By Nov. 13, 1918, St. Louis Health Commissioner Dr. Max C. Starkloff began lifting closures and bans over a period of days. Commercial businesses were allowed to open and 100,000 St. Louis schoolchildren began returning to their classrooms the day after that.

For the next two weeks, the infection rate gradually declined, lulling residents into what proved to be a false sense of security. Keeping a vigilant eye on new case tallies, Starkloff spotted a spike on November 27, when more than 700 cases were reported for the previous 24-hour period, half of them children.