A century before the coronavirus disease — known as COVID-19 — dominated the global consciousness, another deadly virus rampaged across the world.
Researchers have since established that the Spanish Flu of 1918, now known as H1N1, originated from an avian strain that mutated to be able to infect humans. The flu's symptoms resembled those a cold's. Patients would sometimes present with a liquid that would pool in their lungs and eventually suffocate them.
The influenza virus eventually killed 50 million people across the globe, and including 675,000 Americans, the equivalent of 225 to 450 million people today, as CBS News reports.
But cities across the country, from St. Louis to San Francisco, implemented measures in an attempt to fight the contagion head-on.
From fresh-air treatments to gargling saltwater, here are some of the precautions that public health and city officials took when the Spanish Flu ravaged the US in 1918 and 1919.
The contagion was dubbed the Spanish Flu for its believed origin in Spain. However, the exact origin is still unclear — some have suggested France, China, or the US.
Law enforcement, like the 1,700 officers within the Boston Police Department, were given masks to wear while on duty.
Cities like San Francisco took that advice to the next level, even writing a law around it. If a person was caught without a mask in public or even wearing it improperly, they were arrested or fined.
San Francisco was lauded for its proactive response to the virus, but city officials relaxed their restrictions following the fall of 1918. After the third wave in the spring of 1919, San Francisco ended up with some of the highest death rates of the flu in the US.
Cities like St. Louis, Missouri, were more proactive in initially addressing the spread of the flu by enforcing social distancing early on, a feat that proved useful in stunting the spread of the flu.
The city's health commissioner quickly called for schools and movie theatres to close and for public gatherings to be banned after an outbreak was found at a military barracks nearby.
As infections grew by the thousands, volunteer nurses treated residents in their homes.
The precautions that St. Louis took helped the city in "flattening the curve," but the Missouri city was hit hard when the flu returned the following spring in 1919 in what would be the third wave of the flu, just as San Francisco was.
City buildings and venues across the US were converted into hospitals and treatment sites, like Oakland's Civic Auditorium to accommodate the growing number of cases grew.
A makeshift flu hospital was set up in San Francisco's Civic Center to help care for infected patients.
Another practice that officials, specifically in Massachusetts, believed to be effective was "fresh air treatments."