Produced by the University of Michigan Center for the History of Medicine and Michigan Publishing, University of Michigan Library

Influenza Encyclopedia

The American Influenza Epidemic of 1918-1919:

A Digital Encyclopedia

Cleveland, Ohio

50 U.S. Cities & Their Stories

On September 22, the people of Cleveland received their first official warning of the impending influenza epidemic from City Health Commissioner Dr. Harry L. Rockwood. United States Army Surgeon General William Gorgas had notified Rockwood of the disease’s spread and the likelihood of it soon arriving in Cleveland.1 Despite the warning, Cleveland was slow to act. It was not until October 4 that City Director of Public Welfare Lamar T. Beman directed Rockwood to undertake a survey of local influenza conditions and to draft a citywide plan of action for precautionary measures against the disease.2

Health Commissioner Rockwood’s plan called for the isolation of those with symptoms of influenza in a contagious disease ward at City Hospital. Employers were asked to instruct sick workers to take time off of work and rest until the symptoms disappeared. Rockwood acknowledged that this was a drastic measure, especially in critical war industries, but argued that it was necessary and would prevent even more time being lost later during an epidemic. Similarly, schools were asked to inspect and monitor students and to send children with symptoms to their homes for rest. Daily reports of all students excused from school were to be made to the Health Department so that their families could be watched as well. The Cleveland Railway Company ordered its motormen to assist in the arrest of all passengers found spitting on their streetcars. A special advisory board was created to help Rockwood. These measures, along with a public education campaign on how to prevent and treat influenza, were Cleveland’s first plan of attack.3

By the end of the first week of October, the situation in Cleveland had grown serious. On October 7, Rockwood announced that the city likely had approximately 500 cases. Only two days earlier, Rockwood had stated that Cleveland’s epidemic was not alarming. Now he was not so sure. To help control the spread of influenza in the city and throughout the greater Cleveland area, the advisory board met with officials from nearby communities. These officials agreed to cooperate with Rockwood to the fullest extent. The advisory board also released instructions to residents not to go to work if they felt sick: “Don’t think that by doing so you are helping the country in its war efforts. You may have influenza and spread the disease and thus deprive the nation of many men’s work. It is therefore your patriotic duty to stay at home if you feel indisposed.” Proprietors of business where the public might assemble as well as clergy were asked to bar people with cold symptoms, and movie house owners were asked to show slides on influenza prevention.4

The next day’s new case reports greatly worried Health Commissioner Rockwood, and on the morning of October 9 he met with Acting Mayor W. S. FitzGerald and Director of Public Welfare Lamar T. Beman to recommend suspending all public gatherings and to close all places of public assembly. Rockwood initially hoped to check the disease through voluntary action. Now he believed, as he told reporters, “more radical steps are needed.” The next day, October 10, Mayor Harry Davis announced the decision to close all theaters, movie houses, dance halls, night schools, churches, and Sunday schools across Cleveland effective Monday, October 14. Saloons, poolrooms, and cabarets were not included in the order because officials believed that it was only necessary to close places where large crowds tended to congregate. The initial plan was to close movie houses and theaters after their Saturday shows on October 12. After protests from owners, however, Rockwood agreed to give them extra time to make arrangements for their closing. As for schools, Rockwood believed students could be better monitored in classrooms than at home.5

At the same time, state officials in Columbus had determined that the epidemic had grown serious enough to warrant the closure of places of public gathering across Ohio. On October 10, the Ohio Health Department issued a notice to all communities, strongly recommending that they issue a local closure order and gathering ban. The state order gave final authority on the matter to local health departments, however, and Cleveland officials decided to continue with their initial closure order, allowing saloons and similar places of business to operate for the time being.6 Meeting with Health Commissioner Rockwood, school officials devised an elaborate plan: schools would remain open so long as their absentee rates did not climb to twenty percent of enrollment, and would be closed after that point. If the overall absentee rate for all schools combined reached ten percent of total enrollment, then the entire Cleveland school system would shut its doors until the epidemic had passed.7

By October 14, the first day of the gathering ban, school absences were high enough for officials to consider closing all of Cleveland’s schools. Health Commissioner Rockwood admitted that such a move would be a drastic step, but stated, “it would be a calamity to allow them to remain open if a considerable number of the pupils are affected.” Rockwood estimated that there were at least 300 children with influenza in the city. Meeting with school officials later that day, Rockwood and the superintendents decided that it was indeed time to close the schools, effective Tuesday, October 15. Children were to report to their classrooms as usual in the morning, where attendance would be taken before they were dismissed. School nurses and doctors were to make home visits to check on students who did not show for class. Teachers were expected to remain in the city during the closure so that schools could re-open quickly as soon as the danger had passed. They were to receive regular pay during the closure period. Parents were told to keep their children in their own backyards, allowing them to get plenty of fresh air and exercise but preventing them from mingling with other children.8

Children may have been granted an unexpected vacation, but teachers were not. The next day, the city’s 3,500 teachers were told to report to their schools to assist nurses investigating cases from the previous day’s 12,500 absences.9 As it turned out, the vast majority of the absent students were truants who, hearing that schools would be closed if absences were high enough, tried to force the issue by remaining away from school. Only a few hundred actual cases were found during the canvas. Discovering their “plot,” school authorities announced that schools would reopen on Monday, October 21.1 When several hundred more students developed influenza in the course of the next several days, however, school officials decided to keep the classrooms closed as originally announced.11

