ST. LOUIS (KMOV.com) -- If history repeats itself, could we expect to see a second and third wave of the disease, just as St. Louis did during the deadly influenza outbreak of 1918?

Red Cross ambulance 1918 Spanish flu

Nov. 28, 1918 - The influenza closure order was reinstated after a sudden and large increase in the number of new cases. There were 707 new cases in a 24-hour period that ended at noon on November 28. The second issuance order closed the city schools (public, parochial, and private). It also banned all public gatherings, conventions, and banquets. Streetcars could carry only twenty standing passengers in addition to those seated.

(In the photo: The American Red Cross in St. Louis ran five ambulances every day to transport sick patients.)

Mikall Venso, of the Missouri Historical Society, has been studying the influenza pandemic of 1918 for nearly five years.

“It was very fatal,” he said.

Dr. Max Starkloff

Oct. 8, 1918 - Dr. Max Starkloff ordered the closure of schools, movie theaters, saloons, sporting events and other public gathering spots.

Starkloff was the St. Louis City Health Commissioner for 30 years. 

Around 50 million people died globally from what’s been called the Spanish flu. But Venso said it actually started much closer to home.

“A lot of work by some great scholars have pinpointed that it originated actually in Kansas, in a small, rural county in Kansas as early as January of 1918,” Venso said.

Cases may have been in St. Louis in the spring of ’18.

“It’s just sort of the same way today, it’s kind of hard to tell, who really has it,” Venso said.

But it was in the fall of 1918, as the first World War waged overseas, that the fatal flu took off here.

“It was a solider in Jefferson Barracks was the first one in the St. Louis area that was the first reported case and the first reported death,” said Venso.

Life, of course, was much different back then. And they didn’t know a lot about disease.

Pamphlets encouraged people to sleep with your windows open, gargle salt water, even eat onions to fight the flu.

But thankfully, St. Louis had a healer at the helm, head of the health department: Dr. Max Starkloff.

He keenly watched places like Philadelphia. In the midst of an outbreak, they had held a war time parade.

“As soon as they did that, tens of thousands of people gathered in close proximity and then days later people got sick and the deaths skyrocketed,” Venso said.

Philadelphia didn't cancel a parade during a 1918 pandemic. The results were devastating

In September 1918, Philadelphia held a planned Liberty Loan Parade to promote the government bonds that were being issued to pay for World War I. But the parade took place when the pandemic commonly called the "Spanish flu" -- the H1N1 virus -- arrived in the city of 1.7 million people.

So Dr. Starkloff immediately implemented what we now know as social distancing: closing schools, movie theaters, saloons and churches.

[RELATED: Aggressive actions during 1918 Influenza pandemic made St. Louis a city ahead of its time]

“And of course, there was an outcry about that and then people kind of got on board and started to do it, but what St. Louis did, is we flattened the curve,” Venso said. “They didn’t use the exact language, but it was the same principle.”

Other cities eventually followed St. Louis’ lead. Many people even wore masks.

But some studies suggested it was too late: Philly, San Francisco and New York experienced steep curves with ultimate deaths in the tens of thousands.

But St. Louis’ takes a much different shape.

Starkloff had tried implementing even stricter measures, but business leaders pushed back. Then the war ended.

“And so people kind of got out of their homes and wanted to celebrate and commemorate what was happening and then just days later, it really started to climb again, the peak went right back up even higher than it had before,” Venso said.

Restrictions lifted in mid-November, then were imposed again two weeks later. But by mid-December, cases in St. Louis hit their highest peak: 60 deaths in one day.

Below is the timeline of the 1918 influenza pandemic in St. Louis

Easing social distancing too soon, scholars say, created a more significant second wave in St. Louis than in other parts of the country.

So, what does that mean for St. Louis now? Will history repeat itself? 

“Both of the diseases are different, the way they’re moving is different, and all of our situations are different, but I think the big lesson is that there’s a great body of evidence that suggests that social distancing works,” Venso said.

Now, only time will tell.

Eventually, in 1919, life for St. Louisans returned to relative normal.

“There is always hope,” Venso said.

Copyright 2020 KMOV (Meredith Corporation). All rights reserved

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