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Editor's Introduction: This article on the 1918-19 influenza epidemic in three Massachusetts cities has been excerpted from the online American Influenza Epidemic of 1918-1919: A Digital Encyclopedia with the permission of its editors, J. Alexander Navarro and Howard Markel. They write that the nicknamed "influenza encyclopedia" has become the main "internet repository for historical documents on the American influenza pandemic of 1918-1919. One of the great benefits of a digital archive is its dynamic nature. As new material is found it can be readily incorporated. "1
Since launching the site in 2012, the editors have continued to add hundreds of new archival materials, including contemporary medical journal articles, official military reports, newspaper accounts, and other key primary source documents. In all, they have made thousands of pages available to the public. In addition to these primary sources, the site includes detailed narrative essays describing the course of the epidemic in fifty U.S. cities, including Boston, Lowell, and Fall River.2
The project's origin is more relevant than ever given the current SARS coronavirus pandemic of 2020-21. In 2006 the Center for the History of Medicine at the University of Michigan entered into a collaboration with the U.S. Centers for Disease Control and Prevention (CDC) to study the effectiveness of non-pharmaceutical interventions (NPI), such as masks and social distancing, in U.S. cities during the 1918-1919 epidemic. Public health officials at the CDC "were interested to know what lessons could be gleaned from 1918. How did American cities respond in the fall of 1918? Were their efforts successful? Could these methods be used effectively today?"3
The study concluded that "those cities that used social distancing measures and other non-pharmaceutical interventions in 1918 fared better than those that did not. More specifically, we found a strong association between early, sustained, and layered use of NPIand mitigating the consequences of the epidemic."AHowever, Navarro and Markel warn that:
Although influenza infected and affected nearly every community across the nation, each experienced the epidemic in markedly different ways. Contrary to the popular imagination, the history of the 1918 influenza epidemic is hardly a monolithic one and can be best characterized as many tales of multiple places and people. Consequently, narratives that capture the human dimension of epidemic response often can best be...