While the city’s schoolchildren were crafty, some residents were outright brazen. Several churches appealed to Health Commissioner Rockwood to be allowed to hold services provided they were kept to an hour; Rockwood denied their request. Two Jewish synagogues decided to ignore the order anyway and to hold indoor services away from their usual temples. Police arrested nine of the men, who pleaded that they were simply worshipping, not holding regular religious service. At a cigar store card game broken up by police, players insisted they were not gambling. Police did not care: the gambling was not the problem, the public gathering was. In another case, a candy shop owner and six others were arrested for allowing people to congregate in the store. Cleveland police took the public gathering ban very seriously.12

As Cleveland police did their job, Health Commissioner Rockwood prepared the city for the brunt of what he expected would soon arrive. He asked the mayor’s advisory war board for a whopping $105,000 in order to equip an emergency influenza hospital, arguing that the epidemic posed a threat to war industries in the Cleveland area. Though only 350 hospital beds were currently available, Rockwood estimated that 1,000 would be needed within the next few days for incoming influenza patients.13 The Red Cross set aside $20,000 to help Rockwood obtain adequate facilities in the suburbs, with the intimation that more funds would be made available if necessary. Rockwood welcomed the money, as he estimated it would cost $122,000 to equip 1,000 beds and to pay for 100 nurses employed for ten weeks.14

By Monday, October 21, Health Commissioner Rockwood estimated that there were 1,000 influenza patients being treated in Cleveland hospitals, with a new case rate that would very quickly outpace the ability for patients to be properly cared for in city facilities. Rockwood arranged to have the Cleveland Normal School at University Circle converted into a 100-bed emergency hospital, and asked all private hospitals to use their free beds for influenza patients. “Cleveland hospitals, as a whole, have been doing good work,” he told reporters, “yet we have not had the proper support from some. These institutions frequently call on the city for financial help and they should respond now.” The Liberty Loan committee quickly offered use of its headquarters, with room for 20 beds, to serve as an emergency hospital annex to nearby Grace Hospital. Rockwood expressed his gratitude, but added that the city desperately needed other similar offers.15

Within just a few days, the epidemic situation in Cleveland had grown significantly worse. Completing the survey and report of the city’s school children, School Medical Director Dr. L. W. Childs announced that at least 1,269 were sick with influenza. Across Cleveland, some 7,323 cases had been reported since the start of the epidemic, with 776 of these being added to the list on October 22 alone. Rockwood, desperate to halt the spread of the disease, added a series of new regulations to the closure order and gathering ban. Business hours in the downtown district were restricted and staggered. Offices were to close by 4:30 pm, wholesale houses by 4:45 pm, small retail shops by 5:00 pm, department stores by 5:30 pm, grocery and hardware stores by 6:00 pm, and saloons and restaurants by 8:00 pm. Only essential services such as telegraph offices and drug stores could remain open past these restrictions, provided they did not sell tobacco–a concession to cigar shop owners. All open-air gatherings, including political meetings, were prohibited without permission, and none were to be held after sundown. The new closing hours were noted to have been so closely observed that, “not even a cigar could have been purchased last night in the downtown district.” In fact, they may have been too closely followed, as night workers and policemen discovered how difficult it could be to find a bite to eat in the late hours.16

Ministers were not happy with the new situation, however. They complained that saloons were becoming points of congregation since they were allowed to remain open later than other businesses. Health Commissioner Rockwood revised the restrictions and required saloons to close by 6:00 pm, a move that appeased some but left members of the temperance movement upset.17 Unable to use their pulpits to preach their cause, a group of one hundred Cleveland clergy joined together for a house-to-house canvass to gain support for prohibition. They called for the closure of saloons and an end to the “discrimination” of allowing these places of immoral behavior to remain open while churches and theaters were shut tight.18

By the first days of November, the epidemic situation had improved enough for Rockwood to consider lifting the ban. Beginning on November 5, downtown businesses were allowed to remain open until 6:00 pm rather than 4:30 pm. Churches were allowed to hold one service each beginning on Sunday, November 10. Meeting with school officials, Rockwood announced that he would not oppose the reopening of schools in a week or so, provided the epidemic situation did not take a turn for the worse. Some school board officials were not entirely sure, worrying that schools would reopen too soon. Rockwood added that he would lift the rest of the bans at the same time.19

As promised, on the evening of Sunday, November 10, Health Commissioner Rockwood announced the lifting of the closure order and gathering ban effective the next day. Schools would not reopen until Wednesday, November 13 to allow for the continued services of school nurses, teachers, and Catholic sisters volunteering in the fight against influenza. Suburban officials, waiting for Cleveland’s lead, also announced their reopening, including nearly every school outside of the city’s school district.20

Clevelanders were excited to once again head downtown for evening entertainment. Musicians and actors were happy to be employed once again, and owners and proprietors were thrilled to be back in business as theaters, boxing rings, stadiums, and ballparks opened to capacity crowds. The month-long closure had cost proprietors more than $1.25 million combined. Conservative estimates of daily loses ran at $11,000 for theaters, $25,000 for movie houses, $12,000 for bars and saloons, and $2,000 for soda fountains. Hotels had also taken a hard hit, as patrons postponed or cancelled conventions. One assistant manager estimated that his establishment had lost $50,000. The total gross loss for all Cleveland hotels was estimated at $200,000. This amount likely would have been even higher had theatrical companies not been forced to hole-up in Cleveland hotels for much of the duration of the gathering ban. With fewer people traveling downtown for entertainment, the Cleveland Railway Company estimated it had lost approximately $200,000, with the greatest daily losses coming on Sundays.21

