• San Francisco has been praised for adhering to the advice of public health officials and responding to the COVID-19 pandemic quickly.
  • But a century earlier during the Spanish flu pandemic, the city was met with anti-mask advocacy, a movement that also exists during the present-day health crisis.
  • The “Anti-Mask League of 1919” formed to overthrow a law ordering residents to wear masks, which they argued was a violation of their civil liberties. Hundreds of “mask slackers” failed to comply with the law during the pandemic, leading to their arrests. 
  • There were 1,000 reported deaths in the city in mid-October 1918. By February 1919, after the city emerged from lockdown too soon and some protested the mask law, 3,000 had been killed.
  • Then and now, masks aren’t a silver bullet in containing respiratory diseases, but they can help.
  • Visit Business Insider’s homepage for more stories.

San Francisco and the surrounding region has been lauded across the US for its stringent compliance with public health orders during the 2020 coronavirus pandemic.

It was one of the first to enter a shelter-in-place order on March 17. But it also happens to be the birthplace of the poster child of anti-mask sentiment during the 1918 Spanish flu pandemic.

The city enforced the wearing of masks during the 1918 pandemic. But some residents were dismissive, wearing them improperly out of apathy or to smoke, leading to hundreds of arrests. And some heartily fought back against the enforcement, believing that the masks were unsanitary, useless, and a threat to their constitutional rights. 

An “Anti-Mask League” was formed in January 1919 in San Francisco, with its members — dubbed “Sanitary Spartacans” — fighting for the mask-wearing mandate to be repealed.

They eventually got their way, but only after San Francisco became one of the worst-hit cities in the US. Eventually, 45,000 residents were infected.

Anti-mask rhetoric is again present in the modern-day COVID-19 health crisis, as some protest mask-wearing and government shutdowns designed to stunt the spread of the disease.

Here’s how San Francisco’s so-called “mask slackers” and the Anti-Mask League clashed with city officials over laws mandating that residents cover their faces to help in the fight against the flu in 1918 and 1919.

Once the Spanish flu of 1918 had rampaged across the globe, at least 20 million to 50 million people were dead.

flu epidemic, 1918

The Oakland Municipal Auditorium was used as a temporary hospital during the pandemic of 1918.

Underwood Archives/Getty Images

It remains one of the worst pandemics in history.

The nations involved in World War I largely censored negative news except for Spain, which was neutral. And so the country’s coverage of a threatening disease resulted in the belief that the flu originated there, and Spain became its namesake.

The influenza came in waves, with the second one specifically devastating the US during the fall of 1918.

san francisco spanish flu 1918

Nurses stand with child patients during the Spanish flu pandemic in 1918 in San Francisco.

California State Library

One of the many precautions that cities took in quelling the spread of the disease was mandating that residents wear masks.

And these weren’t the N95s or other forms of masks that thousands are wearing during the 2020 coronavirus pandemic.

Surgical masks at the time were constructed from gauze, but the materials that many citizens used for masks were even more “porous and ineffective.”

police mask spanish flu 1918

An American policeman wears a mask in November 1918.

Topical Press Agency/Getty Images

Some fashionable women at the time even simply wore pieces of chiffon as face coverings.

Men, in particular, needed to be persuaded to don face coverings after some perceived them as too feminine.

1919 flu mask spanish flu

A newspaper clip from January 1919.

University of Oregon

Public health messaging attempted to rebrand personal hygiene as a display of red-blooded patriotism, and masks eventually became a symbol of patriotic duty.

There was, however, some resistance to wearing masks, despite the belief shared by many that they were effective in containing the disease.

And San Francisco specifically garnered attention at the time for an organization that formed whose sole purpose was to take down the city’s mask law in January 1919.

newspaper clipping anti mask league

A clipping from a Long Beach newspaper on January 21, 1919. Some referred to San Francisco as “Frisco.”

The Long Beach Telegram and The Long Beach Daily News

The previous fall of 1918 was when the disease touched down in San Francisco for the first time.

san francisco spanish flu 1918

A church service is held outside Grace Cathedral in San Francisco during the Spanish Flu pandemic in 1918.

California State Library

By mid-October 1918, there had been more than 20,000 cases of influenza and 1,000 deaths in the city so far.

At first, there was mostly widespread compliance with mask-wearing orders when the first one was issued by the Board of Supervisors on October 25, 1918.

san francisco mask spanish flu pandemic 1918

A man wearing a mask in 1918.

Western Neighborhoods Project/OpenSFHistory.org/wnp26.1205

Businesses, restaurants, and theaters were also closed, and the city’s Board of Health advised people to avoid large crowds and gatherings.

But not everyone was devout in their adherence to the mask-wearing law.

