In many ways, Bryn Mawr College was among the most provisional of the influenza escape communities we studied. This is because while there were zero deaths resulting from influenza during the second wave of the pandemic, there were 110 cases of influenza (a case rate of 23.6% of the campus student population, which is on par or above that seen in harder hit communities). Nevertheless, because this case study raises a number of pertinent issues related to the wide spectrum of NPI taken in 1918, we included it in our report.
At a Glance
- Type of Site: Women’s college in Bryn Mawr, Pennsylvania.
- Population: 465.
- Pop. Density: N/A
- Geographical Considerations: Located approximately 10 miles outside of Philadelphia; the college housed most of its students.
- Influenza Cases: 110
- Influenza Deaths: 0
- First Reported Case: Sept. 26, 1918.
- NPI Implemented: Surveillance of ingress and egress, students not on campus before protective sequestration were not allowed entry; isolation of cases; vaccinations.
Case Study
Historical Background
In 1918 Bryn Mawr College was (and remains) a small women’s college in southeast Pennsylvania, located approximately 10 miles west of Philadelphia on the famous “Main Line” of wealthy towns extending westward along the rail lines from Philadelphia. Located in the town of Bryn Mawr on a 135-acre campus designed by Frederick Law Olmstead and Calvert Vaux, the college was the first in the United States to offer graduate education to women.
Much of Bryn Mawr College’s success as a leading educational institution can be attributed to the leadership of Martha Carey Thomas. Thomas, who earned her doctorate at the University of Zurich and who was later instrumental in having women admitted to the medical school at the Johns Hopkins University, joined the Bryn Mawr faculty as professor of English and as dean in 1885. She served as president of the college from 1894 to 1922. As president, Thomas was determined to make Bryn Mawr the equal of the male-only colleges and universities in the United States.
President Thomas was knowledgeable about the state of contemporary medicine. Although she did place, in retrospect, too great a faith in the influenza vaccine of the day, she also had a very good understanding of the host of measures that could be taken to prevent or contain an epidemic. She knew from reading articles in the medical journals of the day, for example, that influenza germs could be carried 10 feet from a sneezing or coughing person. She was also the sister-in-law of one of the nation’s leading infectious disease researchers, Simon Flexner, who directed the elite Rockefeller Institute for Medical Research in New York City, with whom she conversed with quite frequently. Although impossible to quantify, Thomas’s medical knowledge may have played a role in both the preparedness planning and the results of the influenza epidemic at Bryn Mawr College.
Bryn Mawr’s Response to the Influenza Pandemic
The first reported case of influenza at Bryn Mawr College occurred in late September 1918 in a student staying at the College Inn. The possibility of the spread of the disease was quickly made apparent, as the patient received regular student visitors. President Thomas therefore immediately attempted to have the patient moved either to the Bryn Mawr hospital or to the campus infirmary, where she could be effectively isolated.
By October 1, campus administrators had begun to enact an “absolutely strict quarantine”—by which was meant a series of NPI designed to mitigate the spread of influenza—in an attempt to deal with the “very serious outbreak of Spanish influenza” that had erupted on campus. Thomas had a strong belief in the efficacy of influenza vaccination (which, as noted elsewhere in this report, turned out to be based on an entirely different microbe than the virus that causes influenza and, hence, not efficacious), and quickly ordered its widespread use on campus. All members of Bryn Mawr’s teaching and executive staff who commuted from Philadelphia via train, along with all managers, wardens, and housekeepers, were vaccinated at the college’s expense. Students and on-campus faculty and staff were offered the vaccine at the cost of $1.00.
