Mask Mandates: A History of Rebellion

ElyaDatabase ID Number: M164

Creator: Cameron Issacs ’21 Public Health

The influenza pandemic of 1918 was the most-deadly flu outbreak in history; it was caused by an H1N1 virus of avian origin. The virus spread worldwide during 1918-1919 and as seen on the map, it was first identified in the United States in April of 1918 on a military base in Kansas. The route of transmission in the United States was often through military travel. Approximately 1/3 of the world’s population became infected with this virus, killing about 675,000 people in the United States1.

While the pandemic spread all throughout the United States, the public health interventions were not equally implemented. Mask mandates were often the most controversial intervention. Cities and smaller towns spanning from the West Coast to the Midwest mandated masks in tandem with other public health interventions (limiting events, closing schools, etc). However, these interventions were not in widespread use on the East Coast. As seen in the map, the mask mandates were largely localized on the West Coast or Midwest2.

This trend is in stark contrast to what is occurring with COVID-19. The COVID-19 has a similar breadth of infection, but the mask mandates were quite different in trends of implementation. Peak outbreaks have occurred in different locations at different times, but the mask mandates remain relatively consistent. The Northeast and West Coast are strong in their public health efforts. While the geography of interventions is different now than it was in 1918, there is similar pushback when it comes to implementation. In San Francisco, there was a large effort by the Anti-Mask League in 1918 to remove these mandates as they claimed the mandate was unconstitutional3. Today, we see similar movements across the country.

Both the influenza pandemic of 1918 and the COVID-19 pandemic spread throughout the United States, often hitting urban areas the hardest but impacting every single town in some way or another. Mask implementation in 1918 was localized to the West Coast and Midwest, while in 2020, the difference is that the interventions are in widespread use in the northeast as well. During both pandemics, there was significant polarization and pushback regarding the best resolution despite clear evidence that intervening early and for the long-term leads to much better outcomes3.


  1. Marrin, Albert. Very, Very, Very Dreadful The Influenza Pandemic of 1918. Alfred a Knopf Inc, 2018. 
  2. Mason, Anthony. A Look at the Role of Masks during the Devastating 1918 Flu Pandemic. CQ Roll Call, New York, 2020. ProQuest,
  3. Giuliani-Hoffman, Francesca. “Face Masks: In 2020, ‘Mask Slacking’ is More Partisan than in 1918, Historians Say.” CNN Wire Service, Aug 16, 2020. ProQuest,

Cite This Work :

Cameron Issacs, “Mask Mandates: A History of Rebellion.” Scale: 1:1:18,489,298. In Elya J. Zhang, ed., Mapping History Series. <> (accessed May 27, 2022).

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