102 years ago, San Francisco faced an intense battle to require masks during the second wave of the Spanish flu
By GREG KERAGHOSIAN | SFGate, San Francisco | Published: December 25, 2020
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SAN FRANCISCO (Tribune News Service) — A resurgent virus killing again. A tireless health expert facing hostility to mask-wearing. Local officials delivering mixed messages on safety and being caught not practicing what they preach.
The second wave of Spanish influenza in December 1918 and January 1919 resembles the most recent surge of COVID-19 in some ways. San Franciscans back then were weary after an autumn of restrictions that were tougher than in most other cities — though they did appear to help reduce cases and deaths.
The driving force behind the push to make masks mandatory a second time was San Francisco's top health official, who had also helped the city stave off the bubonic plague after the 1906 earthquake. The fight to restore a mask ordinance was an intense one. It included hundreds of arrests, a bomb, an Anti-Mask League and weeks of heated debate among elected officials and the public.
Even as a large San Francisco Chronicle headline Nov. 2, 1918, proclaimed, "Continued masking holds influenza in check," Dr. William C. Hassler warned against complacency and continued pleading for people to wear masks, noting a new wave of the virus on the East Coast. Hassler had successfully fought for the city to pass a mask ordinance on Oct. 22, when there were 1,800 new cases. By Nov. 1, they'd dropped to 552.
"Keep on wearing the masks, and we will soon be rid of it," Hassler said.
Not that Hassler or other San Francisco leaders were above a little hypocrisy. Five days before the city lifted its mask ordinance on Nov. 22, Hassler was caught by police not wearing his mask while ringside at a boxing match. Also present and maskless: Mayor James Rolph (his mask was on his chin), Supervisor Joseph Mulvihill and others.
Rolph was fined $50 for the breach, and Hassler was fined $5. Mulvihill would soon contract the flu himself.
With the ordinance lifted in late November, Hassler declared the epidemic stamped out. He estimated that mask-wearing had prevented 20,000 cases and 1,500 deaths — almost as many as the 1,857 who had died by Nov. 22.
But it only took about two weeks for a now-unmasked public to crowd back into previously closed businesses and theaters before a new spike began.
By Dec. 10, Hassler was again strongly urging the public to wear masks and voicing displeasure with the Board of Supervisors for not voting to require them. Cases rose from fewer than 50 when the masks were removed to more than 100 daily, then more than 200 daily.
Hassler's plea to wear a mask could easily be substituted for Dr. Anthony Fauci's today: "This is not only for the protection of the individual wearer, but also for the protection of those with whom he may come in contact," Hassler said. "It has been proved conclusively that the mask is a preventative."
Hospital beds and nurses became scarce as the number of patients spiked, and caregivers suffered a heavy toll. One of them was Kate Crocker, 23, whose father was the nephew of railroad magnate Charles Crocker. Kate Crocker had been caring for flu patients as a volunteer nurse for the Red Cross in San Francisco when she caught the virus herself. She died on Dec. 11.
Like Fauci, Hassler spoke out daily to rally support for masks, but that support was mixed. San Francisco supervisors up for re-election were wary of imposing another order, and they delayed scheduling a vote. Some in the public decried the gauze masks, calling them a burden to wear and a violation of civil liberties. A San Francisco Chronicle editorial said requiring masks would be ineffective and only create panic.
Even some in the science community disagreed with a second mask order. Dr. F.L. Kelly, in charge of the bacteriological lab at the University of California, said, "We don't know any more about the disease today than we did a hundred years ago. There is no known cure or preventative."
"If the Board of Health can force the people to wear masks, then it can force them to submit to inoculation, or to any experiment or indignity," he added.
Hassler was by far the most outspoken local official on the importance of masks, and it came at a personal cost. In mid-December, a bomb addressed to Hassler was found outside the Muirhead Building on 1278 Market St. — it contained gunpowder and broken glass, with a handwritten note to Hassler. But he refused to stay quiet, saying he was "not worrying about bombs."
Two days after the bomb was found, he railed against the Board of Supervisors for voting 9-7 against a mask ordinance and accused them of bowing to business pressures. "The dollar sign is exalted above the health sign," he said at a Public Health Committee meeting.
A leading antagonist of a mask ordinance was Supervisor Eugene Schmitz, the disgraced former mayor who was found guilty in a bribery scheme related to the 1906 earthquake. Schmitz may have been using the mask fight as a way to angle for another run at mayor in 1919 (Rolph defeated him easily).
Schmitz responded to Hassler's accusation of bowing to business owners by telling him at the meeting, "I don't think that's fair to the businessmen of San Francisco. The theatrical people did not show that they exalted the dollar above everything else when they closed their places of amusement voluntarily."
To which Hassler said, "The business was so poor that they preferred to close."
