On Sept. 22, 1918, Cleveland received its first warning of the influenza epidemic from City Health Commissioner Dr. Harry L Rockwood, after having been notified by the U.S. Army Surgeon General William Gorgas.

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.

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.

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.

By the end of the first week of October, the situation in Cleveland had grown serious.