Over the course of the next several weeks, Cleveland life slowly returned to normal. Cases among school children were still reported in numbers significant enough to concern health officials, but not so much as to require another shutdown of the city’s schools. Instead, the “unit system” initially used was once again put in place: if absenteeism reached twenty percent in a classroom or a school, those rooms or even entire school buildings would be closed until an investigation could determine how many students were actually ill. By mid-December, twelve city schools had been temporarily shut, but Health Commissioner Rockwood and school officials believed that no general school closure would be necessary.22 Cleveland slogged through the rest of its epidemic with no further closure orders or bans.

Influenza had exacted a heavy toll on Cleveland. Between late-September and the end of the year, 23,644 residents fell ill with the disease, with nearly 1,600 developing pneumonia. Over 3,600 people died of either influenza or pneumonia that autumn. An additional 800 deaths occurred in January and February 1919. In those five months, 3.5% of the city’s population came down with influenza or pneumonia; of those that caught the dreaded disease, 16% passed away.23 The result was a total excess death rate of 474 per 100,000, the highest in Ohio, and worse than either New York City or Chicago.

Notes

1 “Warns to Watch for Spanish Flu,” Cleveland Plain Dealer, 22 Sept. 1918, 1.

2 “Spanish Flu to Meet with Fight by City,” Cleveland Plain Dealer, 4 Oct. 1918, 1.

3 “Isolation Will Be Used in Flu Fight,” Cleveland Plain Dealer, 5 Oct. 1918, 1; “Wars on Spitting to Help Avoid Flu,” Cleveland Plain Dealer, 6 Oct. 1918, 1.

4 “Open Campaign to Free City of Flu,” Cleveland Plain Dealer, 9 Oct. 1918, 1.

5 “Ban on Meetings Asked in Flu War,” Cleveland Plain Dealer, 10 Oct. 1918, 1.

6 The Ohio state department of health did not issued a mandatory state-wide closure order, believing that local communities should be left free to adapt the general closure order recommendations to their needs. See “Controlling the Influenza Epidemic in Ohio,” The Ohio Public Health Journal 9 (Nov. 1918), 453-456.

7 “Case Goes Under Quarantine,” Cleveland Plain Dealer, 12 Oct. 1918, 1.

8 “Confer Today on City School Ban,” Cleveland Plain Dealer, 14 Oct. 1918, 6, “All City Schools Shut After Today,” Cleveland Plain Dealer, 15 Oct. 1918, 1, “School Head Urges Children Be Kept in Own Back Yard,” Cleveland Plain Dealer, 15 Oct. 1918, 9.

9 “3,500 Teachers to Combat Influenza,” Cleveland Plain Dealer, 16 Oct. 1918, 7.

10 “See Little Flu, Lots of Hookey,” Cleveland Plain Dealer, 17 Oct. 1918, 1, “300 Get Flu Care Soon in Hospitals,” Cleveland Plain Dealer, 17 Oct. 1918, 10.

11 “Influenza Deaths Doubled for Day,” Cleveland Plain Dealer, 22 Oct. 1918, 5.

12 “Flu Closes City Churches Today, Cleveland Plain Dealer, 20 Oct. 1918, 2A; “Influenza No Excuse,” Cleveland Plain Dealer, 21 Oct. 1918, 7.

13 “Wants $105,000 for Flu Hospital,” Cleveland Plain Dealer, 16 Oct. 1918, 7.

14 “300 Get Flu Care Soon in Hospitals,” Cleveland Plain Dealer, 17 Oct. 1918, 10.

15 “29 More Die of Influenza in Day,” Cleveland Plain Dealer, 21 Oct. 1918, 7, “Influenza Deaths Doubled for Day,” Cleveland Plain Dealer, 22 Oct. 1918, 5.

16 “Ban Is Extended as Flu Spreads,” Cleveland Plain Dealer, 23 Oct. 1918, 1, “Catholic Sisters Take Up Flu Fight,” Cleveland Plain Dealer, 24 Oct. 1918, 8.

17 “Closes Bars at 6, New Flu Mandate,” Cleveland Plain Dealer, 25 Oct. 1918, 8, and “Flu Fighters to Serve Free Food,” Cleveland Plain Dealer, 26 Oct. 1918, 8.

18 “Drys to Cite Flu Ban Differences,” Cleveland Plain Dealer, 27 Oct. 1918, 8A.

19 “Flu Orders Start Moderating Today,” Cleveland Plain Dealer, 5 Nov. 1918, 8.

20 “Flu Lid is Lifted Sunday Midnight,” Cleveland Plain Dealer, 10 Nov. 1918, 1B.

21 “Epidemic Brings Big Money Loss,” Cleveland Plain Dealer, 11 Nov. 1918, 7, “Flu Cut $200,000 from Car Fares,” Cleveland Plain Dealer, 21 Nov. 1918, 13.

