At first, officials downplayed the severity of the outbreak, but by autumn, healthy adults and children from cities to remote rural areas were being stricken, with many dying within days.
The first case in Nevada was diagnosed in October, and Reno's Board of Health imposed a precautionary citywide quarantine.
After several confirmed cases became public in Washoe County in October 1918, government ordered the closure of Reno's high school, theaters, churches, saloons and other locations of large gatherings. Dr. M. A. Robinson, a member of the city's board of health, was quoted in the Reno Evening Gazette saying, "Precautions must be taken and everyone is asked to cooperate with the health authorities in keeping the disease from spreading."
The Western Shoshone Agency instructed members of the tribe to "not go to the store unless it is necessary," adding, "if you have to go to the store or office your wants will be attended to on the porches."
Children were "not allowed to mingle on the play grounds" and the University of Nevada, Reno implemented a campus-wide quarantine, according to newspaper reports. Initially, grade schools remained open with students leaving every other seat open - an early 20th century form of social distancing - but they eventually closed. Hotels, schools and fraternal lodges around the state were converted into temporary hospitals.
University of Nevada President Walter Ernest Clark issued the following order: "Beginning (Oct. 11, 1918)...a military guard will be set about campus and no one will be allowed to go from the campus or to come on the campus except by express permission."
At the time of UNR's quarantine, Reno had a handful of confirmed cases, and no confirmed cases on campus, but university officials felt the threat of the flu demanded a serious response to "check the spread."
In 2018, the Nevada State Museum in Las Vegas created an exhibit for the centennial of the 1918 Influenza. The exhibit noted that the 1918 flu killed 40 of Las Vegas' 2,000 residents, but those numbers are believed to be low because many who died with pneumonia during that time were not included in the total count.
With a limited understanding of the illness and no viable treatments, doctors struggled to keep the infection from spreading. Edwin Cantlon was seven years old at the time and living in Sparks when a family practitioner from Fernley visited his family's ranch, as he recalled in 1992.
"Dr. Joslin passed out masks which were similar to the early-day cloth masks used in the operating room, and gave the instructions to soak these masks in rubbing alcohol and then wear them over your nose and mouth," Cantlon says. "This proved to be a chore that was beyond most people, and the smell of the rubbing alcohol, I guess, was the deciding factor, and this was soon discarded."
Out in public, gauze masks became a common sight. In nearby Plumas County, California, anyone caught in public without wearing one was fined $25 - a large fee
Schools, Elks lodges, and other buildings were converted into temporary hospitals to keep patients isolated. At one point, about 80 percent of the children in the Carson City Orphan's Home were sick. Cantlon's family came through unaffected but when the quarantine was lifted, he found that others hadn't been so lucky.
"There was a sizeable epidemic, and schools in Sparks were shut down for a month or so during the winter months," Cantlon says. "And I remember that when I went back to school, two of our classmates had passed on from this."
By the 1930's, medical advances had identified the cause as a virus, and the first clinically tested vaccines to fight it were given to American soldiers during World War II. Among them was Edwin Cantlon, who had attended Harvard medical school and served in the Army medical corps during the war. After it ended, he returned to Reno, where he ran a surgical practice for the next 41 years.
The MLB delayed its 2020 season due to COVID-19. But during the 1918 flu pandemic, baseball players, umpires and fans donned masks and headed to the diamond.