A viral illness with no vaccine has brought life in St. Paul to a standstill.

The city’s schools are closed. Government officials have shuttered bars, restaurants and other businesses.

Critically ill patients overwhelm local hospitals, where nurses and doctors also are coming down with symptoms.

The year is 1918.

Although the crisis brought on by the COVID-19 pandemic is unprecedented, it echoes an earlier outbreak that gripped the city more than a century ago.

LIFE UPENDED IN ST. PAUL, ACROSS U.S.

The misnamed “Spanish flu” upended life in St. Paul and across the U.S. in ways that would be unthinkable now if we weren’t reliving them, says Susan Dowd, a local historian who penned a 2005 article about the pandemic for “Ramsey County History Magazine.”

“The similarities are really quite striking,” Dowd said. “Closing down schools, churches, bars — the sorts of things we’re doing now. It was being contained in 1918 by quarantining people.”

With the first flu vaccine 20 years away, this deadly strain of H1N1 influenza spread unchecked across the globe, killing 12,000 people in Minnesota and 50 million worldwide before it finally subsided in mid-1919.

The lessons of this century-old pandemic are now helping to inform Minnesota’s fight against the COVID-19 virus, including social-distancing guidelines and Gov. Tim Walz’s stay-at-home order, said Richard Danila, deputy state epidemiologist at the Minnesota Department of Health.

Danila co-authored a 2007 article for the journal “Public Health Reports” about the 1918 flu outbreak in the Twin Cities.

“A lot of the stuff we learned from that, we’re using it today,” Danila said. “You need good, consistent communication. If you’re up front and transparent about why things are being done, you’re going to get better cooperation” from the public.

A distant ancestor of the “swine flu” virus that caused another far less deadly outbreak in 2009, the 1918 flu found the perfect transmission vehicle in the massive armies crisscrossing Europe at the climax of World War I. Consequently, the earliest cases discovered in the U.S. were among members of the military.

DEATH IN THE RANKS

When Lt. Fred Scharf’s influenza turned into pneumonia in late September 1918, he was admitted to the Army hospital at Fort Snelling.

By the time he died just a few days later, nearly 270 servicemen were quarantined at the fort with flu symptoms.

Scharf, an Iowa native serving as an instructor for the University of Minnesota Students’ Army Training Corps, was the first to die in Minnesota of what was then called “Spanish flu.”

Although its true origins are still debated — China and Kansas have both been floated as potential suspects — the illness earned its erroneous nickname after a May outbreak in Spain made global headlines.

It took another five months for the virus to reach Minnesota. A soldier returning from Camp Sheridan in Illinois brought it to the little village of Wells near Albert Lea, Dowd writes in her 2005 article. From there, it quickly spread to the Twin Cities, where it infected Scharf and a number of other soldiers.

Within a few days of Scharf’s death, cases began popping up among the local civilian population, too. By Oct. 13, there were 181 reported in St. Paul alone — 24 of them fatal.

CASES BALLOON

While most strains of influenza kill primarily the very old and the very young, the virus that struck in 1918 was unusually deadly for those in their 20s and 30s.

But few St. Paulites appear to have taken the epidemic seriously early on, Dowd said. Businesses remained open and schools continued to hold classes.

This changed with the Oct. 26 flu death of a prominent local physician. That same day, the Pioneer Press reported that the number of flu cases in St. Paul had ballooned to nearly 1,900, including 59 deaths.

“People sat up and took notice,” Dowd writes. “The mood that seemed almost complacent only two weeks earlier changed abruptly as fear set in.”

MEDICAL PROFESSIONALS STRETCHED THIN

The epidemic could not have arrived at a worse time. Many local doctors and nurses were stationed overseas with the military, leaving remaining medical professionals stretched thin.

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Why a Minnesota governor once punched a St. Paul Dispatch editor in the face “The number of influenza patients that needed the attention of physicians and nurses overwhelmed St. Paul and Minneapolis clinicians,” Danila and his co-authors wrote in 2007.

The St. Paul Citizens Influenza Committee, chaired by railroad scion Louis W. Hill, convinced the city to open a free 300-bed hospital.

It wasn’t just health care professionals in short supply.

SCARCE COMMODITIES

Much like hand sanitizer — and, inexplicably, toilet paper — today, Vick’s VapoRub flew off store shelves.

The company, which marketed its signature product as an effective treatment for respiratory illnesses like influenza, placed a notice in the Pioneer Press on Oct. 30, 1918, saying demand for VapoRub was causing shortages.

Another scarce commodity was gauze face masks, which experts at the time recommended wearing as a defense against airborne germs. The local chapter of the American Red Cross produced 50,000 masks.

But cases continued to climb. “In Heaven’s Name Do Something!” the Pioneer Press begged of public officials in the headline of a Nov. 3 editorial.

ST. PAUL SHUTS DOWN

By Nov. 4, the official tally of flu cases in St. Paul approached 3,600, although a handful of private physicians interviewed by the Pioneer Press estimated the total was actually north of 10,000.

That same day, the St. Paul City Council pressured its reluctant health director, Dr. B.F. Simon, to issue a sweeping order closing schools, churches, bars and many other businesses.

The order, which took effect Nov. 6, was based on social-distancing guidelines that would be familiar to almost anyone living through the COVID-19 pandemic. All public spaces where people were routinely within six feet of each other were affected.

Simon also forbade the use of elevators in buildings less than six stories tall and limited the number of people who could crowd onto the city’s streetcars.

Most public gatherings were banned, although an exception was made for work related to the war effort.

“While some accepted the changes imposed on them, others protested regulations they considered unfair,” Danila and his co-authors wrote in 2007. “Some called for more stringent methods, while others blatantly broke the new rules that were intended to protect them.”

EXTREME MEASURES PAY OFF

Several bars and restaurants were caught operating in violation of the closing order, and high school football teams in Minneapolis, where sporting events were banned, scheduled games against teams in St. Paul, where no such ban was in place.

But the extreme measures eventually paid off. New influenza cases declined steadily. They remained in place even as St. Paulites ventured outside to celebrate the Allied victory in World War I on Nov. 11.

The order was finally lifted on Nov. 17, and things appeared to be getting back to normal by Thanksgiving day two weeks later.

But in early December, the number of new flu cases again began to climb. By Dec. 10, the epidemic had sickened 7,275 in St. Paul.

DEATH TOLL OF 1,180 FOR ST. PAUL

The outbreak didn’t taper off for good until after the new year, as the city’s focus turned to welcoming home the troops returning from European battlefields.

The combined death toll in St. Paul from influenza and pneumonia during the outbreak finally settled at 1,180, according to Dowd’s research.

“After it was over, it was quickly forgotten,” she said. “That was just amazing to me. How could people have forgotten? But they did.”