1918 pandemic in Maine: Lessons applicable to public health crises today

The Great Pandemic of 1918 hit southern Maine in September 1918, and spread throughout the state over the next few weeks and months. Eventually, 5,000 Mainers died from influenza, the highest death rate ever recorded in Maine in any year and from any cause. At that time, every Maine municipality had a Board of Health with broad authorities. Maine's cities were equipped with hospitals and were also crowded with recent French Canadian, Italian, and Irish immigrants. Rural areas had few modern resources such as hospitals. Over the last few years, the presenter collected over 2,000 pages of historical documents on the impact of the influenza pandemic of 1918 in Maine. These documents include copies of newspaper articles from the time period in various towns across the state, public health agency archives, and records from interviews conducted 2000 – 2010 by the presenter with elderly Mainers who had memories of the pandemic. From reading these documents, emerged many stories with numerous lessons applicable to today's management of a pandemic or other public health crises in Maine or in any place around the globe. Indeed, the presenter used these lessons when she led Maine, as its State Health Officer, through the 2009 pandemic with H1N1. Lessons include: the role of policy in controlling a public health emergency; the pros and cons of local versus state versus federal authority; addressing a crisis in a rural area without much infrastructure; and addressing a crisis in an urban area with crowded impoverished living conditions.