New daily cases continued to rise through Christmas, hitting 540 on New Year's Eve, accompanied by 31 deaths. Unlike in the first wave, public schools and businesses remained open, including restaurants and cafes. Rather than push for their immediate closure, Hassler tried to use them to motivate mask-wearing. The more people wore them, he said, the more likely these places could stay open.
With new daily cases exceeding 600 on Jan. 10, and hospitals at the limits of their capacity, Hassler did criticize restaurants as leading spreaders of the disease. He insisted they better sterilize their dinnerware and glasses.
The crushing weight of the flu's daily toll on San Franciscans finally turned sentiment toward passing an ordinance in mid-January. Even with Navy nurses returning from World War I to help San Francisco, there weren't enough to help all of the afflicted. Nor was there enough hospital space to house them, despite three new wards at San Francisco Hospital.
The Board of Supervisors convened Jan. 9 to at last require masks. But not without holding a contentious public debate, with anti-mask citizens arguing instead that "everything from thoughts of health to a Russian patent food would prevent and cure influenza," the Chronicle reported.
The mask ordinance passed 15-1, with Mulvihill voting in favor from home while sick with the flu for 10 days. With Schmitz absent, the only "no" vote came from Supervisor Charles A. Nelson, who wanted to add a loophole for those who got a doctor's note exempting them from mask-wearing.
Nelson claimed without proof that 91% of San Franciscans were against masks, and according to a Chronicle report, he "pointed to the danger of musicians being arrested as they blow their horns going down the street and of the stilling of song in the throats of singers by policemen backed by the mask ordinance."
Supervisor Andrew Gallagher, who introduced the ordinance, responded by pointing out that no musicians or singers had been arrested.
On Jan. 13, three days before the order took effect, Hassler estimated 25% of San Franciscans were wearing masks. But two days later, the Red Cross said it couldn't keep up with demand and sold 100,000 masks at 10 cents each. When supplies of tape to apply the masks shrank, the city placed a rush order to the East Coast for more.
For those unsure about the comfort of masks, Hassler assured them they were introducing a new mask that was more breathable than the flat ones used up to then.
The same day the ordinance passed, a new resistance was born: The Anti-Mask League. It was led by the wife of C.E. Grojean (reports don't include her first name), who had fought masks every step of the way, along with local attorney Emma Harrington.
While most San Franciscans followed the mask ordinance, not everyone did: On the first day alone, police arrested 186 people for not wearing them, releasing most of them on $5 bail ($75 in today's money). The bail money went toward transporting medical relief workers.
The Chronicle reported "two well-dressed women" were pulled out of a streetcar by police and taken to a drugstore to buy masks.
On the second day of the ordinance, police arrested another 453 people. One of them was a railroad worker named Frank Cocciniglia, who said he wouldn't wear the mask because he didn't feel like it. A judge told him he would have to serve five days in jail.
"That suits me," Cocciniglia said. "I won't have to wear a mask there."
The league's formation came at a strange time, because as Hassler predicted, flu cases and deaths declined dramatically as soon as the ordinance was passed.
On Jan. 17, the day of the vote, there were 519 flu-related cases and 39 deaths. Four days later, there were 188 cases and 22 deaths. Cases fell under 100 on Jan. 24 and continued to drop. By Jan. 28, with 54 new cases and falling, Hassler declared the epidemic under control and recommended the mask ordinance be lifted.
Nevertheless, the same day Hassler made his recommendation, hundreds of mask protesters appeared at a Board of Supervisors meeting. They cheered Schmitz and Nelson while hissing Gallagher as they took their seats.
The Anti-Mask League proposed its own resolution that would end the ordinance, which Nelson supported by insisting that "plain people rule." Gallagher's retort to Nelson: "You know, if you know anything, the only way to repeal an ordinance is to introduce another ordinance."
Hassler took pains to emphasize that the large reduction in cases due to masks, not the Anti-Mask League, was the cause for Mayor Rolph officially lifting the ordinance Feb. 1. The grip of the Spanish flu was over — though not before it had infected 45,000 people in San Francisco and killed more than 3,000.
With nothing left to protest, the Anti-Mask League collapsed. The group splintered during a meeting that the Chronicle called a "battle royal." One faction wanted to seek Hassler's recall, while the other merely wanted to put a scare into Rolph with a petition. After Harrington's rival called for her ouster as chair, the meeting abruptly ended.
"I rented this hall, and now I'm going to turn out the lights," league member William Scott said.
Word that the mask order had ended didn't travel fast enough for one San Franciscan that day. William G. Read was walking around the intersection of McAllister and Jones when a man showed him a police star and made him pay a fine for not wearing a mask, then ordered him to appear in court.
Read complied, and it wasn't until he reported to a police station that he learned the truth: The so-called policeman was an imposter, and he was out $5.
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