On Oct. 21, 1918, Cleveland reached a milestone of 1000 reported influenza cases last Cleveland hospitals. Within just a few days, the epidemic situation in Cleveland had grown significantly worse.

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. The Health Commissioner, 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.