Influenza victims crowd into an emergency hospital near Fort Riley in 1918. The Spanish flu pandemic killed at least 20 million people worldwide.

In a rare move, K-State officials announced on Thursday the indefinite suspension of in-person classes because of coronavirus concerns.

The move extended the university’s spring break by another week, giving faculty time to prepare for a switch to remote online schooling beginning March 23.

The last time a similar suspension occurred, according to K-State archivists, was in 1918 during the Spanish Influenza pandemic.

It hit the campus in mid-October. The Kansas Board of Health closed all colleges from Oct. 12 to Nov. 10 and then later the local board of health closed K-State from Dec. 9 to 29.

The Young Men’s Christian Association (YMCA) and fraternity houses became makeshift hospitals, wrote K-State Historian Julius Terrass Willard in his 1940 book, “History of the Kansas State College of Agriculture and Applied Science.”

“Great hardship was experienced, as the quarters occupied were not equipped for hospital work,” Willard wrote. “Members of the faculty and other Manhattan citizens made generous contributions of pillows, blankets and other materials. Faculty women and others gave unstinted services such as nurses and dietitians. It was a time of sore distress to the men and their parents. On October 18, 307 men were sick out of a total of 1,188 present in the two sections (of the Students’ Army Training Corps). The influenza developed into pneumonia in many cases, but the mortality rate was lower than in the regular army camps.”

Because of the closings, the winter break was shortened and the second semester was extended an extra week.

According to the Kansas Historical Society, cases of the new flu strain were first recorded in Haskell County and Fort Riley around March 1918 as World War I raged on overseas. Historians believe the virus may have mutated from pigs kept at the Army installation.

Reports of severe flu-like symptoms began cropping up all over the base. Overcrowded tents with poor sanitation and inadequate medical facilities at the time laid the foundation for an outbreak. Within a week, as many as 500 soldiers were hospitalized with similar symptoms. That number dwindled over the course of the month, and it seemed like the worst had passed.

Many of these soldiers soon moved to camps throughout the country and were sent to Europe to help fight in the war, unknowingly infecting local populations. During that period, scientists said the disease mutated and became more deadly.

“By May, many reports of soldiers falling ill were reaching the U.S.,” a Kansas Historical Society article said. “It did not take long for the disease to spread from the soldiers to the civilian population of Europe, and then around the world. Few areas remained unaffected, and there were recorded outbreaks in Asia, Africa, Europe, North and South America, as well as the Arctic and remote Pacific Islands.”

Despite the local roots, the disease became known as the Spanish influenza. Historians believe the name came about because of the lack of media censorship in Spain when the influenza arrived, leading people to think it was an insulated issue there.

Scientists said the disease mutated again and by October, 24 countries, including the U.S., had reported cases of the influenza and several deaths.

What set this particular strain of flu apart from others was how quickly it spread from person to person and because it mostly affected people ages 20-40 who were typically healthy, not the usual young children and elderly with chronic health conditions.

By fall 1918, the disease had seemingly returned to Kansas. This time, however, government officials took quick action to halt the spread of the virus. They started public health education campaigns, limited gatherings of crowds and closed schools, theaters, church services and even some cities.

Hundreds of Kansans still died, but officials made efforts to limit the outbreak and prevent more people from becoming sick.

The third and last wave of the pandemic hit in spring 1919, and “many reported that it was so severe that people could wake up healthy and be dead by nightfall,” the Kansas Historical Society said.

As the season tapered, the number of patients had dropped enough that governments lifted bans from cities and states, allowing people to resume school and church.

Historians estimate the disease killed between 20 million to 50 million people across the world — more than the total number of deaths from World War I — and about 675,000 people in the U.S. alone.

Similar precautions are unfolding today as the novel coronavirus outbreak, or COVID-19, has spread globally and more cases are confirmed in the U.S. and Kansas. The CDC reported Friday a total of 1,629 cases and 41 deaths in the U.S. (The CDC updates statistics on its website Monday through Friday).

As of Saturday, there are eight presumed positive cases of COVID-19 cases in Kansas, most of which are in the Kansas City area. There are no confirmed cases in Riley County. One person, a man in his 70s who lived in a long-term care facility, died from the disease in Wyandotte County.

Social distancing is being practiced as it was in 1918 to slow the spread of the virus. Locally, schools have been closed, events, activities and programs have been cancelled and some people are being encouraged to work from home.

However, the reality of both situations, at least from a medical perspective, could not be more different. Medical technology and knowledge about public health has advanced far beyond that in 1918.

Back then, for example, people did not know influenza was caused by viruses, antiviral drugs and the World Health Organization did not exist, and many countries in Europe were under war censorship regimes that limited the dissemination of accurate, lifesaving information that could limit flu outbreaks.

The totality of COVID-19’s reach has yet to be ascertained as cases are likely being underreported because of lack of testing and changing diagnostic criteria, and the world is still in the throes of mitigating the outbreak.

COVID-19 would have to infect several thousand times as many people as it has now to match that of the Spanish influenza and medical professionals and government officials are taking action to prevent that from happening.

“Rapid identification and isolation of cases, quarantine of close contacts, and active monitoring of other contacts have been effective in suppressing expansion of the outbreak and have implications for other countries experiencing outbreaks,” a recent CDC report said about Singapore’s handling of surveillance and containment measures.

Gov. Laura Kelly issued an emergency declaration for the state of Kansas on Thursday and President Donald Trump declared a national state of emergency for the U.S. on Friday. The former allows the usage of state resources and personnel to help with response and recovery operations in affected counties, and the latter creates assess to billions in federal aid to help with the pandemic.