As schools, employers and hospitals prepare for an expected increase in cases of the H1N1 flu virus, author Nelson Price advises Hoosiers to look back at the early 20^th century when Indiana and the rest of the world suffered through one of the most devastating episodes in history.

Price recently devoted his “Hoosier History Live” radio show to educating the public about the pandemic that claimed as many as 40 million lives globally. (Price’s show airs Saturdays at 11:30 a.m. on 88.7 FM in Indianapolis and can be heard on line at http://wicr.uindy.edu/how_to_listen.htm)

Price noted that the pandemic has been all but forgotten but could offer timely guidance as the state prepares for an outbreak of so-called swine flu this autumn.

“It’s so seldom discussed and apparently was even little mentioned by people who lived through it, despite the fact that, according to some experts, only the two world wars resulted in more human devastation during the 20^th century,” Price said.

The obvious lesson is that the flu spreads rapidly in close quarters, as it did in military barracks throughout the country, according to historian Bill Beck, who has written histories of hospitals in Indianapolis and New Orleans.

Although mortality figures from the era are speculative, it’s believed that 12 percent of Hoosiers developed the illness and about 10,000 died. Nationwide, the death toll was in the 750,000 range.

Epidemiologists realized “something very big was happening” that fall and by October local health departments had issued bans on public gatherings in an effort to contain the disease, Beck told Price’s radio audience.

Among the recommendations made by the Indiana State Board of Health was that people who are “compelled to cough or sneeze hold cloth or paper handkerchiefs over their nose,” according to federal records. Churches suspended Sunday services and stayed open just for prayer and meditation.

Much like the current virus, the 1918 strain hit in waves. A mild wave occurred in the spring and summer that year, Beck said. “There was an extraordinarily lethal wave in the fall and early winter of 1918 and then there was another mild wave that hit in the spring.”

In Marion County, population 290,000 at the time, the bug peaked with 430 deaths in October, 303 in November and 247 in December. “One out of 290 residents died in those three months just of the flu,” Beck said. The city’s ban on Halloween activities may have saved the city from higher fatalities.

Human misery aside, two silver linings can be found in the 1918 flu. Says Beck, “Indiana was in some ways less affected than many of the states out east.” That’s because the state was still quite rural and the disease spread fastest in urban areas like New York City. Such protection no longer exists today.

As an economic matter, the pandemic greatly benefited southeast Indiana’s casket manufacturing industry as well as local funeral homes.

Beck’s grandfather operated a mortuary on South Capitol Avenue in Indianapolis and “worked around the clock. Bodies were literally stacked up because there weren’t enough gravediggers to go out and put them into the cemeteries, plus the public health department had pretty much issued a ban on funerals.”

While few believe the H1N1 virus will be as lethal as the 1918 pandemic — in part because of heightened awareness, better health care and aggressive containment recommendations — Price and Beck both stress the value of studying history to cope with present danger.

Said Beck, “The overwhelming lesson that you learn from the 1918 pandemic is that we like to think that were in control of everything, but there are things that happen that we don’t control.”

Andrea Neal is a teacher at St. Richard’s School in Indianapolis and adjunct scholar with the Indiana Policy Review Foundation. Contact her at aneal@inpolicy.org.