CoronavirusThe NorthSider

Health commissioner credited with saving lives in 1918 pandemic

ST. LOUIS – The tears were many in St. Louis in 1918 and 1919. The worldwide influenza pandemic that year killed 1,703 people and infected 31,500 in the city, out of about 675,000 in the country and an estimated 20 to 50 million in the world.

But it would have been much worse if it hadn’t been for the quick and decisive action of city Health Commissioner Dr. Max C. Starkloff. 

That action was a major reason why the city’s death rate was only an eighth of Philadelphia’s. Starkloff’s actions today are considered models for fighting mass illnesses such as today’s coronavirus.

Starkloff used emergency powers granted by the city charter to close schools, churches, theaters, movie houses and numerous other venues where people gathered and caught each other’s diseases. He forced streetcars to drive with their windows open.

Businesses condemned Starkloff’s actions as overkill, but he had an ally in Mayor Henry W. Kiel. Kiel defeated Starkloff for the nomination for mayor in 1913 but was strongly behind him in this fight.

For six weeks in October and November 1918, churches were closed and movie houses stayed dark. 

The 1918-19 influenza epidemic killed 1,703 people and infected 31,500 in the city of St. Louis.  NEH photo
It wasn’t just the steps St. Louis took but the speed in implementing them. The National Institutes of Health reported in 2007 on two studies that emphasized quick control.

The studies said that in areas where health officials forced numerous forms of social distancing right after the first cases were reported, death rates per week were as little as half of those in the cities that waited weeks to respond.

In one instance, 200,000 people were allowed to attend a parade to sell Liberty Bonds. The flu spread, and 2,600 people quickly died. 

At a 1934 dinner in Starkloff’s honor, Kiel said of his former opponent, “I believe ‘the Doc’ has added many years to my life, probably to the lives of many of you here and of the people of St. Louis.”

Jim Merkel Born and raised in the St. Louis area, Jim Merkel covered communities throughout the area from 1991 to 2013 for the old Suburban Journals of Greater St. Louis. He is the author of five books about the Gateway City published by Reedy Press. The latest is Growing Up St. Louis: Looking Back Through the Decades. He and his wife, Lorraine, live in the Bevo Mill neighborhood of south St. Louis with Miss Jenny the Cat. For more about Jim, visit

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