Since the nation crossed a grim milestone of one million covid deaths on May 17, 2022, I have been examining how the toll from this pandemic compares to the influenza outbreak of 1918-19 in Harford County.((Carla K. Johnson, Associated Press, US Deaths from COVID hit 1 million, less than 2 1/2 years in))
COVID-19
According to the Harford County Health Department, the first COVID-19 case was identified in the county on March 8, 2020, and the first virus-related death occurred on April 13, 2020.((Barry Glassman, Press Release, Weekly Update on COVID-19, March 20, 2020)),((Barry Glassman, Press Release, Harford’s First Confirmed COVID-19 Death, April 17, 2020)) Over the next 26-months, the mortality count ticked upward, the disease taking 585 lives as of May 25, 2022. This results in 2.22 COVID-19 deaths per 1,000 people since the county has a population of nearly 263,000.((Johns Hopkins University, COVID-19 Dashboard, Center for Systems Science and Engineering)),((U.S. Census Bureau, Population Estimate))
Influenza Pandemic of 1918-19
One-hundred-four years earlier another mysterious pathogen ripped across Harford County. This time about 29,000 people lived here as reports of puzzling pneumonia cases trickled in slowly in the middle of September 1918. But soon a bewildering cluster of influenza cases hit Aberdeen Proving Ground and Edgewood Arsenal. As the calendar turned to October the contagion spread, taking a deadly toll as it pummeled Harford County.((Maryland Death Certificates))
The first fatal influenza case involved 33-year-old Hall Wesley Barefoot of Bedford, PA, an electrician on September 24, 1918. He died at Havre de Grace Hospital. The following day, on September 25, Private Joseph Augustus of Fall River MA, 28, a pipefitter at Edgewood Arsenal, died at the base hospital.((Certificate of Death, Hall Wesley Barefoot, State of Maryland, Dept. of Health, Division of Vital Statistics)),((Certificate of Death, Joseph Augustus, State of Maryland, Dept. of Health, Division of Vital Statistics)),((Find A Grave Website)),((Maryland Death Certificates))
Once the pathogen exploded locally, many residents became gravely ill, and an appalling number of deaths occurred. By the end of 1918, Harford County had recorded 474 excess deaths, a 132 percent increase in mortality over the previous six-year average. Another concentrated wave hit in the winter of 1919, as the virus kept Maryland in its clutches. Over that frosty season, the county reported 63 additional excess deaths, an increase of eighteen percent. This metric, excess deaths, measures how many lives were lost beyond what would have been expected.((Department of Commerce, Bureau of the Census, Mortality Rates 1910-1920))
Flu Swept Across Harford County
During the time the novel pathogen raged across the county in 1918-19, a rough indicator is that of these 537 excess deaths, the Maryland Board of Health attributed 450 to influenza or pneumonia. This gave the county a virus-related death rate of about 15.5 per 1,000 people and an overall death rate of 28.6 for all causes in 1918 and 14.4 in 1919. For the six-year average before 1918, the annual total mortality rate was 13.4((Annual Report of the State Board of Health of Maryland for the year ending Dec. 31, 1918. Table 8)).
Harford County had the second-highest mortality rate per 1,000 in Maryland in 1918, while Anne Arundel County ranked the highest.
| County | Total Death per 1,000 in 1918 |
| Anne Arundel | 42.7 |
| Harford | 28.6 |
| Baltimore City | 25.7 |
| Kent | 24.1 |
| Talbot | 23.3 |
| Cecil | 21.8 |
Comparison
While it is difficult to estimate the precise toll of the disease over 100-years-ago, the excess deaths above the expected mortality level provide one measure for assessing suddenly shifting health outcomes. The county recorded 537 excess deaths when the population stood at just over 29,000.
Comparing events that occurred more than a century apart has many perils. For example, the population of Harford County in 1918 was about eleven percent of what it is today, meaning that influenza cut a much bigger, lethal swath through the county in a short, concentrated period of a few months. COVID-19 has taken more lives than the influenza pandemic did in terms of the raw mortality count, but the population is far larger.
During three waves of influenza from 1918 to 1919, there were 537 excess and 450 virus-related deaths. Thus far, in 2022, there have been 585 COVID-related losses and the data on excess deaths has not been developed. Also, the COVID numbers continue to tick upward as the pandemic is not over. In 1918-19, the death rate for influenza-related cases was about 15.5 cases per 1,000 people, while the rate for the current pandemic is 2.2.
| Measure | 1918-19 | 2020-Present |
| Excess Deaths | 537 | TBD |
| Virus-Related | 450 | 585 |
| Total Deaths | 1,275 | TBD |
| Virus-Related Deaths per/1000 | 15.5 | 2.2 |
| County Population | 29,086 | 262,977 |
Military Installations
One confounding element for a comparative epidemiological study of 1918-19 in Harford County centers on the establishment of Aberdeen Providing Ground (APG) and Edgewood Arsenal. APG formally opened on December 1, 1917, on some 69,000 acres. At its height during World War I, APG had a population of five thousand military personnel and three thousand civilian workers, according to the Historic Inventory of the Property. Edgewood had around 9,210 personnel.((Historic American Buildings Survey, National Park Service, Historic Building Inventory, Aberdeen Providing Ground, Maryland, 1982, p. 28))
As construction workers and military personnel showed up to hastily build the cantonments, these locations where a mobile population congregated served as an incubator for spreading the contagion throughout rural Harford County. Also, this increase in transient population does not appear to have been included in Maryland Board of Health population estimates.
Most of the 1918-19 deaths in Harford County — 44 percent — occurred at the Government Filling Station (Edgewood Arsenal). Aberdeen Proving Ground accounted for 38-percent of the deaths, with the remaining 18 percent occurring across the county.