22 “Rooms in Schools Get Flu Ban Now,” Cleveland Plain Dealer, 13 Dec. 1918, 2, “3 More Schools Are Shut by Flu,” Cleveland Plain Dealer, 17 Dec. 1918, 2, “Flu Ban Spreads to More Schools,” Cleveland Plain Dealer, 18 Dec. 1918, 6.

23 Case and death figures taken from City of Cleveland, Ohio, Division of Health: Statistical Records, Years 1916-1924 (Cleveland, 1925), 42-44.

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St. Alexis Hospital at 5163 Broadway Ave, SE. Click on image for gallery. St. Alexis Hospital at 5163 Broadway Ave, SE.
Public Square, the “Heart of Cleveland.” Click on image for gallery. Public Square, the “Heart of Cleveland.”
East Technical High School, the city’s first public trade school. Click on image for gallery. East Technical High School, the city’s first public trade school.
Map of southern Ohio, also showing Cleveland (and thus the city’s importance to the state). Click on image for gallery. Map of southern Ohio, also showing Cleveland (and thus the city’s importance to the state).
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Cleveland, Ohio

Timeline of Events

Excess Death Rate (per 100,000) Daily EventsClick day to view details. Selected Event
graphNational
200Excess Death Rate (per 100,000)
180 
160 
140 
120 
100 
80 
60 
40 
20 
0 
Total Excess Death Rate 474
Total Deaths per 100,000 population over duration of epidemic (roughly 1918 September 14 through 1919 February 22).
 19181919
 AugustSeptemberOctoberNovemberDecemberJanuaryFebruaryMarchApril
Sa273101724317142128512192629162330714212841118251815221815222951219
Fr2629162330613202741118251815222961320273101724317142128714212841118
Th2518152229512192631017243171421285121926291623306132027613202731017
We243171421284111825291623306132027411182518152229512192651219262916
Tu2330613202731017241815222951219263101724317142128411182541118251815
Mo2229512192629162330714212841118252916233061320273101724310162431714
Su21284111825181522296132027310172418152229512192629162329152330613

September 21, 1918

The citizens of Cleveland receive their first official warning from Health Commissioner Dr. Harry L. Rockwood regarding the possibility of a Spanish influenza epidemic in the city. Rockwood urges people to take several precautions, including covering noses and mouths when sneezing or coughing, and advises the ill to avoid public places like theaters and churches.

September 27, 1918

Home Service nurses unavailable for overseas service are requested to go to the army camp hospitals to care for influenza patients.

Case School will quarantine its students for two weeks; football games for these weeks are also cancelled.

October 1, 1918

Camp Sherman requests 50 Cleveland nurses for temporary influenza service.

October 4, 1918

Public Welfare Director Lamar T. Beman instructs Health Commissioner Rockwood to make a survey of local conditions regarding influenza and to inaugurate a citywide plan for precautionary measures. Health Commissioner Rockwood asks that physicians report every Spanish influenza case.

The civilian branch of the local Red Cross also starts to take preventive steps against influenza. The organization sends notice to 360 home service chapters, asking them to organize at once to prevent the spread of the disease by cooperating with hospital and public health officials.

The E. 55th Street Hospital bars visitors except for the immediate families of patients; family members will only be admitted after examination for flu symptoms.

October 5, 1918

Plans to isolate those afflicted with influenza are put into place. Public Welfare Director Beman asks Superintendant C.C. Heyner of City Hospital to prepare one of the contagious disease wards for the exclusive treatment and isolation of influenza patients

Health Commissioner Rockwood appeals to all employers to instruct any worker that shows symptoms of influenza to take a few days off. Similarly, school authorities are asked to send students with symptoms home. Rockwood asks Dr. L.W. Childs, Medical Director for Cleveland Schools, to have children in all classrooms examined daily and to instruct them on how to prevent the disease; daily reports of all students excused from school are to be made to the Health Department so that their families may be watched.

Sanitary officers are sent to factories to post signs against spitting. Shop owners are asked to ventilate their stores and to make sure to avoid sweeping floors during working hours.

October 6, 1918

George L. Radcliffe, Vice President of the Cleveland Railway Company, orders all conductors and motormen to cause the arrest of all persons found spitting on cars. Railway officials assure Health Commissioner Rockwood that they will provide additional ventilation on streetcars to avoid stale air.

Rockwood asks that all hospitals refrain from allowing visitors except for critical cases

Dr. C.E. Sawyer, Secretary of the Volunteer Medical Service Corps of the Council of National Defense, asks women physicians of Cleveland to assist in the treatment of influenza in the East.

October 7, 1918

Mt. Sinai Hospital opens an influenza ward with 25 beds for 18 men and seven women.

Passengers complain that streetcars are not well ventilated as promised by the railway company. Cars are reported to be crowded due to the gasoline restrictions, and a number of cars had all windows closed.

The Lake Division of the Red Cross creates a special committee for influenza to be led by James I. Fieser. All available supplies and nurses will be furnished to health authorities free of charge.

October 8, 1918

Thirty-eight homes throughout the city are placed under quarantine.

Health Commissioner Rockwood asks the health officers of Cleveland Heights, Lakewood, East Cleveland, and other suburban towns to help in the influenza campaign by observing any preventive measures issued in the city of Cleveland.

Rockwood calls for all school doors and windows to be opened twice a day for several minutes, and for children to be given breathing exercises. He asks children to bring a clean handkerchief to school everyday and to use it.

