page_title: Max C. Starkloff
section_title: Armistice Day and the resurgence of the flu
hierarchical_section_title: Max C. Starkloff / Second tenure and the 1918 influenza pandemic / Armistice Day and the resurgence of the flu
caption_attribution_description: English: Comparison of Boston, Philadelphia, St. Louis, and Seattle death rates for the last 16 weeks of 1918 during the 1918 influenza pandemic. Based upon 10941Table11.xls from *Hatchett, Richard J.&#32;(2007-04-06).&#32;"Public health interventions and epidemic intensity during the 1918 influenza pandemic". Proceedings of the National Academy of Sciences&#32;104&#32;(18): 7582–7587.&#32;Proceedings of the National Academy of Sciences. DOI:10.1073/pnas.0610941104. ISSN 0027-8424.
context_page_description: Max Carl Starkloff was an American physician and the Health Commissioner for St. Louis, Missouri, from 1895 to 1903 and from 1911 to 1933. He is noted for closing all public venues and prohibiting public gatherings of more than 20 people in October 1918 during the 1918 influenza pandemic. His actions are credited as being an early instance in modern medicine of social distancing.
context_section_description: Armistice Day occurred on November 11, 1918. Due to the public holiday, stores were closed, but public celebration occurred outdoors as the people St. Louis celebrated the end of World War I. With the waning of the flu pandemic in St. Louis, Starkloff relented to the gradual reopening of public places.
  This proved to be premature, as there was a resurgence of the flu among the young. Schools had reopened on November 14, but by November 28, Starkloff had them closed again and had banned those under 16 "from stores, including department stores, ten-cent stores, and theaters." Influenza cases peaked on December 3 at 1,467, and influenza deaths peaked on December 10 at 58. By year's end, new cases had fallen to 50 a day. Starkloff ended restrictions on December 28, and schools reopened on January 2, 1919.
caption: Weekly excess pneumonia and influenza death rates per 100,000 for Boston, Philadelphia, St. Louis, and Seattle during the last 16 weeks in 1918
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