Delaware Hospitals Overwhelmed during Pandemic of 1918

After that deadly killer, the Spanish flu, slipped silently into Delaware in 1918, a devastating autumn outbreak crushed the state’s health care system.  By the middle of September, the pathogen started making considerable inroads in New Castle County, and in the waning days of the month, nearly a thousand Wilmington residents fell ill.  This unchecked spread created a tremendous strain, crushing all parts of the early 20^th-century health care system.  However, in particular, the surge of the stricken needing around-the-clock inpatient care completely overwhelmed medical centers as beds filled up and officials scrambled to increase capacity. 

In this two-part series, we examine the impact of the pandemic of 1918 on Delaware hospitals.  It begins by exploring the inpatient system in 1917, the year before the virus staggered the state.  The second part considers the direct consequences of the 1918 autumn surge and actions officials took to increase capacity. 

When that unforgettable year, 1918, arrived, Delaware hospitals already suffered from a shortage of nurses and doctors as many caregivers were off serving the military.  Moreover, hospital beds were in short supply, a condition that existed long before World War I.  The city had three public hospitals and one proprietary (physician-owned) facility.  In New Castle County, the Trustees of the Poor managed the County Hospital, a place previously known as the County Almshouse.  Below the canal, two public centers existed to provide around-the-clock bedside nursing care, the “Milford Emergency Hospital,” and Dr. Bebee’s Hospital in Lewes.  There were also a few federal and state institutions.

Delaware Hospitals in 1917

Presented in chronological order, this is a list of inpatient medical centers in 1917 with notes about the institutions. 

• United States Marine Hospital, Lewes – Located on the government reservation at Breakwater, the “Delaware Breakwater Quarantine Hospital” opened on October 20, 1884, under Acting Surgeon William P. Orr.  It included a surgeon’s quarters, six patient beds, a kitchen, and a small shed.  The Marine Hospital Service inspected arriving ships, checking for infectious diseases.  By 1912, the American Medical Directory reported that the “United States Marine Hospital” had 32 beds.   But sometime during 1917, the United States Navy took over the station as a base, as the processing of immigrants stopping there during World War I.((American Medical Directory. United States: American Medical Association, 1912.  http://bit.ly/35f8Imn))

• New Castle County Hospital, Farnhurst – Originally known as the New Castle County Almshouse, the poorhouse opened at Farnhust in 1884.  According to the Morning News, the legislature changed the name to the New Castle County Hospital in 1899, which pleased most of the Trustees as the institution had always been conducted more as a hospital than an almshouse.  ((Trustees of the Poor, Morning News, April 27, 1899)).  Late in the 1890s,  the Trustees of the Poor added a “pest house,” a separate building to treat contagious patients.   The public hospital had 250 beds in 1917.((Farnhurst, Delaware, a web page, https://www.farnhurst.com/new-castle-county-almshousehospital-1884–1933.html))

• Homeopathic Hospital, Wilmington – The first public hospital in the city started admitting patients on February 10, 1888, at Shallcross Avenue and Van Buren in the former Heald’s Hygeian Home.  Originally envisioned to be a general hospital for all doctors, allopathic physicians objected to homeopathic doctors having admitting privileges, so funders established it as a homeopathic medical center.  By 1917, it had 75 beds.  When its door swung open to receive patients, it was the only hospital in Wilmington.  In 1940, it was renamed Memorial Hospital.((Homeopathic Care Before it was Trendy,” Delaware Today, July 14, 2014, http://bit.ly/2MHqbxr)),((Homeopathic Hospital Association of Delaware, Thirty-FirstAnnual Report for the year ending November 15, 1918, in the collection of the Wilmington Public Library))

• Delaware State Hospital for the Insane, Farnhurst – A center for the treatment of mental illnesses, the hospital was established in 1889.  It had a capacity for 450 patients in 1917.

• Delaware Hospital, Wilmington – With the homeopathic hospital flourishing and drawing many patients, allopathic practitioners decided they, too, needed a hospital.  They purchased a lot at 14^th and Washington streets and built a new 100-bed brick structure, which was named the Delaware Hospital.  The first patient, James Sutherland, arrived on February 22, 1890.((Delaware Hospital, Twenty-Eighth and Twenty-Ninth Annual Report, 1917 and 1918, in the collection of the Wilmington Public Library))

• Dr. J. J Jones Private Hospital, Wilmington.  Established in 1896 by Dr. John J. Jones at 1012 Delaware Avenue, Wilmington.  By 1917 the private hospital had 30 beds.

• Emergency Hospital, Milford, DE.  Established in 1908, on the fourth floor of the Central Hotel, the medical facility, the first public facility in southern Delaware, received emergency cases that were not contagious.  it had grown to 16 beds by 1916.((American Medical Directory, 5^th edition, 1916, 327, Hathi trust https://bit.ly/3pME0cg))

• Physicians and Surgeons Hospital, Wilmington – As the number of doctors increased in the city in the waning decades of the 19^th century, many were not affiliated with either of Wilmington’s public hospitals.  These unaffiliate doctors decided in 1909 to set up an open hospital, which they called physicians and surgeons.  They bought a large home at eight and Adams streets, which they equipped and opened on December 20, 1909.  The institution also established a training school for nurses, the first class graduating in 1915.  By 1917, the facility accommodated 25 patients, and in 1921 Physician’s and Surgeon’s established the first contagion unit in Wilmington, putting an end to the longtime problem of what to do with patients suffering from infectious disease.  Up to that time, contagious patients were either sent to the Farnhurst Pest Hour or quarantined in their own homes.  In 1928, the governing association changed the name to Wilmington General Hospital, as this represented the institutional mission, “an open hospital for all people,” which also welcomed all reputable physicians and surgeons.  On April 25, 1929, operations moved to a greatly expanded modern hospital at Broom and Chestnut streets.((Morning News, “P & S Hospital to be Wilmington General Hospital,” June 11, 1928. p 14))

• Beebe Hospital — The first hospital downstate, the proprietary institution opened in 1916.((Helping Hand – Hospitals Had Many Changes, January 5, 1993, News Journal))

Once the surge slammed the state at the end of September 1918, the existing medical centers overflowed with patients, beds spilling into hallways and other spaces where ever they could be jammed.  This forced physicians to save beds for the most gravely ill while others suffered at home. 

Next (coming soon) — In part two, we examine how Delaware hospitals established facilities and took other measures to expand capacity.

For more on Delaware Hospitals and the Spanish influenza see the Delmarva Spanish Flu Archive