An interesting story, but at the end I felt like nothing had happened. Cleo goes through some difficult things, but in the end it didn't feel like she changed that much. This would be find except that at the end of the book I got the feeling I was supposed to think she changed a lot.
There are some interesting details about the Spanish flu. Some of it is quite graphic, so if medical descriptions make you squeamish this might be one to skip. There were also bits that felt strangely modern but might be accurate to the time (I'm no expert on 1918 Portland, so I just trusted the author on this one because there are very few stakes in whether people wore deodorant back then or not).
Also, this book counts for the Diversity on the Shelf challenge because the author is a woman of color, but I don't recall anyone being explicitly described as a character of color in the book.