On September 27th, North Carolina reported to the Public Health Service. With cases reported from Raleigh and Wilmington, officials tersley noted "all the hospitals are crowded." By the first week of October, the diease was epidemic at Raleigh and Wilmington. A week later, officials reported that the situation was especially bad in Fayetteville. By the final week of October, officials had become cautiouly optomietic, saying that the situation “is improved.” By November 2nd, “a general improvement for the state was noted.” Influenza did remain prevalent throughout the state but officials belived, correctly, that the worst had passed.

c1918. A bird’s eye view of Charlotte, North Carolina looking north, with Camp Greene in the background to the left. On October 24 1918, the city of Charlotte was quarantined. [Credit: The Library of Congress]

In the wake of the pandemic, local newspaper accounts estimated that between October of 1918 and March of 1919, over thirteen thousand North Carolinians died from influenza. Because man deaths went unrecordered, this figure is questionable and probably too low.

During the pandemic, officials in North Carolina were quick to take action. In early October, the State Board of Health, with the advice of the government and State Superintendent of Schools, called on the authorities of every town or community where influenza had appeared to promptly close the schools and ban all public meeting. For those who might question such a draconian order, state officials provided a grim assement of hte situation, saying, influenza " is now spreading from Wilmington up the Atlantic coast and inland via the Atlantic Coast Line and Seaboard railways.”

Alcohol was often used to treat influenza patiend. However, Dr. W.S. Rankin, of the State Board of Health, refused to approve an order for rum to be used at various emergency hospitals, saying that there was no scientific evidence for the use of alcohol and its use should be discouraged. The State Board of Health urged instead that hospitals rely on “sunshine and open air." They claimed that this approach had worked in an orphanage in Thomasville. There, 410 out of the 460 children had contracted influenza and the Board claimed all were cured by "sunshine and open air."

Accreoss the state, residents adn physiciains also used calomel to treat influenza. Calomel was ineffective as were many other treatments used during the pandemic.

The state's many mill towns suffered tremendous losses from the pandemic. Overcrowding, poor sanitation, and poverty all served to exacerbate the number of cases and deaths in these regions.

During the height of the pandemic, Selena W. Saunders, accompanied a trained nurse to Cramerton, in the North Carolina textile belt "This new disease was different," Saunders said. "It struck suddenly, spent itself quickly in a burning three-day fever, often leaving its victim dead. The people lost faith in the remedies they had relied on all their lives, and they became frantic. Some of them locked themselves in their house, and refused to open the door for anyone.... Merchants nailed bars across their doors, and served the customers one-at-a-time at the doorway. We found whole families stricken, with none able to help the others. In one family the mother died without knowing that her son, who lay in the adjoining room, had died a few hours earlier. For two weeks, volunteer workers made and delivered hot chicken soup and other meals for the sick and needy..."

c1916. An advertising bill for the Pickwick Theater believed to have been located in Chapel Hill, North Carolina. At the height of the pandemic, theaters, schools, and other public gathering places were closed down indefinitely. [Credit: The Library of Congress]

In Winston-Salem, Dr. Wingate Johnson estimated that he worked between 30 and 40 hours at a stretch during the height of the epidemic. He visited most of his patients in their homes as they were quarantined. Johnson would sleep for about four hours, call his nurse for a supply of tongue depressors and medicine, and then start up again for a forty or thirty hour “day.”

By October 6th, Winston-Salem had officially closed its churches and canceled social functions. By the 16th and 17th, soda foundations, tobacco houses and stores were also closed. A teacher at Salem College conducted classes by telephone through a special hook-up arranged by the phone company.

Segregation meant that emergency hospitals were divided along racial lines. As the African-American community had fewer trained phyicians and nurses than the white community, this meant that many African Americans were unable to access any type of health care during the pandemic.

But even white people found it difficult to find trained professionals to care for them. The local paper formally announced that “Ladies of the cit will serve as nurses,” but the truth was most of these women knew nothing about caring for the sick.

During the pandemic, Dan Tonkel was a child living in Goldboro. Looking back on the fall of 1918 he remembered “I felt like I was walking on eggshells. I was afraid to go out, to play with my playmates, my classmates, my neighbors. I was almost afraid to breathe. I remember I was actually afraid to breathe. People were afraid to talk to each other. It was like—don’t breathe in my face, don’t even look at me, because you might give me germs that will kill me” He added “Farmers stopped farming, merchants stopped selling. The country more or less just shut down. Everyone was holding their breath, waiting for something to happen. So many people were dying, we could hardly count them. We never knew from one day to another who was going to be next on the death list.”

On October 24th, Charlotte was quarantined. At the time, there were 400 reported cases in Charlotte with many more in nearby Camp Greene.

On Nov. 14th, the Wilmington Morning Star reported an outbreak of influenza on a ship docked in the Cape Fear River. The government vessel, City of Savannah, had arrived two days earlier carrying 1,900 Puerto Ricans to Fayetteville to aid in the construction of Camp Bragg. By the time the ship left Wilmington harbor, 28 of the Puerto Rican laborers were dead from influenza.

In Raleigh, the Tabernacle Baptist Church served soup to the city’s victims. Ernest Carroll, a member of the Church who served the soup, died of the pandemic and the Church named its kitchen and dining all for him.

In late November, a Public Health Service Officer stationed in Releigh informed the Surgeon General Blue that, “the working force of this office has been severely taxed within the last few weeks as a result of the influenza situation. So great has been the demand on our services for relief of persons ill with the disease, all office work has been of necessity laid aside.”

Although influenza peaked in the state during the fall, the disease remained prevalent in North Carolina during the winter and spring of 1919.