By October 10th, 1918, the influenza outbreak had been spreading through the area for at least two weeks. The infection rate spread rapidly and began to put a strain on local medical responders. This article from the Johnson City Staff newspaper mentions the toll that the disease had taken on both individuals and entire families, and acknowledged that the available medical staff was not enough.

The Red Cross began raising the call for volunteers to help combat the growing problem and assist medical personnel. In addition to qualified nurses, they were asking for able volunteers, and for necessary items including bedding and gowns. The call for volunteer service seen here was targeted specifically towards women, and highlighted the need of volunteers from both black and white communities. 

The volunteer work included general care in sick wards and hospitals, as well as the cooking and delivery of food by motor car to families who were unable to provide for themselves due to illness. Red Cross stories, updates, and calls for service ran regularly in most area newspapers throughout the duration of the pandemic in the area.

Although it was not as emphasized in local press coverage, African American communities felt the impact of influenza and contributed to fighting it as well. The Herald and Tribune, Johnson City Staff, and Greeneville Sun would occasionally mention African American communities and individuals, but research suggests that there was not a specific African American news publication in the area at that time. 

This shows us not only how serious the influenza outbreak had become in the area by October 1918, but the toll that it had taken on families and the strain that it placed on the medical system. It also shows how the area responded, and how volunteers contributed to the effort to combat the spread of the disease.