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Some of the earliest evidence of social distancing in the Medieval Period come from the period of the Black Death in the 14th century. In this time, in parts of Europe, doctors and carers looking after patients wore pointed, bird-like masks. This was intended to keep people who were not sick away, while also enabling doctors to ostensibly have some protection. People did seem to make attempts to keep away or isolate themselves to avoid infection during the Black Death, but public coordination is not clear in records. Clothing in early Modern Europe increasingly became elaborate for the upper classes and this usually was the most ostensible way social distancing was maintained, once again demonstrating that wealth and class, rather than health, were the main reasons to distance segments of the population from other segments. Lower classes were never expected to approach nobility unless invited to do so. Women's skirts also developed large hoops, which increasingly became popular in the 18th and 19th centuries. These hoops, called crinolines, were intended to act as barriers as well as fashion items. The idea was to keep genders segregated, particularly for middle and upper class women who wanted to maintain their reputation. Generally, women who did not do much work wore such dresses, as they were far too cumbersome to be of practical use. This cumbersome aspect warned others to stay away from well-off ladies, while also demonstrating that the woman did not have to do manual labour, indicating her high status. In fact, in the 19th century Victorian era, larger skirts were ways for women to indicate that they were of the highest class and even distinguished themselves from other well-off ladies. Men could not come too close to these women, also suggesting their purity. During the 19th century, outbreaks of small-pox occurred and some evidence does suggest the skirts did help in preventing women from catching this infection, mainly because it was hard for anyone to come close. However, historians also point out sometimes women died because these skirts were too large and easily caught fire in emergency situations, inhibiting the person from easily escaping. In the late 1890s, skirts began to narrow, but hairpins and large hats became popular. These also became symbols to others that they should avoid getting too close to upper-class females.
==Modern UsesDevelopments== Perhaps something approaching current practices of social distancing, without implying class-based differences, is first evident in New York's polio outbreak in 1916. More than 2000 people died in New York from polio and the city took widespread social distancing guidelines to limit the outbreak. This included closing movie theatres, meetings were either limited or cancelled, various public gatherings were outlawed, and children were told to avoid water fountains and pools, limiting their contact with even parks and playgrounds. The response was relatively effective, as the death toll was limited relative to the threat. The most clear case of social distancing being needed for a public health emergency developed during the Spanish Flu pandemic of 1918. In September 2018, Philadelphia held a major parade, sometime after the first cases of the pandemic flu were reported. The city government allowed the parade to go through even though they had known about the outbreak, with over 20,000 people gathered to watch the parade. Within days all of the city's 31 hospitals were filled with flu patients, causing 4500 or more to die. Similarly, New York began to experience a large intake of sickness and death.
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