On October 27, 110 people were arrested for flouting officials and either refusing to wear masks in public or wearing them improperly.

san francisco flu mask spanish flu 1918

A policeman wearing a flu mask leads two men away from the Ferry Building in 1918.

California State Library

Source: Stockton Daily Evening Record

They were sent to jail for “disturbing the peace,” and those who could afford it were released under a $10 bail.

san francisco spanish flu 1918 masks

A policeman takes in a citizen for not wearing his flu mask properly in San Francisco in 1918.

California State Library

Some served 30-day jail sentences, according to a report from the San Francisco Chronicle. Many more were gradually imprisoned in the following weeks for the same reason — the Chronicle reported 175 arrests on November 2, 1918.

The jails became overcrowded, with officers working double-duty to process cases.

Some incidents were more violent than others.

A blacksmith named James Wiser refused to wear a mask in public and stood on a street corner attempting to convince others in a crowd to discharge their masks.

mask protests san francisco spanish flu

A clipping from the San Francisco Chronicle on October 29, 1918.

The San Francisco Chronicle

When a health inspector, Henry D. Miller, attempted to reprimand him, Wiser assaulted him and “knocked him to the ground.” In his daze, Miller shot Wiser as well as two bystanders. No one was killed, but both men were arrested.

Despite the conflicts, case counts started to decline in November. The city’s early actions — including the enforcement of masks — seemed to have stunted the spread of the disease.

san francisco spanish flu 1918

People wait in line to receive masks on San Francisco’s Montgomery Street in 1918.

California State Library

Restrictions started to lift on November 16. Theaters, entertainment venues, and sporting arenas began reopening, with patrons required by law to wear masks while inside for the time being.

Even San Francisco Mayor James Rolph and the city’s public health officer, Dr. William Hassler, attended a boxing match at the Civic Center Auditorium.

san francisco spanish flu pandemic 1918

A boxing ring and audience at Civic Center Auditorium on November 16, 1918.

San Francisco History Center, San Francisco Public Library

However, they did so without masks, and police easily identified both men for their failure to comply. Hassler reasoned that his mask must have slipped as he took a drag from his cigar. He coughed up a $5 fine. 

Mayor Rolph was fined $50 by the city’s police chief a few days later.

But the celebration didn’t last long — early December saw a spike in cases.

san francisco mask spanish flu 1918

A policeman wearing a flu mask speaks to a maskless man during the Spanish flu pandemic in San Francisco in 1918.

California State Library

Hassler again began asking for residents to voluntarily wear masks instead of ordering them to do so. Many refused.

san francisco spanish flu 1918

A policeman gives a woman a warning for not wearing a mask during the Spanish flu pandemic in San Francisco in 1918.

California State Library

Officials placed all their bets on the use of masks and didn’t bother shuttering businesses this time around. 

A Red Cross ad placed in the San Francisco Chronicle urging members of the public to wear masks read: “A gauze mask is 99% proof against influenza. Doctors wear them. Those who do not wear them get sick. The man or woman or child who will not wear a mask now is a dangerous slacker.”

Red Cross workers even met the public halfway, setting up flu mask booths and selling them at high-traffic areas such as the Ferry Building.

spanish flu 1918 san francisco

Red Cross workers sell flu masks in San Francisco during the Spanish flu pandemic in 1918.

California State Library

It was seemingly a close call at first — infection numbers dipped, and so people relaxed.

san francisco masks spanish flu 1918

An information counter is staffed by masked workers during the Spanish flu pandemic in San Francisco in 1918.

California State Library

But then 612 new cases were found on January 10, and the surge prompted Hassler to push for a reinstated mask law. On January 17, it was made official.

Resentment once again boiled in some residents who were fatigued by yet another retightening of rules and angered by what they perceived as a violation of their civil liberties.

anti mask league newspaper

A clipping from a newspaper in Santa Ana, Calif., on January 25, 1919.

Santa Ana Register

Others were skeptical of whether or not the masks were even effective in preventing the transmission of the disease, a view point that the state of California and other counties were also beginning to share.

And so the Anti-Mask League formed in San Francisco.

anti mask league san francisco spanish flu 1918

A clipping from the San Francisco Chronicle on January 25, 1919.

The San Francisco Chronicle

Members included influential San Franciscans, a few physicians, and even a member of the Board of Supervisors.

A woman named Emma Harrington served as chairperson, according to records of a Board of Supervisors meeting. Harrington was an activist, the first woman to vote in the city of San Francisco in 1911, and was seeking the position of Justice of the Peace.

Another supporter of the league was Eugene Schmitz, a former mayor of San Francisco found guilty of taking bribes following the destructive 1906 earthquake. Nicknamed “Handsome Gene,” he was sentenced to five years in prison shortly after the disaster.