A series of even more restrictive measures were then implemented. Students were advised to avoid crowds (yet they were also expected to go to chapel and association meetings) and to get plenty of both exercise and rest. Students were forbidden to enter theaters and other places of public assembly, were prohibited from crossing Montgomery Avenue (the main street separating campus from town) and were informed they could not ride public transportation. Furthermore, non-resident students were excluded from the college unless they lived near enough to campus to walk. Off-campus visitors, including mothers, were henceforth prohibited from entering residence halls; mothers were allowed to see their daughters only if the daughters were ill and being cared for at the infirmary. Students were likewise forbidden to visit private homes (even those on the campus side of Montgomery Avenue) without the express permission of the dean. All gatherings save those of an academic or religious purpose were prohibited. In late October, in response to a new regulation from the Pennsylvania Board of Health calling for an end to public gatherings and recommending the closure of schools, Thomas ordered the four-day quarantine of all students returning to campus from home.
Despite these restrictions, life at Bryn Mawr seemed to continue in a fairly regular fashion, and the various NPI to prevent the spread of influenza do not appear to have been as strict as they could have been. In the first week of October the college held its thirty-fourth annual opening ceremony in Bryn Mawr’s overflowing chapel. Liberty Loan rallies, tennis tournaments, hockey games, and chapel services continued throughout the semester. In early November, the traditional “Lantern Night” event (a ritual in which freshmen are handed colored lanterns by sophomores while singing Pallas Athena) was held before “a quarantine audience of Faculty and upperclassmen.” Some students were also allowed to sleep in residence halls other than their own, a violation of the campus health department orders. At least one student, apparently unaware of the protective sequestration and the ban on leaving campus, was discovered to be regularly wandering the aisles of Wanamaker’s department store in downtown Philadelphia.
Whether as a result of lax measures or from other causes, influenza did spread throughout the campus. On October 17 the school newspaper reported 42 cases of influenza, four of which had developed into bronchial pneumonia. By the end of the second wave of the pandemic in mid-November, the college had experienced some 110 influenza cases (not including those infected at home) out of a total population of 465 students (or 23.6% of the campus population). Several faculty members, including Dean Helen Taft (daughter of former President and Chief Justice William Howard Taft), also became ill. No deaths, however, were recorded as a result of these infections.
Research Materials
Because of President M. Carey Thomas’s forceful role in Bryn Mawr’s attempted protective sequestration/quarantine, her correspondence is full of references to the 1918–1920 influenza epidemic. Digitized sources include:
Newspapers:
Archival Material:
Bryn Mawr College News
| Date | Title | |
|---|---|---|
| 10/2/1918 | Enlist Now | bmcn01 |
| 10/2/1918 | Quarantined Again | bmcn02 |
| 10/10/1918 | Crowd Waiting as Loan Booth Opens | bmcn03 |
| 10/10/1918 | Bryn Mawr Opens Fifth War Year With Stand for Liberal Studies | bmcn03 |
| 10/10/1918 | Anti-Flu Party | bmcn03 |
| 10/10/1918 | Bryn Mawr Scrubs Lancaster Inn | bmcn03 |
| 10/10/1918 | A Sad Fable in Slang | bmcn04 |
| 10/10/1918 | Quarantine Rules Extended | bmcn05 |
