Historians and epidemiologists have compared the COVID-19 outbreak to the Spanish Flu of 1918. At the time, Milwaukee was a leader in mitigating the spread of the virus. The city’s socialist leadership partially explain its success. A few years before the outbreak of the virus, Milwaukee’s municipal Socialist government modernized its public health infrastructure. Because of this, when the Spanish Flu hit, the city was able to coordinate a successful public health campaign to combat it. In doing so, it put itself on the path to becoming a national model for municipal public health.
In 1910, the Milwaukee Socialist Party achieved a stunning victory. Under the leadership of the politically shrewd Victor Berger, the Socialist Party won a majority on Milwaukee’s Common Council, the County Board, three local judges, the city treasurer, the city attorney, the comptroller, and the mayor. It was the most triumphant victory for the Socialist Party and any area in the United States.
While party leaders championed the inevitable goal of Milwaukee becoming a cooperative commonwealth, they were well aware that their electoral coalition was not solely composed of party activists. The party won well above its membership numbers by building a broad coalition that included recent immigrants, trade unionists, and middle-class professionals concerned with local corruption. The coalition approach to politics meant that—despite winning an electoral majority—the socialist government still had to prove itself to the public through its governance.
Before the election of the socialist government, Milwaukee’s public health infrastructure was substandard. A series of cholera outbreaks and infection scares led to the creation of a permanent Board of Public Health in 1867, but the Board failed to bring the city on par with its contemporaries. Like many major cities at the time, Milwaukee was under the control of a corrupt political machine led by the local Democratic Party. In 1898, the Democratic machine appointed Dr. F. M. Schulz as head of the Board of Public Health. Schulz willfully fired known Republicans and replaced them with unqualified but loyal Democrats. The blatant corruption led to the Democrats being temporarily ousted from power in the 1906 election and the removal of Dr. Schulz from office. His successor, Dr. Gerhard A. Bading, was a Republican who espoused a gospel of administrative “efficiency.” Living up to his creed, he made sweeping austerity cuts that gutted the health department’s patronaged jobs, but also limited its functions. During his second year in office, Bading saved the agency $18,000 but decided to hand the amount over to the city treasurer rather than use it to expand services.
After the Socialist Party was swept into power in 1910, the city’s Board of Health experienced a dramatic transformation. The Socialist mayor Emil Siedal appointed Dr. F. A. Kraft to head the Board. Kraft set to work on creating a modern public health system that corrected the deficiencies of previous administrations. Both Schulz and Bading were aware of the rising number of Milwaukeeans experiencing intestinal infections due to water contamination. Schulz raised the issue within the council, but the lethargic machine Democrats refused to act. Bading was more decisive. He swiftly shut down contaminated wells, but this action left several Milwaukeeans without easy access to water. Kraft, shocked by the callousness of his predecessors, advocated for investments in a modern water filtration and sewage treatment system. After a typhoid epidemic in 1910, the Socialist controlled government moved on the issue and treated the city’s water supply with hypochlorite lime. Kraft also improved public health access for Milwaukee’s children. Kraft supported the Socialist city planners Wilbur and Elsie Phillips in creating a Child Welfare Commission. Using the city’s Polish dominated fourteenth ward as a test case, the Phillips were able to demonstrate that they could cut the ward’s infant morbidity rate in half through a series of child-focused programs. It did not take long for Child Welfare Commission’s proposals to be universally practiced throughout the city, and eventually, become a public health model throughout the municipal reform movement. Both water treatment and the child welfare policies solidified Kraft’s contributions to Milwaukee, but his most significant impact was on the was in developing a new administrative framework for the Board. Kraft’s approach to public health emphasized prevention and community coordination. The Board of Health was no longer considered a passive agency but worked in tandem with civil society organizations to better the lives of Milwaukeeans. In doing so, he established a set of public health guidelines that became the Board framework until the 1970s.
Despite the successes of Seidal’s government, the Socialist Party was not able to hold onto power. Seidal lost the mayoralty in 1912 to former Board of Public Health head Dr. Bading. Wanting to prevent another Socialist victory, both Democrats and Republics agreed to support Bading as a “fusion” candidate. During the campaign, Bading promised to remove Kraft as head of the Board after it was argued the Board had added excessive amounts of hypochlorite lime to the water supply. In 1914, Kraft was replaced by the city’s bacteriologist Dr. George C. Ruhland. Kraft’s discharge was politically motivated—Bading never hid his disdain for the Socialists—but Ruhland was not a believer in Bading’s ideology of administrative “efficiency.” To the chagrin of many who wanted to see the Milwaukee Socialist Party crushed, including Bading, Ruhland continued with Kraft’s popular policies. Under Ruhland, despite the issue of overtreatment, Kraft’s water treatment program became a permanent practice and the city’s child welfare policies continued.