October 9, 1918

Classes at St. Lawrence Parochial School are suspended at the request of Health Commissioner Rockwood. Out of a class of 92 children, 47 were found to be ill at home and six others were sent home with influenza.

The following instructions are adopted by the Cleveland Health Department and agreed upon by several suburban health officials: “Don’t go to work if you don’t feel well. Don’t think that by doing so you are helping the country in its war efforts. You may have influenza and spread the disease and thus deprive the nation of many men’s work. It is therefore your patriotic duty to stay at home if you feel indisposed.”

Health Commissioner Rockwood recommends that all public gatherings, except for Liberty Loan rallies, be suspended in Cleveland and Cuyahoga County. He asks Liberty Loan leaders to refrain from having large gatherings. The Health Department also requests that owners of public assemblage places (saloons, poolrooms, etc.) allow educational posters calling attention to precautions, and to prevent crowding. Motion picture houses are asked to show slides explaining what the public can do to help fight influenza. Placards are to be placed on streetcars highlighting the need to keep windows open and calling upon people with colds to avoid riding. Lastly, clergymen are urged turn away congregants suffering from colds or flu.

October 10, 1918

Fourteen new cases are reported at St. Luke’s Hospital, making the total there 46, most of which are physicians and nurses. As a result, the hospital announces it will be closed to visitors and new patients.

Ten Cleveland nurses depart for Camp Sherman.

October 11, 1918

Health Commissioner Rockwood, with the backing of Mayor Harry Lyman Davis, announces that starting Monday (10/14), all theaters, moving picture houses, dance halls, lodge meetings and fraternal or other organizations, night schools, Sunday schools, and churches in Greater Cleveland are to be closed for at least two weeks. Unaffected are public schools, as Rockwood, Medical Director Childs, and R.J. Jones, acting Superintendent of Cleveland Schools, deem it inadvisable.

The Student Army Training Corps at the Case School of Applied Science, 700 students strong, is quarantined at the order of Army medical officers. Schoolwork is stopped and students are to remain in their barracks except for drills. Visitors are barred. Dr. Charles Howe, president of the school, explained that the quarantine is a preventive measure, noting there have not been large numbers of influenza cases among the students.

The Steel Products Company begins a campaign in which employees perform calisthenics and breathing exercises for 15 minutes twice a day. A physician and nurse have also been engaged to instruct and treat the employees, as well as their families.

October 12, 1918

The State Health Board orders closed all indoor gatherings, including saloons and schools, which were exempted in Cleveland’s closing order. Mayor Davis, however, says these places will continue to run for the time being. Health Commissioner Rockwood and school officials announce that a school will be closed if it shows an absent list of twenty-percent due to influenza, and that the whole school system will be closed if overall absences reach ten-percent. St. John Cantius School is asked to close under these rules.

Conditions in Cleveland-area army camps cause a halt in the sending out of selective service men from Cleveland. Liberty Loan officials announce that the remainder of its campaign will involve only outdoor meetings.

The opening of a hospital for the treatment of influenza among soldiers attached to the National Electric Lamp Association is announced. Six soldiers being treated at East Cleveland Hospital will be transferred to the hospital.

October 13, 1918

Night workrooms at the central headquarters and branches of the Red Cross close due to the continued spread of influenza.

Classes will be suspended for one week at Adelbert College. Health Commissioner Rockwood asks that all public funerals be discontinued.

James L. Fieser, Chairman of the Red Cross Committee on Influenza for the Lake Division, recommends the organization of groups of women to augment the professional nursing force.

Many churches hold brief masses today at the behest of the Health Department. Some voluntarily close though the closing order does not go into effect until tomorrow.

October 14, 1918

Closing order for all theaters, moving picture houses, dance halls, lodge meetings and fraternal or other organizations, night schools, Sunday schools, and churches goes into effect.

East Cleveland and Lakewood public schools are ordered closed. Health Commissioner Rockwood meets with R.G. Jones, Acting Superintendent of Schools, and Dr. L.W. Childs, Medical Director of Schools, to determine the policy regarding schools.

The City Council votes unanimously to adjourn immediately in order “to set the city a good example.”

October 15, 1918

All public and private schools are ordered closed indefinitely. School sports will not have games or practices during the school closings. Children are sent home this morning shortly after reporting to school. Nurses and school doctors will visit the homes of students who do not report. Teachers will continue to be paid and are expected to remain in the city during the closing.

Health Commissioner Rockwood extends the closing ban to include all poolrooms, bowling alleys, and cabarets, effective today. Public weddings are banned. Rockwood also issues a special caution to restaurants, saloons, and cafes that loitering is strictly forbidden; what constitutes loitering is to be determined by managers and the police. Outdoor meetings are to be permitted only upon the authorization of health officials.

Rockwood approves the division of the city into districts with physicians assigned to each district, thereby maximizing the number of patients each physician can see.

Hospital superintendents, presidents of trustees of the hospitals, and the Advisory Committee to Health Commissioner Rockwood, meet with Mayor Davis and Rockwood to plan additional hospital facilities. Patients have been being treated at Mt. Sinai Hospital and the City Hospital, but every bed is filled. Other hospitals will be asked to loan beds to these hospitals or arrange for the admission of flu patients.

Dean G.W. Leutner of Western Reserved announces that the College for Women will be indefinitely discontinued.

