When the 1918 influenza pandemic, also known as the Spanish flu, swept through Miami, the city was only 22 years old and some of its basic infrastructure was even younger than that. Miami City Hospital, now Jackson Health System, the largest safety net public hospital in the area, had only opened its doors a few months before it would see a wave of critical patients due to the pandemic.
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The city ordered businesses to close earlier than normal, though many believed at the time that Florida’s sunshine helped reduce susceptibility to infections. The young hospital system quickly became overwhelmed with patients and sick staff — and for Miami's predominantly black community the flu was especially deadly.
University of Miami researcher and urban planner Jorge Damian de la Paz spoke to WLRN about how the city handled the pandemic back then.
On closing schools and businesses
De la Paz: Local authorities banned public gatherings, stopped landlords from evicting sick tenants and urged people to stay home. The mayor eventually ordered all downtown businesses to close by 4 p.m. to 1) reduce crowds and 2) because flu germs were thought to be less powerful in the sunshine. Most of the city was under public health orders.
Local schools were closed on Oct. 8  and reopened on Nov. 4, after being thoroughly cleaned and fumigated. During the closure, the school board promised teachers that they would get a full year's salary no matter how long the epidemic lasts. The superintendent said something to the effect [that] teachers are getting paid small enough, they should not be expected to bear the burden of a protracted closure.
I guess one of the most remarkable things about Miami at this time is just how really young the city was and what the restrictions were compared to the threat of a pandemic.
An overwhelmed hospital and the public responds
De la Paz: The local institutions that were critical to containing the outbreak were extremely new.
Miami City Hospital, now known as Jackson Health System, opened just three months before the great flu pandemic. The new city hospital was immediately filled to capacity during the outbreak. And at one point, almost all the nurses were infected with the virus.
During the 1918 pandemic, the initial hot zone was the Naval Air Station on Dinner Key and the commander of the base was upset about the conditions at [the hospital] when his officers were admitted. The Navy medical officer briefly commandeered control of the hospital for a day. That prompted the city to do an audit and that’s how the city found out or confirmed most of the nurses had contracted influenza and untrained volunteers were caring for the sick. This is pretty early in the pandemic, like the second week.
Residents ended up volunteering as caregivers and emergency drivers. A grocery truck was even used as a makeshift ambulance.
Residents and civic groups mobilized to treat the infected and contain the spread of the disease. Trinity Church delivered soup to the homes of the sick. Locals donated hospital supplies and food, including hundreds of limes and grapefruits.
On race and substandard living conditions for black people
De la Paz: D.A. Dorsey, Miami's first black millionaire, turned his Crescent Hotel in Overtown into a temporary hospital for black people.
The Crescent Hotel seemed to be one of the few places for black people to be treated at the time. Jackson was a segregated hospital until the 1960s. It’s not clear if they treated black patients during the pandemic, but I have not found any evidence yet. It’s my understanding that if you were black and you had the Spanish flu you were taken to the Crescent Hotel in Overtown.
I pulled all of the influenza-related deaths for October and November 1918 and began plotting the addresses on a historic map to get a rough sense of how the disease spread over time. I found that more than 10 of the influenza-related deaths in those notices went down one avenue [in Overtown] alone.
Besides the Naval Air Station at Dinner Key, the geographic range of white influenza deaths was much more evenly distributed across the city from Edgewater to Brickell and present day Little Havana. In the early 20th Century, most of Overtown’s built environment was made up of dense rows of distressed wood frame shacks, which were often overcrowded and lacked water and sewer connections. Early in the pandemic, the city health officer said that Overtown was far more vulnerable than the rest of the city due to its substandard conditions and density. Public officials also kept Overtown under quarantine a few days longer than the rest of the city.