Editing Spanish flu (section)

===Public health management===
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| image1            = Coromandel_Hospital_Board.jpg
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| caption1          = Coromandel Hospital Board ([[Dominion of New Zealand|New Zealand]]) advice to influenza sufferers (1918)
| image2            = 19180927 Gauze Mask to Halt Spread of Plague (Spanish flu) - The Washington Times.jpg
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| caption2          = In September 1918, the Red Cross recommended two-layer gauze masks to halt the spread of "plague".<ref name=WashTimes_19180927>{{cite news |title=Gauze Mask to Halt Spread of Plague |url=https://newspaperarchive.com/washington-times-sep-27-1918-p-3/ |work=The Washington Times |date=27 September 1918 |page=3 |access-date=5 October 2020 |archive-date=8 October 2020 |archive-url=https://web.archive.org/web/20201008051659/https://newspaperarchive.com/washington-times-sep-27-1918-p-3/ |url-status=live }}</ref>
| image3            = 1918 Headlines from Chicago newspapers - Spanish flu - 1918 influenza pandemic.jpg
| caption3          = 1918 Chicago newspaper headlines reflect mitigation strategies such as increased ventilation, arrests for not wearing face masks, sequenced [[inoculation]]s, limitations on crowd size, selective closing of businesses, curfews, and lockdowns.<ref name=USAtoday_20201122/> After October's strict containment measures showed some success, Armistice Day celebrations in November and relaxed attitudes by Thanksgiving caused a resurgence.<ref name=USAtoday_20201122>{{cite news | vauthors = Hauck G, Gellis K |title=We're celebrating Thanksgiving amid a pandemic. Here's how we did it in 1918 – and what happened next |url=https://www.usatoday.com/in-depth/news/nation/2020/11/21/covid-and-thanksgiving-how-we-celebrated-during-1918-flu-pandemic/6264231002/ |work=USA Today |date=22 November 2020 |archive-url=https://web.archive.org/web/20201121183814/https://eu.usatoday.com/in-depth/news/nation/2020/11/21/covid-and-thanksgiving-how-we-celebrated-during-1918-flu-pandemic/6264231002/ |archive-date=21 November 2020 |url-status=live }}</ref>
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While systems for alerting public health authorities of infectious spread did exist in 1918, they did not generally include influenza, leading to a delayed response.{{sfn|Spinney|2018|pp=83–84}} Nevertheless, actions were taken. Maritime quarantines were declared on islands such as Iceland, Australia, and American Samoa, saving many lives.{{sfn|Spinney|2018|pp=83–84}} [[Social distancing]] measures were introduced, for example closing schools, theatres, and places of worship, limiting public transportation, and banning mass gatherings.{{sfn|Spinney|2018|pp=87–88}} Wearing [[Surgical mask|face masks]] became common in some places, such as Japan, though there were debates over their efficacy.{{sfn|Spinney|2018|pp=87–88}}<ref>{{cite book |last1=Segrave |first1=Kerry |title=Masking America, 1918–1919: Efforts to Control the Great Influenza Pandemic |date=2024 |publisher=McFarland and Co. |location=Jefferson, NC |isbn=978-1-4766-9449-8 |url=https://mcfarlandbooks.com/product/masking-america-1918-1919 |access-date=1 September 2024 |archive-date=1 September 2024 |archive-url=https://web.archive.org/web/20240901234543/https://mcfarlandbooks.com/product/masking-america-1918-1919/ |url-status=live }}</ref> There was also some resistance to their use, as exemplified by the [[Anti-Mask League of San Francisco]]. Vaccines were developed, but as these were based on bacteria and not the actual virus, they could only help with secondary infections.{{sfn|Spinney|2018|pp=87–88}} The enforcement of restrictions varied.{{sfn|Spinney|2018|p=91}} To a large extent, the New York City health commissioner ordered businesses to open and close on staggered shifts to avoid overcrowding on the subways.<ref>{{Cite web|date=20 September 2021|title=How NYC beat deadly 1918 flu without vaccines, lockdowns, mask mandates or school closures|url=https://www.silive.com/news/2021/09/how-nyc-beat-deadly-1918-flu-without-vaccines-lockdowns-mask-mandates-or-school-closures.html|access-date=23 September 2021|website=silive|language=en|archive-date=21 September 2021|archive-url=https://web.archive.org/web/20210921151432/https://www.silive.com/news/2021/09/how-nyc-beat-deadly-1918-flu-without-vaccines-lockdowns-mask-mandates-or-school-closures.html|url-status=live}}</ref>
A later study found that measures such as banning mass gatherings and requiring the wearing of face masks could cut the death rate up to 50 percent, but this was dependent on their being imposed early in the outbreak and not being lifted prematurely.<ref>{{cite journal | vauthors = Bootsma MC, Ferguson NM | title = The effect of public health measures on the 1918 influenza pandemic in U.S. cities | journal = Proceedings of the National Academy of Sciences of the United States of America | volume = 104 | issue = 18 | pages = 7588–7593 | date = May 2007 | pmid = 17416677 | pmc = 1849868 | doi = 10.1073/pnas.0611071104 | s2cid = 11280273 | doi-access = free | bibcode = 2007PNAS..104.7588B }}</ref>