The near-closure of the entire city, mandatory face masks and hundreds of deaths were just weeks ahead, along with an epic battle of commerce versus public health.

But nobody in the coastal town by the border was too worried about a deadly flu rampaging across the world in September 1918. “San Diego is full of colds just now,” a local newspaper noted, but that wasn’t even in a story. It was just an advertisement for something called Dover’s Powders.

Things changed almost instantly. Within days, camps of World War I soldiers were quarantined, the local health board president warned of a disease “more murderous than any epidemic the nation has yet experienced” and officials shut down schools, theaters, churches and more.

The deadliest epidemic to ever hit the nation had come to San Diego, where it would take the lives of 368 people, or about one in every 200 residents. Many of those stricken were young and strong, unlike the victims of this year’s flu season in the county. (So far, 14 people have died, their ages ranged from 46 to 92, and all but one were already weakened by existing illnesses.)

From Kansas to the World

The epidemic of the Spanish flu didn’t start in Spain. The first reports in the world came from a military camp in Kansas, where dozens of men died after struggling to breathe amid fever, headaches, chills and fluid-filled lungs.

Other soldiers survived to be shipped out to Europe to fight in World War I in Europe. They almost certainly spread the illness to that continent, where hundreds of thousands fell ill and died.

As September 1918 turned into October, hundreds would die in single days in Philadelphia and Boston, and the first reported cases of the deadly flu appeared in San Diego at the Army’s Camp Kearny.

By early October, four military facilities were quarantined. The “Bluejackets” training at a naval training camp at Balboa Park had to stick around and not take their usual liberty three times a week. They played sports and games instead, the San Diego Union reported.

No Spitting in Balboa Park

“Order has been passed out that there is to be no expectorating on the streets of the park,” the paper reported. “The punishment is that the lad spitting on the street or the plaza must wear a cigar box swung about his neck, and this box is partially filled with sand and serves as a receptacle for the cigarette and cigar stubs of the victim’s shipmates.”

The city itself, though, didn’t worry too much. Bustling with 70,000 residents and just three years past the exposition that put Balboa Park on the national map, San Diego had other things on its mind. Soldiers were flooding the city to prepare to fight in the war, and the recently elected mayor who’d run on a “More Smokestacks” platform, was pushing for more business.

As the flu worsened, city leaders took a pro-business position. They weren’t too interested in shutting anything down to prevent the flu’s spread even after the local coroner quit to protest their lack of action. What about tourism? Company balance sheets? Individual wallets? They were in danger too, and furious businessmen fought the closure of stores.

At a public meeting, a theater owner who didn’t want to shut down declared that doctors were overcharging flu patients. A doctor exploded in anger: “If this man will meet me on the street and repeat his statement, he’ll be in the hospital, or I will!”

An Angry Mayor and No ‘Pretty Faces’

Minds changed. Even the mayor tired of hearing from those who wanted to keep stores and theaters open despite the spread of infection. “There is a class of people blind and indifferent to the death and sick rate, apparently unconcerned about everything else but nickel nursing and sight-seeing,” declared the mayor, Louis Wilde. “If we cannot put life and health above dollars and pleasure for a few days, we had better abolish the Bible and the Constitution. I cannot see a particle of difference between the invasion of France by the heartless, lustful Huns and the invasion of our homes by some epidemic permitted by greed and politics.”

Ultimately, the city was almost entirely shut down for several days in December, with schools, theaters, dance halls, churches and many other public places ordered closed. Masks were mandated, and if citizens refused, they were fined and listed in the newspapers. (“We miss their pretty faces,” moaned the San Diego Union when young women wore masks.)

Decades later, in 1985, a 100-year-old woman told the San Diego Union that she wouldn’t allow her two young flu-stricken children to get out of bed until their temperatures returned to normal: “several young people died because they got out of bed too soon. It took a great deal of care to get over the flu then.”

By Christmas Eve 1918, the epidemic had dissipated enough to stop the mask requirement. It was still raging to the north, however, and health officials urged locals to avoid going to Los Angeles if possible. The Union even blamed people from L.A. for continuing to bring the flu here.

50 Million Dead

The new year, 1919, finally brought the end of the Spanish flu epidemic. San Diego had avoided the high death tolls that struck other parts of the country and the world, perhaps because it wasn’t densely populated. By one estimate, the flu killed 50 million people worldwide.

The Spanish Flu epidemic still haunts the medical world today. Why did the flu kill so many young people, whose strong and healthy bodies should have fought it off? How did it spread so easily in a world that was hardly as interconnected as it is today? And what should the government do — or not do — when an epidemic strikes in these days of skepticism about basic prevention tools like flu vaccinations?

Civil rights advocates have been raising the alarm about epidemics since states began revising their laws after Sept. 11 and the growing threat of bioterrorism.

Regulations about quarantines, in particular, have come under fire from critics who say they don’t allow for due process. The problem is that “the history of quarantine is replete with discriminatory practices,” according to a 2010 Loyola of Los Angeles Law Review article.

In California, Quarantine Law Is Strong

Each state has its own rules about medical emergencies. California’s laws are vague and only require local health officials to meet a “low standard of proof” before quarantining someone, according to the Loyola article. In Los Angeles County, for example, it’s more complicated to quarantine an animal with rabies than a person with an infectious disease.

California’s quarantine law allows law enforcement officers to destroy property to prevent the spread of an infection. State health officials even have the ability to “quarantine, isolate, inspect, and disinfect” entire cities or “localities.”

In other words, the state could declare San Diego off limits to the rest of the state, or prevent its residents from going elsewhere, all to keep a germ from spreading.

This story relies on details from “The Spanish Influenza Epidemic in San Diego, 1918-1919,” by Richard H. Peterson, in the spring 1989 issue ofSouthern California Quarterly, the National Archives and “Unforgettable: Pandemic 1918,” by Jeff Smith, in the Sept, 23, 2009, San Diego Reader, and San Diego History Center notes by historian Richard Amero.

Randy Dotinga is a freelance contributor to Voice of San Diego. This content is not available for republishing without his consent. Please contact him directly at randydotinga@gmail.com and follow him on Twitter: twitter.com/rdotinga.

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