Overcoming South Bend’s Influenza Outbreak to Enumerate the 1920 Census

This year, the federal government undertook the all-encompassing task of completing the U.S. Census, a project instituted every ten years. The census is a national count of everyone living in the United States, providing policymakers with essential demographic information that they use to map congressional districts and allocate federal funds. However, the COVID-19 pandemic created difficulties for its completion, specifically in counting those who did not complete the census form by mail or online. As the New York Times reported earlier this year:

 Already, a multi-day nationwide count of roughly a half-million homeless people has been put off. Processing of mailed-in census forms has slowed because the bureau shaved its staff at regional centers in Jeffersonville, Ind., and Tucson, Ariz. And social-distancing cuts in the bureau’s call center work force have slowed down responses to people who want to complete the census by phone or need other kinds of help.

2020 Census materials in Detroit. Brittany Greeson, New York Times.

These kinds of obstacles are not new to census-takers. In fact, a similar problem occurred in South Bend during the 1920 Census, where a small, but powerful Influenza epidemic stunted the city’s completion of the census.

In South Bend, the work of the 14th decennial census started on January 3, 1920, with seventy-one initial enumerators (census takers) tasked with counting the city’s population. Initially, weather proved a more formidable foe. “The enumerators were somewhat handicapped owing to the severe weather encountered on the first day,” the South Bend News-Times noted. Despite the weather slowing down progress, enumerators succeeded in getting citizens to cooperate and answer all their questions. Inspector for the local district, attorney Edwin H. Sommerer, anticipated a count of the city population in fifteen days and the rural population in thirty.

South Bend News-Times, January 3, 1920. Hoosier State Chronicles.

Within a few weeks, this task was complicated by an outbreak of Influenza, a lingering problem possibly stemming from the widespread Spanish Influenza epidemic a year prior. The city downplayed the outbreak’s potential to become another epidemic on January 16, when Dr. Emil G. Freyermuth, secretary of the city’s board of health, reported that no cases had been noted by physicians and that a chance of an epidemic was an “exaggeration,” as recounted in the News-Times. Freyermuth seemed to be contradicted by the South Bend News-Times itself, which published a notice in the January 17 edition that “the ranks of the [paper] carriers are sorely depleted at the present time on account of the mild form of influenza prevalent in the city.”

South Bend News-Times, January 17, 1920. Hoosier State Chronicles.

By January 20, the outbreak had worsened, leaving factories in South Bend short on labor as a result. Four were reported dead the next day, including a student at Notre Dame, and the illness reached epidemic proportions at local Army camps. Despite continued assurances about the mildness of this outbreak by Dr. Freyermuth, the situation worsened to such an extent that the Salvation Army volunteered to assist in combating it.

On January 26, the South Bend News-Times officially declared an epidemic, after 1,800 cases were reported around the city (250 at Notre Dame alone) and twenty-two deaths over the prior weekend. Dr. M. V. Ziegler of the State Board of Health confirmed these numbers, but Notre Dame physician, Dr. F. J. Powers, denied the high level of cases, “stating that the majority was afflicted with colds and la-grippe [another name for the flu].” Regardless of the disputes, the city reeled from the disease.

South Bend News-Times, January 26, 1920. Hoosier State Chronicles.

The epidemic devastated census-taking, incapacitating forty-five of the eighty-five-member staff and crippling those still healthy enough to continue. Census district chief Edwin H. Sommerer told the News-Times, “the enumerators working find it difficult to complete their task because of the sickness in the homes.” The News-Times doesn’t mention whether enumerators took any preventative precautions to avoid infection, other than just staying home. By contrast, mail carriers only experienced a loss of five workers during the outbreak, which was attributed to them being more acclimated to the intense winter weather.

By January 27, the epidemic began to subside, with only one death reported on the Monday after the weekend in which twenty-two people died. Employees in factories, stores, and offices also started returning to work. Even though this news was positive, the News-Times encouraged its readers to remain vigilant, noting “This marked decline does not mean, however, that all danger is past . . . the public is warned by the health department to exercise the greatest precaution in avoiding colds.”

South Bend News-Times, January 27, 1920. Hoosier State Chronicles.

Despite delays, South Bend’s census enumeration continued, with some staff returning to duty starting on Wednesday, January 28 and over the subsequent days. By the end of January, the team completed half of the districts, most of which were cities, but still needed to complete the rural populations. On April 9, the News-Times reported that Sommerer and his team finished South Bend’s census, with only one-hundred names not accounted for. The city’s final count was sent to LaPorte for a larger district tabulation and then on to Washington, D.C. for inclusion in the federal count. In all, South Bend’s population increased by 32.2%, from 53,684 in the 1910 Census to 70,983 people in the 1920 Census. As the The city’s population increase “can be credited almost entirely to the industrial development of South Bend,” the News-Times wrote.  Additionally, residents’ land valuation almost doubled, from $26,000,000 in 1910 to $43,000,000 in 1920. Months of bad weather, a flu outbreak, and some uncooperative citizens never stopped Sommerer and his crew of enumerators from obtaining the final figures and providing a demographic portrait of South Bend.

South Bend News-Times, July 28, 1920. Hoosier State Chronicles.

South Bend’s 1920 Census, and the flu outbreak that nearly derailed it, can inform modern census analysis. The COVID-19 pandemic has already affected the completion of the 2020 Census, with the deadline to to be counted extended to October 31. However, if Indiana’s enumerators are as dedicated to their roles as Sommerer’s team was 100 years ago, there is no doubt that an accurate count of our state will be completed.