| 10/10/1918 | Community Center Steps Forward in Influenza Emergency | bmcn06 |
| 10/17/1918 | Evens Succumb in Wild Hockey Game Against Odds | bmcn07 |
| 10/17/1918 | Desperate Cases Cared for in Emergency Hospital | bmcn07 |
| 10/17/1918 | Found | bmcn07 |
| 10/17/1918 | Flu Rumors Exaggerated | bmcn08 |
| 10/24/1918 | Faculty Hit By Epidemic | bmcn09 |
| 10/24/1918 | College Well Isolated | bmcn09 |
| 10/24/1918 | Influenza Hospital Gets Outdoor Ward and Diet Pantry | bmcn09 |
| 10/24/1918 | Even Classes Twin Tennis Singles Fails | bmcn09 |
| 10/24/1918 | Manful Measures vs. Flu | bmcn09 |
| 10/24/1918 | To the Editor of the College News | bmcn10 |
| 10/24/1918 | News in Brief | bmcn11 |
| 11/7/1918 | Cornstalks and Gay Costumes at Halloween Revels | bmcn12 |
| 11/7/1918 | Quarantine Lifted Gradually | bmcn12 |
| 11/7/1918 | Lantern Night Proves Freshmen’s Power of Song | bmcn12 |
| 11/7/1918 | “No Admittance” to Pembroke | bmcn13 |
| 11/7/1918 | News in Brief | bmcn13 |
| 11/7/1918 | Academic Work Has Precedence Over War Work | bmcn14 |
| 11/7/1918 | Comic | bmcn14 |
| 11/14/1918 | Classes Give Way to Peace Celebration | bmcn15 |
| 11/14/1918 | Emergency Hospital Becomes Convalescent Home | bmcn16 |
| 11/14/1918 | Dressings Can Be Made in Village | bmcn16 |
| 11/14/1918 | Churches Attended Again | bmcn17 |
| 11/27/1918 | No Excuses for Cuts Taken to Consult Specialists | bmcn18 |
| 1/9/1919 | Freshmen Rank High in Health | bmcn19 |
| 1/22/1919 | Medical Exams Now On | bmcn20 |
Official Letters of President M. Carey Thomas, Special Collections, Bryn Mawr College Library, Bryn Mawr, Pennsylvania
| Box/Folder | From/To | Date | Description or Title | |
|---|---|---|---|---|
| Letterbook #63/Reel 138 (Jan. 2, 1918-Oct. 7, 1918) | M. Thomas to H. Taft | 9/26/1918 | Details first case of influenza at Bryn Mawr | mct01 |
| “ | M. Thomas to Dr. M. Rea | 9/26/1918 | Thomas worries about the first influenza patient’s behavior. | mct02 |
| “ | M. Thomas to M. Aubert, French High Commission | 10/1/1918 | Explains the epidemic and quarantine to M. Aubert | mct03 |
| “ | M. Thomas to C. Applebee | 10/1/1918 | Restricts assistants during the influenza epidemic. | mct04 |
| “ | M. Thomas to President Mary E. Woolley | 10/2/1918 | Fear of traveling to introduce influenza. | mct05 |
| “ | M. Thomas to Rea | 10/4/1918 | Instructions on who is to be vaccinated against influenza. | mct06 |
| “ | M. Thomas to Bell | 10/5/1918 | Solicits nursing aid. | mct07 |
| “ | M. Thomas to M. McGroarty | 10/7/1918 | Wants to keep anyone not affiliated with the college away from the campus tea room while the epidemic persists. | mct08 |
| Letterbook #64/Reel 139 (Oct. 7, 1918-June 22, 1919) | M. Thomas to H. Taft | 10/8/1918 | Number of patients in infirmary. | mct09 |
| “ | M. Thomas [secretary] to H. Taft | 10/10/1918 | Realizes that the influenza epidemic has taken time away from Taft’s busy schedule, but Thomas would like some recommendations on names for several campus positions. | mct10 |
| “ | M. Thomas to Mrs. W. Gope | 10/10/1918 | Keeping Elizabeth Gope away from campus until influenza subsides. | mct11 |
| “ | Thomas’ secretary to C. Bell | 10/10/1918 | Regards Miss Bell serving as a nurse in the infirmary. | mct12 |
| “ | M. Thomas to Miss M. Mills | 10/11/1918 | Dean Helen Taft is ill with influenza | mct13 |
| “ | M. Thomas to President William Howard Taft | 10/12/1918 | Dean Helen Taft is ill with influenza. | mct14 |
| “ | M. Thomas to E. Orlady | 10/12/1918 | The policy of mothers visiting daughters in the infirmary. | mct15 |
| “ | M. Thomas to M. Woodbury | 10/12/1918 | The warden in Denbigh during the influenza epidemic. | mct16 |
