The Spanish Flu in Glasgow

The influenza pandemic of 1918 was the deadliest in modern history, killing more people across the world than the Great War whose last year it shadowed. It is generally reckoned to have entered Britain through Glasgow, appearing in the city in May 1918 and spreading south within weeks. It killed many thousands of Glaswegians, struck hardest at the young and strong, and then — almost uniquely among catastrophes on this scale — was very nearly forgotten.

This page tells that story: why the disease was misnamed, how it reached Glasgow first, the three waves in which it came, the strange cruelty of a flu that killed the healthy, the helplessness of a war-drained city, and the long silence that followed — until the questions of 1918 returned to the same streets in 2020.

The flu that wasn’t Spanish

The disease was never Spanish. The name was an accident of wartime censorship: in the combatant nations — Britain, France, Germany, the United States — the press was forbidden from reporting anything that might dent morale, and a raging epidemic among troops and workers was exactly such news. Neutral Spain laboured under no such restriction, and when its uncensored newspapers reported a mysterious illness sweeping the country in the spring of 1918 — and when the King of Spain, Alfonso XIII, fell gravely ill — it created the false impression that the disease had begun there. The true origin remains disputed, with candidates in the United States, France and China, but wherever it started, one great engine of its spread was certain: the vast movement of soldiers to and from the trenches of the First World War, along the Western Front.

Britain’s first cases

Britain’s first cases appear to have been Glasgow’s. The earliest signs came in the first week of May 1918, when clusters of a sharp influenza-like illness broke out in three of the city’s factories and a boys’ industrial school — over four hundred cases at a stroke — and the first indication that this was something more than ordinary influenza showed, quietly, in the city’s mortality statistics for that month, as the general death rate and the death rate from pneumonia began to climb. The outbreak was reported in The Lancet that July. Glasgow’s position as one of Britain’s great seaports, tied by ship and troopship to the whole world, is the likeliest reason it was struck first; within weeks the illness had spread down through the country, reaching London by June.

From the city it ran along the lines of everyday life into the surrounding towns. In one grim early instance, an outbreak traced to the constant traffic between a Glasgow home and a school in Lanarkshire reached an orphanage at Lanark, where eight children died. It was an early sign of the disease’s cruellest characteristic, and of how the ordinary movements of a connected society carried it everywhere.

The three waves

The pandemic came in three waves. The first, through the spring and summer of 1918, was widespread but comparatively mild — a short, sharp fever that most people shook off in a few days, so unremarkable that doctors at the front had called it ‘three-day fever’. The city coughed, ached and largely recovered, and attention returned to the war.

The second wave, gathering from October 1918, was a different and far deadlier thing. Ferociously infectious and lethally fast, it could turn a healthy adult into a dying one within a day or two, and it arrived just as the war ended, so that the crowds celebrating the Armistice in November helped carry it. Across Scotland the monthly death toll reached its terrible peak — more than four thousand deaths in November 1918 alone. A third wave followed in the early months of 1919, less severe than the second, before the pandemic finally burned itself out as enough of the population acquired immunity; by the summer of 1919 the new cases had stopped.

The disease that killed the young

What made the 1918 flu so uniquely frightening was whom it killed. Ordinary influenza is most dangerous to the very old and the very young; this one inverted the rule, falling most heavily on adults in the prime of life, aged roughly between twenty and forty. In its worst form it was not really the flu that killed but the catastrophe it triggered in the lungs, which could fill with fluid so fast that victims suffocated, their faces darkening to a blue-grey as they were starved of oxygen, delirious in their final hours. Households lost mothers, fathers and breadwinners in a matter of days while grandparents survived — a pattern that struck contemporaries as almost a deliberate cruelty, and that has been linked since to the way the disease turned the strongest immune systems against their own bodies.

A city with no defences

Few cities were worse placed to meet such a disease than Glasgow. It was among the most crowded places in Britain, its people packed into the tenements and single-ends bequeathed by a century of headlong industrial growth, its poorest districts dense beyond modern imagining, its workers pressed together daily on crowded trams and in war factories. Four years of war had drained away doctors and nurses to the forces, and rationing had left many people undernourished and less able to resist infection.

And medicine had almost nothing to offer. There were no antivirals and no vaccine; there were no antibiotics for the bacterial pneumonia that did so much of the killing — penicillin lay a decade in the future. The tools available in 1918 were essentially those that had served against cholera two generations before: fresh air, isolation, rest, aspirin and endurance. Hospitals overflowed, the sick were nursed at home by exhausted families, and the undertakers fell behind.

The Glasgow response

Public authorities, here as elsewhere, improvised. Official advice, issued by the Local Government Board and the city’s medical officers, ran to healthy living, well-ventilated rooms and the avoidance of crowded gatherings — sound enough, if hard to follow in a tenement city — while some eminent voices were frankly fatalistic, one distinguished physician dismissing attempts to check the disease as about as useful as a barbed-wire fence against flies. There was genuine disagreement over what to close. Where some cities shut their cinemas as suspected seed-beds of infection, Glasgow’s authorities took the opposite view, judging a picture house better ventilated than the homes many of its patrons would otherwise sit in, and largely kept them open — a decision still debated by historians.

The war added its own burdens. Glasgow was a port of entry for returning and transiting troops, and the Fourth Scottish General Hospital in the city, with the help of the British Red Cross, treated many of the servicemen who arrived carrying the disease. The apparatus of Victorian public health that had conquered cholera — the medical officers, the sanitary inspectors, the reforms of the previous half-century — now met an enemy it could track but not stop.

The forgotten pandemic

For all its scale, the 1918 pandemic left astonishingly little public trace. It was grieved house by house and commemorated almost nowhere: there are no great civic monuments to the flu dead as there are to the fallen of the war, no day of remembrance, little in the way of public memory at all. Part of the reason was timing. The flu arrived entangled with the last agonies of the war and the flood of relief that came with the Armistice, and a nation already exhausted by grief seemed to have no capacity left to mourn a second catastrophe. The dead of the trenches were heroes with names on a hundred thousand war memorials; the dead of the flu were simply, and quietly, gone.

Glasgow remembered it again, suddenly and completely, in the spring of 2020, when a new pandemic brought the questions of 1918 — about closures and crowds, masks and waves, isolation and endurance — back to the same streets. Researchers who combed the city’s own health records found that the 1918–19 pandemic had raised the death rate in Glasgow higher than anything since, a grim record that stood until the arrival of the Covid-19 pandemic. The greatest pandemic in modern history had also become its most forgotten — until the city was made to remember.

The pandemic in numbers