The Fort Wayne Visiting Nurse League

Josephine Shatzer, first paid nurse, image courtesy of Visiting Nurse Archives.

With a staff of over 155 and over 170 volunteers, today’s Fort Wayne Visiting Nurse is a far cry from its humble beginnings. In 1888, a group of Fort Wayne women organized the Ladies Relief Union with a mission to “help the sick poor of Ft Wayne.”  Calling themselves the Visiting Nurse Committee, they soon discovered a link between poverty and disease.  Dr. Jessie Calvin, a Fort Wayne sanitation and indoor plumbing pioneer, encouraged women’s church groups to raise money for a qualified nurse that could meet community needs.

Prior to the 1860s, nursing was “typically considered a domestic responsibility provided in the home by family members.” Nursing as a profession evolved after the Civil War, when women gained experience caring for wounded soldiers. Historian Clifton J. Philips noted that in the post-war period, women’s religious orders were “especially active in establishing hospitals in an attempt to extend to the general public, and the poor in particular, some of the services formerly rendered to sick and wounded soldiers.” As hospitals materialized, so too did nursing groups and training programs. By 1897, The Fort Wayne Journal-Gazette noted that “modern nurses” wished to “be given her proper position as a skilled assistant in serious illness.”

Nurse with a Ford Model T purchased in the 1920s, so that nurses could more efficiently reach patients, image courtesy of Visiting Nurse Archives.

The paper added that:

The daily or visiting nurse is a recent development of modern nursing and meets the needs of many people who find it inconvenient to have a nurse stopping in the house and requiring more or less attention from servants perhaps already overtaxed. The visiting nurse comes in for an hour or so every day to perform those services for which her skill is needed.

On March 1, 1900, an organizational meeting was held in Fort Wayne and the Visiting Nurse League became a reality. At a salary of $10.00 a week, Josephine Shatzer was hired as the League’s first nurse.  During harsh weather she took a trolley, but normally she could be seen making her rounds on her bicycle.  Regardless of transportation, it was clear that she wasted no time.  On her first day she saw six patients.  Next she established a baby milk station at First Presbyterian Church, instructing new moms how to prepare formula.

Fort Wayne Daily News, September 29, 1900, 5, accessed Newspapers.com.

She also volunteered at free immunization clinics, bathed patients, delivered meals, changed bedding, dressed wounds, cared for the elderly and ill in their homes and endeared herself to all she served. At the end of her first year she had made hundreds of calls, utilizing supplies donated by local churches, relief societies, and drug stores. For those patients who could pay, the charge of a one-hour visit was fifteen cents.

The Fort Wayne Daily News praised the program in 1900, noting that the league “found favor with all classes of people” and that visits to the “sick poor” conveyed not only “help and benefit, but hope and good cheer to every member of the family.” In 1913, the Public Health Nursing Association appointed a visiting nurse to serve African American patients at the Flanner Guild. Dr. Calvin continued to guide the League, through the years of World War I and the 1918 flu epidemic, which took the lives of 3,266 Hoosiers.

Nurse treating a young burn victim, image courtesy of Visiting Nurse Archives.

By 1919, a nurse named Dixon had reached a salary of $100.00 a month. League expenditures in 1920 stood at $1,300 annually and in 1922 the Community Chest offered its support.  Insurance companies began to hire nurses from local visiting nurse groups to assess policyholders who were ill, and paid the League seventy-five cents a visit.  By 1923, the League reorganized and served in an advisory, instructional health teaching capacity. The Great Depression wrought poor health conditions: eight nurses made over 29,000 visits to 4,477 patients.  One made 3,255 orthopedic visits to 104 crippled children, many of whom were victims of polio.  Sisters of Saint Joseph Hospital provided free hospitalization in the pediatric ward for those who could not pay.  In the 1940s, World War II increased demands for nursing schools to produce eligible Nurse Corps candidates.

In 1954, the agency changed its name to Visiting Nurse Service, Inc.  By 1956, it undertook a program that cared for stroke victims in their homes, which served to collect data on medication, exercise, loss of function and the need for expanded therapy service. By 1962, the agency’s director Eva Rosser introduced a State Board of Health-funded program that focused on treating the chronically ill in their homes, instead of a hospital or nursing home.  Later the group provided care as home health aides and the agency became certified for Medicare on July 1966.

Nurse visiting a patient, likely just after World War II, image courtesy of Visiting Nurse Archives.

With certification came additional paper work.  According to History of Visiting Nurse, by 1983, “a record number of visits for a single month occurred (2,200), due to earlier hospital releases and greater technology used in the home.” During this period, the glucometer was used for the first time, registered nurses were trained to perform phlebotomy services, and around-the-clock care was made available for all patients. In 1984, Medicare Hospice Benefit became available and Visiting Nurse Service merged with Hospice of Fort Wayne, Parkview, and Lutheran Hospices.  The agency introduced computerized billing and, by the end of the decade, services for the frail and disabled.  By 1990, Hospice service visits totaled 38,177, a forty percent increase over previous months.

History of Visiting Nurse noted that in 1990 the agency moved to the “Moellering Unit of the nearly vacant former Lutheran Hospital.” In 1995, the 1984 merger dissolved and Visiting Nurse Service and Hospice became a free standing agency. By February 2001, a new Hospice Home facility opened and in 2006 a building expansion added patient rooms. In 2011, nurse practitioners joined the staff and the “Watchful Passage” program began, in which trained volunteers remained at patient’s bedside during the last few days of life. In 2018, Visiting Nurse staff and volunteers can proudly stand tall celebrating 130 years of community service.