Circulating Now welcomes guest bloggers E. Thomas Ewing, PhD, and Sydney Murphy from Virginia Tech to share their research into the reporting around Mortality rates in Mexico City during the 1890 influenza epidemic.
On February 12, 1890, during a meeting of the Academy of Medicine of Mexico, physicians reported on influenza cases among their patients. One speaker, Semeleder, described a range of symptoms among the sixty or more patients he observed in recent weeks. Most cases resulted in a full recovery, but some patients who acted “carelessly” experienced “more severe symptoms.” The President of the Academy, Chacon, stated that while the disease spread quickly and extensively, most people fully recovered, except those with underlying health conditions, such as cardiac disease. Some speakers, including Lavista and Olvera, had been sick themselves, and contributed descriptions of their own symptoms to this discussion. A summary of this meeting was published in Gaceta Médica de México (vol. 25, No, 6, March 15, 1890, pp. 115-120), one of many international medical journals available in the National Library of Medicine.
The toll of the influenza epidemic in Mexico City is revealed by the growing number of deaths in early 1890. The weekly totals are derived from newspapers which reported during the epidemic. During the first four weeks of 1890, total deaths were very similar to the average of 285 recorded in the previous, non-epidemic, year. During the week ending February 2, however, total deaths increased by almost 50%, from 400 to more than 600. The number decreased slightly the following week, but still remained above the average recorded in the previous year. The first five weeks of 1890 recorded more than two thousand deaths, an increase of nearly 50% over the same period in 1889. This chart also illustrates how quickly the death rate decreased during February, with weekly totals receding almost to the averages recorded the previous year.
This data provides an important perspective on the discussion at the Academy of Medicine on February 12, 1890, which revealed how medical professionals, when confronted by a sudden outbreak of a new disease, used the space of a professional meeting to share observations and discuss issues such as diagnosis, treatment, and outcomes. By the time this professional association discussed the emerging threat of epidemic influenza, however, the death rate had already peaked, and would continue to decline for the rest of February. This essay asks about the implications of health professionals debating the severity of an epidemic at a time when the worst outcomes of the disease outbreak had already happened.
This research builds upon previous efforts to measure the mortality associated with the so-called Russian influenza in Paris, France, and other European cities. Although the death toll from the 1889–1892 epidemic was below the remarkable totals associated with both the 1918 influenza epidemic and COVID-19 in 2020, the Russian influenza provides useful insights into the ways that medical experts and public media responded to a widespread disease outbreak and the threat of increased mortality. Physicians and reporters in early 1890 faced questions similar to those posed in the early stages of COVID-19: how many would be infected and how many would die?
The first reports of a European epidemic appeared in Mexican newspapers in early December, which meant that medical professionals had more than a month of warning prior to the disease first appearing in Latin America. The Academy of Medicine initially discussed the epidemic in the second week of January. According to El Tiempo (January 12, 1890), physicians speaking at this meeting predicted that the climate and altitude of Mexico City meant that the disease would not become epidemic, in contrast to the cold and humid conditions which caused the disease’s “malignant character” when it began in Europe. Perhaps reflecting this perception that the pandemic was not a threat to Mexico, the journal Gaceta Médica de México did not include this discussion in the summary of the January meetings (Vol. 25, No. 5, March 1, 1890, p. 95).
In early February 1890, newspapers began to report on an alarming increase in deaths in Mexico City. El Tiempo (February 1, 1890) declared a “lamentable” increase in mortality during the past week. La Patria (February 6, 1890) and El Tiempo (February 7, 1890) asked how the health council planned to respond to the sudden increase in deaths.
El Municipio Libre regularly provided daily reports on deaths in Mexico City. In January 1890, these reports provided a detailed listing of individuals by name, place of birth, age, marital status, cause of death, place of residence, and cemetery. These granular accounts make it possible to trace the steady increase in deaths during the first weeks of the new year and then the sudden increase toward the end of the month as the epidemic reached the capital city. The report published on January 28, for example, identified 23 deaths from pneumonia, bronchitis, and other respiratory diseases, accounting for one-third of the total 66 deaths. None of the deaths were attributed to influenza, even though the day’s total was 50% higher than the average for non-pandemic years. For the next two weeks, when death totals reached the highest levels, El Municipio Libre did not publish daily reports (and did not explain this omission). On February 9, 1890, El Municipio Libre resumed daily mortality reports, with 81 deaths, almost twice the average from the beginning of the year, reported for February 7, 1890.
The absence of daily reports was criticized by other newspapers, such as La Patria, February 12, 1890, which cited rumors that the government had prohibited publication because the mortality was so high that it might cause panic. The English-language newspaper, The Two Republics, commented on February 8 that it could only guess why these reports had been omitted, but “we are sure that less anxiety would be caused by making known the large increase in the death rate than in suppressing the facts.” On February 13, Universal Diario de la Mañana praised the authorities for withholding reports of very high death numbers as a prudent strategy to prevent alarming the public. On February 14, El Nacional declared that it was better for the public to know the truth than to be lulled into complacency if death reports were withheld by municipal authorities.
The most detailed report on daily mortality in February appeared in The Two Republics on March 23, 1890. The graph above reveals the very high mortality in the first week of February and then a steady decrease back to normal levels. This data table also illustrates how the days with the remarkably high mortality also recorded the highest proportions of deaths from respiratory illness.
In addition to reporting numbers, newspapers also published vivid illustrations of the impact of the epidemic. El Tiempo reported on February 9, 1890 that nearly forty coffins were stacked in a mortuary awaiting transport to cemeteries for burial. On the same day, La Voz de México reported that the shortage of coffins to bury the growing number of dead was leading to sharp increases in prices. The coffin shortage, as a vivid example of excessive deaths, was republished in United States newspapers. On February 20, more than a week later, the Evening Star (Washington, DC) cited “private letters” from “American residents of the Mexican capital” who stated that the “truly terrible” results of the influenza meant that many bodies were buried without coffins. This same report appeared in numerous American newspapers in the two weeks that followed as part of global reporting on this pandemic.
By the second week of February, daily death totals began to decrease. On February 10, only 61 deaths were reported by El Municipio Libre, a decrease of 25% from the previous day’s report. On February 15, 1890, El Siglo Diez y Nueve reported that just 47 deaths confirmed that the epidemic was notably declining. On February 15, 1890, El Tiempo declared that 47 deaths was a normal level and “we can calm down now.” After a week of stable or declining daily totals, El Nacional declared on February 22, “mortality is decreasing and we are celebrating.”
This research explores a historical moment in ways informed by the recent experience of the global COVID-19 pandemic by examining the ways that health experts and media outlets respond to growing evidence of a health crisis. As physicians meeting at the Academy of Medicine acknowledged the spread of disease by describing patients under their care, they underestimated the severity of the impact, even as the number of deaths rose rapidly in the two weeks prior to their meeting. In fact, the death rates had already decreased almost to normal levels by the time of this discussion. In certain ways, therefore, newspapers were a more accurate, timely, and detailed source of evidence for the scale of an epidemic, as compared to this dialogue among medical professionals. Yet newspapers also had their limitations, including gaps in published daily death totals, inconsistencies in reporting, and a tendency to use hyperbolic language. Any effort to reveal the data about mortality during an epidemic must thus rely on combinations of sources, including the daily reports of popular press and the expert analysis of health professionals.