News of the Anti-Mask League was reported in publications outside of California, including this Canadian newspaper.

newspaper clipping anti mask league 1919

A clipping from a newspaper in Victoria, British Columbia, Canada, on January 18, 1919.

The Victoria Daily Times

An Oregon newspaper clipping notes the league’s intent was “to oppose by all lawful means the compulsory wearing” of masks.

newspaper clipping anti mask league 1919

A clipping from a newspaper in Salem, Oregon, on January 19, 1919.

Statesman Journal/Business Insider

The Anti-Mask League held a public event on January 25, drawing 4,500 people at the Dreamland Roller Rink to put an end to the law mandating that residents wear masks in public.

san francisco dreamland auditorium

The New Dreamland Auditorium, pictured here in 1928, was once the Dreamland Roller Rink.

Western Neighborhoods Project/OpenSFHistory.org/wnp30.0133

The league crafted and submitted a petition to the city calling for the mask ordinance to be repealed. It read in part: “We earnestly pray that the people be granted speedy relief from the burdensome provisions of this measure.”

The resolution was supported by a city supervisor, Charles Nelson, who declared the mask-wearing ordinance “an infringement of our personal liberty” and an affront to the “spirit of a truly democratic people.”

At a Board of Supervisors meeting, Anti-Mask League members even “hissed” at Supervisor Andrew Gallagher, the author of the mask ordinance, according to the San Francisco Examiner.

san francisco mask spanish flu 1918

San Francisco Supervisor Andrew Gallagher wears a mask in 1918.

California State Library

Source: San Francisco Examiner

But Mayor James Rolph stood his ground, professing that the mask ordinance was law and therefore shall be obeyed.

san francisco masks spanish flu 1918

A clipping from the San Francisco Chronicle in October 1918 shows influential residents, including Dr. William Hassler, wearing masks.

The San Francisco Chronicle

He said members of the league, which consisted of about 4,000 people, were the only ones in the city making such drastic requests to rescind the ordinance.

“Do you think I am going to stultify myself here against the wish of 99 1/2 percent of the doctors; against the officials of the army and navy?” Rolph said during the meeting. 

He also expressed his belief that the masks were a contributing factor to the decrease in cases.

san francisco spanish flu 1918 flu mask

A man offers a flu mask to passerby in San Francisco.

California State Library

“I shall repeal this ordinance when the doctors, the Board of Health and common sense permit,” he said according to a San Francisco Examiner article on January 28, 1919. 

The mayor said that efforts should instead be focused on addressing more dire issues such as how to help soldiers reacclimate to everyday life when returning from war.

“We should give our minds to serious matters instead of fighting the little inconvenience occasioned by the wearing of a mask for the protection of the general public,” Rolph said according to records of a Board of Supervisors meeting.

The number of new daily cases peaked first on January 10, 1919, with 612 infections, and then on January 16, with 538 cases.

anti mask league san francisco spanish flu

A clipping from the San Francisco Examiner on January 28, 1919.

The San Francisco Examiner

The number of new cases steadily decreased following January 16. An asterisk beside the January 17 record is accompanied by a note reading: “Mask law became effective.”

 On January 27, there were 54 new infections with 13 reported deaths.

Hassler and the city’s Board of Health deemed the coast clear, and the mask ordinance was once again rescinded on February 1.

anti mask league

A clipping from the San Francisco Chronicle on February 1, 1919.

The San Francisco Chronicle

On the same day, the Anti-Mask League held a meeting, where political turmoil spelled the end of the organization. Harrington was ousted as chairwoman, and the group fizzled out.

By the end of the winter in 1919, nearly 45,000 people had been infected with the flu in San Francisco and 3,000 had died.

san francisco spanish flu 1918

Doctors give each other vaccinations for the flu in San Francisco in 1918.

California State Library

The population of the city at the time was about 500,000, according to census data.

For every 100,000, 673 died due to the flu or pneumonia that it caused, earning San Francisco one of the highest death rates in the country, the 13th highest out of 66 major US cities according to one study.

During the 2020 coronavirus pandemic, the Centers for Disease Control and Prevention now recommends people to wear masks or face coverings, though state and local government mandates vary across the country.

Connecticut reopening mask woman coronavirus

Patron Francesca Macartney Beale dines at Douro restaurant on May 20, 2020 in Greenwich, Connecticut.

John Moore/Getty Images

Source: Business Insider

But masks used nowadays are not built from the porous gauze material that people used during the Spanish flu pandemic in 1918.

san francisco spanish flu 1918

A policeman adjusts a citizen’s flu mask in San Francisco in 1918.

California State Library

Research from the California State Board of Health shows that 78% of nurses at San Francisco General Hospital were infected with the flu in 1918, despite diligent mask use.

