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==Modern Developments==
[[File:Distancing.png|thumbnil|250px300px|left|Figure 2. Death rates comparing Philadelphia and St. Louis in the 1918 flu pandemic.]]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 cancelledcanceled, 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.<ref>For more on the 1916 polio outbreak, see: Oshinsky, D.M., 2005. <i>Polio: an American story</i>. Oxford University Press, Oxford ; New York.</ref>
The most clear clearest 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 200,000 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. Many cities in the United States began to record outbreaks of the flu and some did go into a relatively rapid lockdown and created strict social distancing policies. No national-level coordination was developed, but mayors and governors began to take action in their own hands, although by later 1918 most cities began to enforce some social distancing.
