A Brief History of Pandemics

For the past month, the coronavirus outbreak has been unsurprisingly dominating the headlines. Inevitably being under lockdown and facing uncertainty about the future, it is as important as ever to follow the current events. However, in the interest of a slight change in scenery for a few minutes, it could be worth looking back in history to previous pandemics and their response.

To begin, it is worthwhile to state the obvious by defining a pandemic. WHO defines a pandemic as the spread of an infectious disease worldwide, which people do not have any immunity to yet. Labelling it a pandemic had nothing to do with a change in the way the virus spreads but merely means that it might change the way countries viewed the problem.

One of the most infamous pandemics in recent history was not in the 21st century but the 20th. The outbreak of H1N1 in 1918, more commonly known as the Spanish Flu, was an influenza outbreak that happened right on the tail of WW1 and is claimed to be even deadlier than the war, with the virus killing 20-50 million people worldwide between 1918 and 1919.

It was unique in the fact that it seemed to target young people with 50% of deaths occurring between people in their 20s-40s. Scientists speculate that this is because the virus attacked the immune system quickly, causing what is known as a cytokine storm in the lungs- an overreaction of the immune system that causes inflammation.  Also, people born before 1889 had experienced a similar strain of influenza and developed immunity, leading to a lower mortality rate.

The title Spanish flu is a bit of a misnomer. Scientists and epidemiologists do not know the place of origin for the virus. The reason that it was named as such was that Spain was the first country to report on the outbreak as they had no role in WW1 and so was not subject to wartime censorship like many other countries were. In fact, the first case of this type of influenza was reported in a military base in Kansas, USA.

However, the response to the outbreak varied throughout the world. In studies of how social distancing affected the spread of the disease in American cities, it was shown that cities like Milwaukee and Chicago who enacted strict social distancing measures, mortality rates dropped and there was a general success in flattening the curve of the outbreak. However, for cities that didn’t take such action, such as Philadelphia who even allowed a public parade to take place in the city, showed the highest spike in deaths from H1N1 in the time that followed. The implications of this in regards to the coronavirus outbreak further highlights the need to adhere to social distancing action put in place by the government in the UK and around the world.

The Spanish flu was not the last pandemic caused by H1N1. More recently, the Swine flu pandemic was also caused by a strain of H1N1. Declared a pandemic by WHO in 2009 and, while deadly, the mortality rate of this pandemic was significantly lower than the outbreak in 1918 with an estimate of 18,036 deaths being caused by it. Called Swine flu as the people in the past who caught it generally caught it from working with infected pigs, though that wasn’t the case in 2009. Symptoms of both these influenza pandemics were very similar to those of the flu and the regular flu jab can now protect children from getting a severe case of Swine flu.

The aforementioned pandemics were all caused by influenza but there have been previous pandemics caused by a species of coronavirus. The notorious SARS outbreak of 2002 originated in China. SARS had a higher mortality rate than coronavirus at about 11%, but the total number of people infected globally was much less at a little over 8,000 cases globally with 774 deaths. While fewer social distancing measures were put in place for this pandemic, contact tracing was very useful as the symptoms were more severe than for COVID-19.

Though we are in difficult times at the moment, the importance of looking into and learning about previous pandemics can be highlighted in a simple quote from Theodore Roosevelt- ‘The more you know about the past the better prepared you are for the future.’ Therefore, it is crucial to adhere to government and NHS advice and stay safe.

– Ipek Tsil Kara, year 11

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