| “ | M. Thomas to C. Applebee | 10/14/1918 | The spread of influenza through hockey games. | mct17 |
| “ | M. Thomas to President M. Woolley, Mount Holyoke College | 10/14/1918 | Thomas cannot make it to Mount Holyoke due to the epidemic. | mct18 |
| “ | M. Thomas to M. Stone | 10/15/1918 | Thomas is quarantined and cannot receive visitors. | mct19 |
| “ | M. Thomas to F. Frankfurter | 10/15/1918 | Asks Frankfurter if he could postpone his visit until after Prof. Kingsbury recovers from influenza. | mct20 |
| “ | M. Thomas to E. Settermus | 10/16/1918 | Thomas regretfully declines invitation to attend the British Educational Mission dinner because of the campus quarantine and travel restrictions. | mct21 |
| “ | M. Thomas to S. Hurst | 10/21/1918 | Nurse compensation. | mct22 |
| “ | M. Thomas to Prof. R. Jones | 10/22/1918 | Concerns the doctor and nurse at the infirmary. | mct23 |
| “ | M. Thomas to S. Hurst | 10/22/1918 | Staff member vaccinations. | mct24 |
| “ | M. Thomas to Dr. T. Branson | 10/23/1918 | Explains Bryn Mawr’s experience with the epidemic thus far. | mct25 |
| “ | M. Thomas to M. McGroarty | 10/23/1918 | Intricacies of the ‘quarantine’. | mct26 |
| “ | M. Thomas to S. Hurst | 10/23/1918 | Professor Kingsbury, sick with influenza, cannot return to work until November 1, as per doctor’s orders. | mct27 |
| “ | M. Thomas to H. Taft | 10/23/1918 | Taft’s expenses due to the epidemic. | mct28 |
| “ | M. Thomas to M. Heng | 10/24/1918 | Miss Heng will be vaccinated. | mct29 |
| “ | M. Thomas to D. Chambers | 10/26/1918 | Details the quarantine of Bryn Mawr | mct30 |
| “ | M. Thomas to A. Huntington | 10/26/1918 | Letter notes Thomas’ relationship to Dr. Simon Flexner. | mct31 |
| “ | M. Thomas to E. Brownwell, President of Shipley School | 10/30/1918 | Congratulations to the Shipley School for their conduct during the epidemic. | mct32 |
| “ | M. Thomas to H. Taft | 11/1/1918 | Idea of not letting students who had influenza do war work until after Christmas. | mct33 |
| “ | M. Thomas to Mrs. A. Lyman | 11/2/1918 | Concerns the delays in education caused by the epidemic. | mct34 |
| “ | M. Thomas to B. Ehlers | 11/2/1918 | Letter of reprimand for allowing students from one dormitory to spend the night in another dormitory despite the Health Department ruling against it. | mct35 |
| “ | M. Thomas to A. Dunn | 11/5/1918 | Letter of reprimand for disobeying health orders. | mct36 |
| “ | M. Thomas to Dr. C. David | 11/6/1918 | Clarifies the vaccination regulations. | mct37 |
| “ | M. Thomas to Dr. M. Rea | 11/7/1918 | The creation of a head nurses’ report. | mct38 |
| “ | M. Thomas to Comptroller | 11/7/1918 | Increase of Mary Taylor’s salary for the work she is doing in the infirmary. | mct39 |
| “ | M. Thomas to P. de Monteliu | 11/12/1918 | Financial losses as result of not being able to use the trains due to the epidemic. | mct40 |
| “ | M. Thomas to Prof. R. Jones | 12/10/1918 | States that the college operating expenses have gone up, in part because of the influenza epidemic. | mct41 |
| “ | M. Thomas to S. Hurst | 12/21/1918 | Regards various payments relating to the influenza epidemic. | mct42 |
| “ | M. Thomas to Mrs. G Crile | Undated | Influenza epidemic over. | mct43 |
| Official Incoming Correspondence/Reel 162 | Ellen G. to M. Thomas | 10/3/1918 | Describes the epidemic in Philadelphia. | mct44 |
| “ | Comptroller to M. Thomas | 10/18/1918 | Influenza is hampering business relations. | mct45 |
| “ | Capt. T. Foley to M. Thomas | 10/22/1918 | Wishes Bryn Mawr well in the epidemic. | mct46 |
| “ | H. Taft to M. Thomas | 11/5/1918 | Return letter on students’ war work. | mct47 |
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