On Nov. 19, 1918, Birmingham experienced a second wave in new influenza cases from very few to 115 in one day. As November rolled into December, the number of new cases reported daily had not declined significantly.

The Board of Health, along with members of the School Board, the City Commission, and city and county physicians, met to decide whether or not to close schools once again. The group decided that a large portion of the new cases being reported were not actually influenza, but were other illnesses such as severe colds being diagnosed too quickly as influenza by overworked physicians

A group of local physicians disagreed with the decision, and in a signed statement advised parents to keep all children at home for their safety.