the pandemic aftermath, schools adjusted training schedules for students who required extended leave to recover or care for sick family members. Some students returned but lost the stamina to work an entire shift and left nursing school. Other students changed course after the epidemic, pursuing public health or industrial nursing, where a focus on disease prevention and health maintenance aimed to improve baseline health for future outbreaks.


After studying the papers of the Visiting Nurse Society of Philadelphia (VNSoP), which serviced most of the city, and the Starr Center and Whitter Center, which mainly supported Black migrants and children, I discovered that agencies struggled to respond to the diverse social issues emerging from familial death and post-influenza impairment. Within four months of the pandemic, the VNSoP argued that directly paying a family’s rent, coal, or food costs should be counted as providing healthcare for influenza survivors. In this instance, entrenched political resistance among Philadelphian politicians to “dependence” following direct monetary support to impoverished families failed to hamper the widespread public support and increased funding the VNSoP enjoyed through 1923 and beyond.


After my work in the VNSoP, Edith Nunan, and Roberta M. West papers and nursing school records, I reexamined the Emergency Aid and League of Women Voters papers at the Historical Society of Pennsylvania. Now I have a network model of the connections between volunteer organizations, social service agencies, and local suffrage activists; I am beginning to understand the overlaps between nurses and the suffrage movement in Philadelphia. In 1915, Philadelphia cast the majority of votes against women’s suffrage in the state constitutional referendum. The women who volunteered during the influenza crisis in the fall of 1918 used their work to cultivate widespread support for suffrage in the city.


Kislak Center

In the special collections at the Kislak Center, I viewed the papers of community leader and civil rights activist Dr. Nathan F. Mossell, who founded the Frederick Douglass Memorial Hospital (FDH) and Training School. I also examined the documents of his niece, Sadie Tanner Mossell Alexander, the first Black woman admitted to the Pennsylvania Bar. Mossell’s resistance to the increasing segregation of medical programs led to state-level sanctions and funding loss; the influenza crisis saddled his hospital with debt at the most inopportune time. Alexander’s research for the University of Pennsylvania and the Henry Phipps Institute offers a snapshot of Black family life and health between 1918 and 1922, a helpful follow-up to DuBois’s The Philadelphia Negro. I was surprised to discover how the influenza outbreak and its aftermath intersected with the local movement for civil rights following the Great War. In the case of FDH, the epidemic worsened the political and economic consequences of unyielding resistance to segregation.



While this fellowship provided financial resources to travel, it also afforded me the institutional capital to build relationships with archivists at non-Consortium institutions nationwide, including the University of Kentucky and the Catholic University of America. The archival materials I viewed over the last year shifted the focus of multiple dissertation chapters and provided ample resources to finish the project. Beyond dissertation research, the weekly fellows' meetings allowed me to connect with other scholars and familiarize myself with topics and research methods outside my purview.


Finally, the scrapbooks, records, and reports from the VNSoP, the Starr Center, the social work programs of several Philadelphian hospitals, and Sadie Alexander’s research for the Phipps Institute research provided me with an understanding of the explosive growth of pediatric health, disease prevention, and industrial safety within the public health movement. In a recent interview on historical parenting practices with Anna North from Vox, I discussed the nutritional and environmental improvements Progressive Era reformers in Philadelphia pursued in the wake of the epidemic. Progressive paternalism isn’t a discovery, but my awareness of the overlapping concerns among reformers about post-influenzal health and post-war Americanization shaped my conversation with North. We agreed to speak again about influenza orphans, post-viral health problems, and other post-pandemic issues faced by families in the city. Thanks to the Consortium’s support, I look forward to pursuing this and other public-facing conversations on the varied outcomes of global pandemics.


Bethany Johnson