However, a study conducted by the National Academy Sciences in 2007 found that the mortality rate was reduced by at least 25% thanks to the measures San Francisco put in place, which included mask-wearing mandates.

The most effective way to prevent respiratory viruses — including the flu and COVID-19 — from spreading is lowering the chance that a respiratory droplet from someone who is infected lands on someone else, thereby infecting them.

san francisco social distancing mission dolores coronavirus

People sit in social distancing circles at Dolores Park on May 20, 2020 in San Francisco.

Justin Sullivan/Getty Images

Implementing social distancing measures as early as possible — as well as sustaining them — is the most straightforward way to do that.

Wearing masks helps too, but they’re not a silver bullet.

During the COVID-19 crisis, San Francisco maintains an order directing people to wear masks when they’re in close proximity to essential businesses as well as when they are near others.

san francisco mask shelter in place

San Francisco in April 2020.

Justin Sullivan/Getty Images

Covering our faces in public will likely be a mainstay for the foreseeable future.

But like the Anti Mask League in 1919, there are some protesting public health advice and orders during the 2020 coronavirus pandemic.

california protest coronavirus

Supporters of President Donald Trump rally to reopen California on May 16, 2020 in Woodland Hills.

David McNew/Getty Images

Similar to how masks were a symbol of patriotism during the Spanish flu pandemic, masks have become politicized during the COVID-19 crisis.

A Costco worker recently turned a shopper away for not wearing a mask upon entry into a store, despite the company’s mask policy for customers to do so as Business Insider’s Mary Hanbury reports. 

And a security guard working at a Family Dollar store in Flint, Michigan, was shot and killed after refusing to allow a customer to enter unless she instructed her daughter to put on a mask.

As Business Insider’s Kate Taylor and Áine Cain report, retail workers are taking the bulk of the backlash from “anti-maskers” who are blowing off mask policies enforced by stores, states, and local governments.

“The employees are downright afraid to ask people to put on masks,” Kroger employee and Michigan resident Kristine Holtham told reporters on Wednesday. “Believe me, if you ask someone to put on a mask, it’s like asking them to throw their gun away.”

By the end of March 2020, 42 states and 94% of the US population was under some sort of lockdown order, many of which included a form of mask-wearing.

new york face covering smoking mask coronavirus

Tom Bonnett, from Brooklyn, smokes a pipe under his mask on May 2, 2020 in New York City.

Yana Paskova/Getty Images

Source: Business Insider

The shutdowns undeniably have wreaked havoc on local economies, with small businesses shuttering and sending unemployment rates through the roof.

coronavirus texas restaurant

Vanessa Zubia-Meza and her mother Margie Zubia in their restaurant called El Paseo on May 18, 2020 in downtown El Paso, Texas.

PAUL RATJE/AFP via Getty Images

Source: Business Insider

Protests in Ohio, Pennsylvania, Florida, and other states began taking place as a result, with residents pressing for the reopening of business activity.

pennsylvania protest coronavirus shutdown mask

A demonstrator at the Pennsylvania Capitol Building to protest the continued closure of businesses due to the coronavirus pandemic on May 15, 2020 in Harrisburg, Pennsylvania.

Mark Makela/Getty Images

Some protestors wear masks, some don’t.

One of the first rounds of protests began in Michigan as residents pushed back against Gov. Gretchen Whitmer’s stay-at-home order, which includes a compulsory face-mask law.

Coronavirus lockdown protest Michigan

People take part in a protest for “Michiganders Against Excessive Quarantine” at the Michigan State Capitol in Lansing, Michigan on April 15, 2020.

Jeff Kowalsky/AFP via Getty Images

Oklahoma has also seen its fair share of dissent.

A 100-person anti-lockdown protest was even held outside San Francisco’s City Hall on May 1, with many citing the economic fallout and small business strife as a reason for participating.

san francisco protest covid-19 coronavirus

Demonstrators protest California Gov. Gavin Newsom’s continued statewide shelter in place order outside of San Francisco City Hall on May 01, 2020.

Justin Sullivan/Getty Images

Source: CBS San Francisco

Some states are already opening in some way or another, such as Georgia, Tennessee, and even California.

tennessee reopening coronavirus pandemic

An employee wearing rubber gloves and a mask greets patrons at Puckett’s Grocery & Restaurant on April 27, 2020 in Franklin, Tennessee.

Jason Kempin/Getty Images

City leaders across the US are tasked with figuring out how to refuel economies and save businesses from going under while also containing the spread of COVID-19.

LoadingSomething is loading.


Visual Slideshow
San Francisco

Chevron iconIt indicates an expandable section or menu, or sometimes previous / next navigation options.