How three physicians protected Nova Scotians during a public health crisis a century ago
COVID-19 is the second known pandemic to appear in Nova Scotia. The first was the Spanish flu, a strain of the H1N1 virus, which lasted from 1918 to 1920. The virus killed about 2,000 Nova Scotians, 38,000 Canadians and 35 million people worldwide.
The Spanish flu appeared in Nova Scotia in early September 1918. Over 1,300 Nova Scotians died from the virus between October and December 1918. Deaths occurred in every part of the province with about 800 in cities and towns, and 500 in rural areas. The pandemic continued until May 1919, then disappeared between June and December 1919; it reappeared in February 1920, causing 280 deaths from February to May of that year.
The virus diminished in May 1920 and it did not re-appear thereafter.
The response of Halifax doctors to the arrival of Spanish flu in Nova Scotia
Nova Scotians were fortunate that three Halifax doctors immediately grasped the seriousness of the virus and acted quickly to prevent its spread throughout the province. In early September 1918, mayor of Halifax Dr. Arthur C. Hawkins sent Halifax doctors to Boston to learn how they dealt with the pandemic, which had broken out there a month before it appeared in Halifax. Dr. Hawkins shared a report from these doctors with Dr. William H. Hattie, the public health officer for Nova Scotia, and with Dr. Norman E. MacKay, the quarantine officer for Halifax.
The recommendations in the report strike a similar tone to what we’ve experienced during the COVID-19 pandemic:
- Close all public places in the city including schools, universities, churches, libraries and bowling alleys
- Inform the general public that they should isolate themselves and avoid others
Dr. Hattie published an article in newspapers across the province informing the public of the seriousness of the pandemic and the importance of self-isolation. Dr. Norman E. MacKay took steps to ensure that all public institutions were closed in Halifax and Dartmouth, and that they remained closed for over six weeks. Sydney, Cape Breton and other large towns in the province followed suit, closing all public places during October and November 1918.
How did the Spanish flu get into Nova Scotia?
The Spanish flu was brought into Nova Scotia by:
- Soldiers and seamen arriving back into the province from World War 1
- Fishermen from Gloucester, Massachusetts, who regularly visited seaports all around the coast of Nova Scotia to buy supplies
- American soldiers who, because of an outbreak of the flu on their ship, came into Sydney for medical assistance
Unlike COVID-19, people were not tested to confirm if they were infected with the Spanish flu. Therefore, it’s unknown how many Nova Scotians were infected. Medical scientists were unable to test for a disease which they were unable to identify at the time.
How did federal and provincial governments react to the Spanish flu?
The federal and provincial government did not take a leadership role in combatting the Spanish Flu pandemic. In fact, the House of Commons and the Nova Scotia House of Assembly did not hold sessions during the fall of 1918 to establish plans to fight the virus.
The planning and action to deal with the virus in Nova Scotia landed on the capable shoulders of Drs. Hattie, Hawkins, and MacKay, as well as the 18 county health officers who were under the direction of Dr. Hattie.
In early September 1918, only Nova Scotia, New Brunswick, Quebec and Ontario had public health officers. The data on death rates collected from the Spanish flu tells us that these health officers played an important role in preventing the virus from killing large numbers of people in eastern and Atlantic Canada compared to provinces that did not have public health officers.
Thanks to their efforts, Drs. Hattie, Hawkins and MacKay, and the people of Nova Scotia achieved the best health outcomes in Canada from the Spanish flu. The three doctors took immediate action to close all public places and to alert the public on how they should isolate themselves from others. Fortunately, Nova Scotians demonstrated a high degree of compliance in following the recommendations of the three doctors.