October 16, 1918

The Museum of Art and all public libraries are closed. The Cleveland School of Art announces it will close for the duration of the epidemic.

3,500 schoolteachers report to their schools to assist school nurses in investigating the cases of yesterday’s absent students. School Medical Director Dr. Childs reports that about 12,500 students were absent. Teachers will not be expected to enter homes with illness. They are only to determine if each absent student is healthy or ill, and if ill, the length of the illness, the name of the attending doctor, and whether the illness is influenza or suspected influenza. These reports are to be given to school principals, who will then relay the information to school nurses who will be sent to the homes of ill pupils.

Twenty-five young women at the Cleveland Normal School volunteer to assist in the Cleveland hospitals.

Health Commissioner Rockwood asks for an appropriation of $105,000 from the mayor’s advisory war board in order to equip a hospital for fighting influenza. Rockwood estimates that 1,000 beds will be needed in the next few days for influenza patients; currently only 350 are available.

Municipal criminal court cases still held, but spectators are barred from courtrooms.

October 17, 1918

A large percentage of the 12,500 absent students on Monday turned out to be truants instead of influenza sufferers according to the teachers’ home canvass. Less than one-percent of Cleveland children have influenza.

The Cleveland Chapter of the Red Cross sets aside $20,000 for use by Health Commissioner Rockwood. He promises to use the money to equip 300 extra beds for influenza patients. Rockwood is also named the Cuyahoga County Red Cross representative and will directly control the provision of hospital facilities in the suburbs as well as the city. He requests that the entire Red Cross list of trained nurses be reserved for use through the Health Department.

Rockwood arranges for daily case and death reporting to be done by wards, allowing for more concerted efforts in particular parts of the city.

A hospital assignment bureau for the distribution of influenza patients and their nurses is created at the Health Department, with Charlotte Ludwig, Chief of the Bureau of Nursing, at its helm.

Hospitals are instructed to limit the admission of patients to only urgent cases.

October 18, 1918

Schools will remain closed through end of October.

400 beds available for influenza patients at Mt. Sinai and City Hospitals. 700 more beds are prepared at other hospitals.

October 19, 1918

Health Commissioner Rockwood calls upon all trained nurses who are married or retired and all women who have experience with caring for the sick to volunteer for service. Rockwood says 200 more nurses are urgently needed. He has also arranged for the rental of 400 blankets, 400 mattresses, 1,200 counterpanes, 2,000 pillowcases, 2,000 sheets, and 800 pillows from the Cleveland & Buffalo Transportation Company.

Plans are announced to have the Cleveland Normal Training School converted into a temporary hospital if the epidemic grows serious.

Film on how influenza is spread through carelessness begins to be shown on street corners in those wards most affected.

Masks are provided to municipal criminal court.

October 20, 1918

For the first time masses are not held in churches. However, four Catholic congregations hold outdoor services on church grounds.

The Day Nursery Association offers five nurseries as hospitals for ill, orphaned children and another as a temporary home for destitute children exposed to influenza. Admissions are to be directed by Charlotte Ludwig, Chief of the Bureau of Nursing.

125 students at St. Ignatius College are quarantined as a precaution despite no cases having reported.

October 21, 1918

The campaign for governor and other offices are to be waged without any general campaign meetings or party rallies. Candidates are preparing campaigns that focus on organization, personal contact with individuals, and advertising.

Health Commissioner Rockwood asks surgeons to delay operations in order to free-up space for influenza cases. A building originally constructed for the Liberty Loan headquarters is offered for use as a temporary hospital today. This “frame building” will house twenty beds for influenza patients.

Rockwood forbids all open-air gatherings except with special permission. The Detention Home for Juveniles is quarantined, and police will no longer send prisoners there. The Lend-a-Hand and Perkins nurseries offer to care for well children who have ill parents.

Patrolmen visit two improvised Jewish synagogues and nine men are taken take to the central station on charges of violating the quarantine. The men pleaded, “they were worshipping.” Rubin Rothman and six others are arrested at Rothman’s confectionary store for violating health orders by keeping the store open and allowing people to congregate.

October 22, 1918

Health Commissioner Rockwood wires Surgeon General Blue urging him to have postal authorities disinfect mailbags and mail, noting that postal clerks have a particularly high rate of infection.

October 23, 1918

New regulations fixing the closing times for saloons, restaurants, and downtown businesses are enacted. Saloons and restaurants must close at 8pm, with the exception of places that cater to night workers. Downtown offices are to close at 4:30pm. Wholesale houses and cloak and suit factories are to close at 4:45pm. One-line retail houses like bookstores and jewelers will close at 5pm. Department stores will close at 5:30pm, and grocery and hardware stores at 6:00pm.

Four hundred Catholic teaching sisters, mostly from parochial schools, offer their services as nurses.

October 24, 1918

Federal Judge Westenhaver decides to cease civil trials requiring juries until after December 9 due to the difficulty in obtaining juries; only criminal trials will be held. Cleveland courts, with the exception of probate, juvenile, and municipal courts, close following a request by the Bar Association. Juvenile court will try only the cases that cannot be postponed.

Twenty-five laborers from the Waterworks Department are enlisted to help dig graves at local cemeteries, which are having difficulty keeping up with demand.

Mt. Sinai hospital has reached capacity. City Hospital begins converting nurses’ quarters to more flu wards.