While the Socialist Party was never able to achieve the same electoral success it did in 1910, it was able to take back the mayoralty in 1916. Under the Socialist banner, former city attorney Daniel Hoan defeated Bading by a 1,200-vote margin. Unlike Seidal in 1910, Hoan lacked a majority on the Common Council. From the time of his election for the next four years Democrats and Republicans successfully united to block all his appointments. The political obstructionism prevented Hoan from making changes to the Board of Public Health. Nevertheless, Hoan and Ruhland worked together in leading the city out of one of its gravest public health crises.
The first cases of the Spanish Flu in Milwaukee were diagnosed on September 15, 1918. Four individuals—one laborer and three sailors—contracted the disease at the Great Lakes Naval Training Station, located across state lines in Illinois. The disease first appeared at the station four days prior, but it took only a week for it to overwhelm the station’s hospital. Once the first cases were reported in Milwaukee, Ruhland immediately requested that the station be put under quarantine. Station officials agreed, but the move was already too late. By September 21, Milwaukee reported a hundred infection cases.
In response, Ruhland encouraged Milwaukee residents to avoid crowds, and refrain from kissing, spitting, and shaking hands. Unfortunately, the bulk of Milwaukee residents ignored Ruhland’s orders. With the First World War still ongoing, many Americans were gripped by a sense of fervent nationalism. Throughout the month of September, numerous “Patriot Meetings” were held to support the Wilson administration’s fourth Liberty Loan drive. On September 27, a large gathering of “patriots” met at the Strand Theater to support the loan drive. The following day the city went through with its plans to host a massive Liberty Loan parade that drew approximately 25,000 participants.
The parade was a massive mistake. The large crowd allowed the virus to spread throughout the population mercilessly. Ruhland worked quickly to deal with the city’s folly. He appointed an advisory committee to oversee quarantine efforts and expanded the city’s hospital facilities. By early October, Mayor Hoan and the rest of the Common Council realized that ending the pandemic required that the city throw its full weight behind the effort. On October 11, they supported Ruhland in ordering the cessation of all nonessential gatherings and for the Board of Public Health to launch an education campaign on how to avoid the disease, relying largely on the civil society connections that Kraft had established to get the word out. The methods were effective. By October 14 the virus peaked at 6,000 confirmed cases, potentially 30,000 unconfirmed infections, and a death toll over 350.
By late October, the virus subsided enough that Ruhland agreed to lift the ban on public gatherings starting November 4, one day before the 1918 election. When November 4 arrived, there was a frenzy of political campaigning. In the end, the election was disastrous for the local Democratic Party. War-weary and scorned by the foolishness of the Liberty Loan drive, voters took out their frustrations on Wilson’s party. Wisconsin’s Republican Governor, Emanuel Philipp, easily won re-election, and the Republicans won ten of Wisconsin’s eleven Congressional seats. The Socialist Party also saw tremendous gains. It was their best electoral results since 1910. Not only did Socialists win several county and municipal seats, but the last Congressional seat went to the Socialist Party leader Victor Berger, who won despite being under a federal indictment for opposing the war.
An armistice was called on November 11, and while hostilities had ended, Ruhland was still ordered to report for the draft in late November. The Common Council agreed to grant him a ninety-day leave of absence to report to duty, but Hoan vetoed the leave. The Socialist mayor, already hesitant to show signs of supporting Wilson’s war, argued that Ruhland was needed in Milwaukee and his role as a public servant superseded his obligations under the draft. Hoan’s veto ended up being prescient. By mid-November, the Spanish Flu resurged. During the first week of December, approximately 300 new patients were diagnosed with the virus per day. In response, the Board of Public Health ordered theaters and churches to reduce their capacity, closed schools, encouraged residents to wear masks, and called for the quarantining of infected households. This time around residents obliged. By the end of December, the virus had run its course. The restrictions were lifted in early January.
The virus was ruthless. By the end of 1918, it killed 1,173 Milwaukee residents, approximately 23% of all Spanish Flu deaths in Wisconsin. Nevertheless, Milwaukee managed the crisis successfully. Despite the folly of the Liberty Loan parade, the city had the second lowest death rate in the United States. Largely, this success can be attributed Ruhland and the actions of the Board of Public Health, but these would not have been possible if Socialists like Kraft had not modernized the Board in 1910 or if Mayor Hoan had forfeited Ruhland to draft. In the end, the long-term effects of the city’s response to the pandemic were positive. Hoan would go on to be Milwaukee’s longest serving mayor, maintaining control of the office for a record setting twenty-four years. During that time, Milwaukee became known for its stellar public health program. Throughout the 1930s, it was widely recognized as the healthiest city in the United States.
The Milwaukee experience demonstrates that a competent government can fight off the worst of outcomes of a pandemic. Ruhland should receive credit for his actions, but if the Socialist Party had not modernized the Board of Health in 1910, even the best head would not had been as successful. The fundamental lesson is that critical public health problems cannot find solutions unless there are investments in a public infrastructure that focuses on prevention and coordination. This cannot happen if the government is controlled by corrupt lackeys, austerity ideologues, or in some cases both. To succeed against a pandemic, governments must put the lives of their people above short-term profits and short-sighted nationalism. Unfortunately for Americans, Trump has done neither. Given the history, it would better to put the socialists in charge.