October 25, 1918

Going into effect today is a new order by Health Commissioner Rockwood requiring saloons to close at 6pm due to reports that people were congregating at saloons after other businesses were closed. All elevator operators are now required to wear masks. Dr. Rockwood announces that regulations and restrictions will continue for another week.

Street Railroad Commissioner Sanders sends an order to President John J. Stanley of the Cleveland Railway Company to reduce streetcar service after 7pm and on Sundays until quarantine regulations are modified. Lower revenues and less traffic are responsible for the order

October 26, 1918

Food centers are established in some districts to provide for those who lack warm meals due to influenza. City authorities will begin flushing the streets by opening fire hydrants several times a day and have streetcar flushers, stored since summer, resume action. The waterworks department provides 100 additional gravediggers.

Superintendent of Schools Jones announces his plans to shorten holidays and hold school until noon on Saturdays in order to make up missed time.

Officials at the Union Club and the Excelsior Club offer their buildings for use as influenza hospitals. Health Commissioner Rockwood accepts the offers, though is unsure if there are enough nurses to handle the added facilities.

Health authorities close the first public bar for failing to prevent loitering and congregating.

October 27, 1918

Major Victor Heiser, sent by the federal government to investigate influenza, speaks with Health Commissioner Rockwood, explaining the steps other cities have taken. Heiser suggests isolating all influenza patients, keeping no more than two in a room, and having all influenza patients wear masks.

Rockwood notifies the School of Medicine of Western Reserve College that 3rd and 4th year men are urgently needed in area hospitals. The scarcity of nurses is also very grave –Rockwood estimates that of the 700 to 800 trained nurses in the city, twenty-five percent are ill with influenza. Beds in hospitals are now 200 in excess of the supply of nurses.

Permission is given to some churches allowing them to hold outdoor services today. One hundred Cleveland ministers, upset that the Health Department has not closed saloons, commit to doing a house-to-house canvass for the support of prohibition.

October 28, 1918

Today’s death total of 118 is the highest for any single day thus far. Lakewood, East Cleveland, and Cleveland Heights report no improvement, prompting their mayors and health officials to call for tightening restrictions.

Policemen are to act as an answering service in order to ensure that doctors can be located for emergency cases.

The City Council adopts by unanimous vote a resolution to require Public Service Director Bernstein to cause the frequent flushing of city streets.

October 29, 1918

Health Commissioner Rockwood hears numerous complaints of extreme crowding on streetcars due to the reduction of cars in service. Street Railway Commissioner Fielder Sanders argued that if there was congestion, it must have been due to some other cause than taking street cars off line.

Rockwood asks that apparel merchants refrain from allowing the return of purchased goods and to decline to send goods out on trial. He especially cautions against stores allowing children and others to try on Halloween masks.

Rockwood forbids “Hallowe’en revelers” from downtown area.

October 31, 1918

Health Commissioner Rockwood announces plans for a day and night physician service to see that influenza victims receive prompt attention. The service, made possible through the aid of the United States Public Health Service (U.S.P.H.S.), will entail a telephone service through the Health Department and the addition of physicians sent by the U.S.P.H.S. to help district physicians run their offices continuously. Physicians, when absent from their offices, are to provide information to the Health Department as to where they can be reached in case a patient calls requesting them; if a doctor cannot be reached, a district physician will be sent to treat the patient. An emergency request is issued for 100 doctors from Cleveland to help in more afflicted areas of Ohio. Physicians who volunteer will be compensated $400/month and $4/day for expenses.

The Cleveland Colored Ministers’ Alliance complains to Mayor Davis about the closing of the churches while saloons are allowed to remain open.

November 3, 1918

Superintendent of Schools Jones voices the hope that the epidemic will have subsided enough to allow for schools to open next Monday.

Councilman Sulzmann announces that he will introduce a resolution at the next city council meeting to require all second-hand furniture, bedding, and clothing removed from influenza homes to be fumigated before being resold.

November 5, 1918

Health Commissioner Rockwood relaxes some of the city’s bans. Downtown business will be allowed to remain open until 6 pm instead of 4:30pm, churches will be allowed to hold one service next Sunday morning, and schools will re-open during the early part or middle of next week if there is no turn for the worse in influenza conditions. The reopening of schools, Rockwood intimates, will be accompanied by the lifting of all other restrictions.

November 7, 1918

Missions, hospitals, and day nurseries report being overcrowded with children who have lost one or more parents to influenza. The Cleveland Humane Society appeals for aid in placing them in permanent adoptive homes or temporary boarding places. Sixty children have been turned over to the society, thirty of whom have lost both parents, and twenty of whom are less than year old.

November 8, 1918

A sudden improvement in conditions leads Health Commissioner Rockwood to optimistically announce that restrictions will be completely lifted on Monday at 6pm, though he emphasizes that this is not definite and that continued improvement is necessary. Contravening this is Superintendent of Schools Jones, who states that schools will not open before Wednesday, 11/13.

The public will be allowed to attend the “greatest football contest in the history of Cleveland” tomorrow between Cleveland and Chicago Naval Reserve.

East Cleveland health authorities will lift their ban Monday morning and church services will be allowed on Sunday.

November 9, 1918

Further improvement of conditions prompts Health Commissioner Rockwood to move up plans for lifting the ban to Sunday at midnight. Funerals are to remain private and hospital visits will continue to be allowed for critical cases only. The schools will not open until Wednesday (11/13) in order to allow for the continued service of school nurses, teachers, and Catholic sisters in helping fight influenza. Rockwood notes that even by Wednesday the Health Department would feel the loss of their service and has asked again that volunteers offer their service to make up for their return to the classroom.

November 10, 1918

Churches hold mass and Sunday school classes this morning.

At midnight the ban is lifted.

November 11, 1918

Health Commissioner Rockwood urges people to continue to use caution in avoiding crowds, covering mouths, to go home upon any symptoms, and reminds employers to keep workplaces well ventilated.

November 12, 1918

Public Libraries reopen.

Public school reopening is delayed until Monday, November 18 by recommendation of Health Commissioner Rockwood, prompted by yesterday’s celebrations for the end of World War I. Acting Superintendent of Schools Jones: “So many children were out and exposed during the celebration that Dr. Rockwood feared epidemic conditions might be made worse [by having children attend school].”

November 13, 1918

High School football games will not resume until a week from Saturday as it was announced that schools would not resume until next Monday. The season, however, will be extended by one week so that teams may play two more games.

Lakewood, Cleveland Heights, West Park, and parochial schools reopen.

November 14, 1918

Funerals, starting today, may be public and held in churches as long as the dead is not an epidemic victim.

November 18, 1918

Public schools reopen.

November 30, 1918

Health Commissioner Rockwood renews efforts to encourage people to take precautions. Sanitary policemen will begin distributing sanitary “dodgers” today in the Public Square, schools, and other gathering places.

Red Cross asks that available nurses contact it in light of an increasing demand for nurses.

December 1, 1918

Lakewood High School is closed because of a recurrence in influenza.

December 7, 1918

Practically all Cleveland suburbs adopt either complete or partial influenza bans. Berea, West Park, and Rocky River close their schools, and East Cleveland closes its schools as well as moving picture shows and churches.

Health Commissioner Rockwood, however, states, “The situation in Cleveland is not alarming.”

December 11, 1918

Rosedale School is closed for the remainder of the current year. Dr. Childs, Medical Director of Cleveland Schools, begins an investigation of conditions at all Cleveland schools in order to determine what should be done.

Authorities in East Cleveland, Cleveland Heights, and Lakewood announce that restrictions will likely continue through the first of the year.

December 12, 1918

Hazeldell School is closed for one day because 490 of its 1,719 students are absent. If investigation shows that many absentees have influenza, then it will be closed for the year.

A “unit system” of closing schools is put in force. Under the plan, any room in which the number of absentees reaches twenty-percent of enrollment is to be closed for one day; the teacher is to investigate the absences, and if ten-percent of students have influenza, the room is to be closed indefinitely. The same plan also applies to entire schools.

The Cleveland Academy of Medicine and Health Commissioner Rookwood jointly issue a regulation asking that physicians report any case “in which the clinical symptoms are those ordinarily associated with so-called ‘grippe’ or ‘influenza,’ including apparently simple colds which present any suspicious constitutional symptoms.”

The ban in East Cleveland is modified to permit regular church services Sunday.

December 13, 1918

Churches in Lakewood are to be limited to one morning service and no Sunday school. The city also bars children under 16 from motion picture shows and requests parents to keep children off street cars and away from public gatherings.

December 14, 1918

Cleveland nurses and physicians who volunteered to aid ailing military installations such as Camp Sherman are allowed to return to the city to help with the rebound of influenza there.

December 16, 1918

Health Commissioner Rockwood appeals for the release of 200 nurses from army cantonments to be returned to Cleveland.

December 17, 1918

The number of closed schools increases to twelve after further closings today.

Councilman Herman H. Finkle, in charge of a committee investigating alleged profiteering by nurses, introduces a new measure that amends an ordinance requiring two guilty charges to revoke a license to require only one.

December 24, 1918

Second peak of the influenza pandemic – death rate is 28 per thousand. The peak of the first wave 66 per thousand and occurred earlier in November.

December 27, 1918

Health Commissioner Rockwood serves as a witness for the State Health Board profiteering investigation.

December 30, 1918

Public schools in Cleveland and all suburbs, except for Cleveland Heights, reopen. Cleveland Heights to start next Thursday.

January 10, 1919

S.M. Bond, President of the Associated Charities, appeals to Clevelanders to help influenza sufferers. He states that 980 families, with thousands of children, recovering from influenza are in the organization’s care, and need warm clothing and nourishing food.

January 21, 1919

The Cleveland Academy of Medicine continues its general investigation of area physicians, referring individual cases to State Board.

January 28, 1919

Cleveland Anti-Flu Society is formed. Its first goal is to ensure the passage of a $5 million appropriation by Congress for influenza research.

February 3, 1919

Resolution urging Congress to support $5 million appropriation is introduced in City Council.

February 27, 1919

Change in weather blamed for jump in flu cases from 10-12 daily to 40-50 daily.

March 1, 1919

Health Commissioner Rockwood asks for increased facilities and aid in response to swelling number of flu cases. Rockwood also asks the City Council to compel physicians to report flu numbers. Thirty-four deaths previous week, compared to 54 deaths during the current week with incomplete data.

April 8, 1919

Cleveland Volunteers of America campaign to purchase an 18-acre farm to house flu orphans.