History of Pandemics and the World’s Response

History of Pandemics and the World’s Response

Some of us might be feeling disheartened hearing news about the coronavirus every day and wondering why God has punished us so harshly. Well! This is not the first time in human history that a pandemic has occurred and also it’s not going to be the last one.

The term Pandemic is used to define a situation where a disease rapidly spreads across the continents or countries and affects a large number of people within a short span of time. To qualify as a Pandemic, the disease must be infectious {it spreads from one person to another}.

The history of infections in humans is as old as human history, however, even since the humans moved from jungles to agrarian societies (around 10000 BC), the spread of diseases from one person to another became much easier.  There have been few references for an Influenza pandemic in as early as 1200 BC affecting West Asia, Central Asia, and South Asia; though much detail is not available about it. Let’s talk about some of the most devastating pandemics in human history and how the world responded to it.

 

The Plague of Athens (429-426 BC)

Reference: Alchetron. Available from: https://alchetron.com/Plague-of-Athens

The Plague of Athens had destroyed the ancient city of Athens in Ancient Greece. Various estimates have accounted for a death toll of 75000 to 100000. Athens being a port city depended on its port Piraeus for all supplies. Thucydides, a historian, who was present at that time contracted the disease and survived, has described the disease in his book ‘History of the Peloponnesian War’. He said that the disease started from Ethiopia, passed through Egypt and Libya, and then entered Greece perhaps through the port Piraeus.

People experienced fever, cough, red eyes, sore throat, and diarrhea as the main symptoms. Many doctors, who were treating the patients, contacted the disease and died. The disease killed 25% of the population of Athens. People lost all moral values. Thucydides wrote,the catastrophe was so overwhelming that men, not knowing what would happen next to them, became indifferent to every rule of religion or law.” No one was willing to take care of the ill and dead bodies were piled on one another. But some people survived the illness, perhaps they had developed immunity. Those who survived the disease finally came to the rescue of the ill. Scientists suggest that the disease could possibly be Typhus or Toxic Shock Syndrome or Viral Hemorrhagic Fever. Plague is a disease caused by bacteria named Yersinia Pestis; so technically this was not a Plague.

 

Black Death (1347-1353 AD)

Reference: Center for Disease Control and Prevention. Available from: https://www.cdc.gov/ncidod/dvbid/plague/cheob6x4.htm

A plague has been the scrounge of mankind for ages. Among the 5 biggest pandemics in terms of deaths, 3 were due to plague. Antonine Plague of 165 AD- 180 AD killed 5-10 million people in the Roman Empire. Plague of Justinian of 541-542 AD killed 40%-50% in Europe. But the third one and the biggest of them all was Black Death from 1347-1353. It killed 200 million people by some estimates, 60% of Europe’s population was wiped out.  As discussed above, this disease is caused by bacteria named Yersinia Pestis that infects rats. A flea named Rat Flea bites infected rats and then bites humans and infects them.

The disease probably originated in East Asia or Central Asia and traveled along the Silk-Route to reach Europe. Lack of hygiene was one of the main reasons for the spread of the disease, the other being malnutrition that led to weak immunity. The symptoms included fever, headache, and enlarged lymph nodes.

The extent of the impact of the disease can be perfectly summarized in the words of Italian chronicler Agnolo di Tura from Siena:

“Father abandoned child, wife husband, one brother another; for this illness seemed to strike through the breath and sight. And so they died. And none could be found to bury the dead for money or friendship. Members of a household brought their dead to a ditch as best they could, without a priest, without divine offices … great pits were dug and piled deep with the multitude of dead. And they died by the hundreds both day and night … And as soon as those ditches were filled more were dug … And I, Agnolo di Tura … buried my five children with my own hands. And there were also those who were so sparsely covered with earth that the dogs dragged them forth and devoured many bodies throughout the city. There was no one who wept for any death, for all awaited death. And so many died that all believed it was the end of the world.”

Reference: By Pieter Bruegel the Elder – Museo del Prado, Public Domain. Available from: https://commons.wikimedia.org/w/index.php?curid=74450965

However, the human race survived. Immunity again came as a savior.

The Spanish Flu (1918 AD to 1920 AD)

This was the deadliest Influenza pandemic in human history caused by the H1N1 virus. The virus infected around 500 million people (one-third of the world’s population). The number of deaths estimated between 17 million to 50 million; some experts estimate deaths around 100 million. Spain was not a participant in the 1st World War hence its media was free from censorship. The Spanish media reported extensively on the spread of flu in its nation including the critical illness of King Alfonso XIII. These media reports led to a false impression that Spain was the worst affected country. Some scientists claim that the disease originated in the camps of the British Army posted in France, while others claim that the virus was spread from China. Like all influenza viruses, this disease spreads when a person coughs or sneezes, and the virus spreads to people nearby. Some countries used social distancing and quarantine as a protective measure.

Reference: By Alberta Board of Health – University of Calgary Press Sept 2016[1], Public Domain. Available from: https://commons.wikimedia.org/w/index.php?curid=88467690
While a normal Influenza Flu would kill more children and elderly, this epidemic was having 50% of its victims of the age group of 20-40 years. Young adults normally have a stronger immune system than kids or the elderly. This strong immune system became their nemesis as the virus triggered a cytokine storm (overreaction of the body’s immune system) that lead to a higher mortality rate in young adults.

Almost all major countries were affected. About 12-17 million Indians died (5% population). About 1 million Chinese died and about 500000 Americans lost their lives. Pneumonia was the leading cause of death.

However, the disease disappeared quickly after a second wave. One of the explanations offered was that the virus mutated rapidly to a less virulent strain, this happens usually in the case of most Influenza Viruses.

COVID-19 (2019 AD to present)

With the world becoming a global village the spread of infections is much easier now. The virus has reached almost every country. The Spanish Flu can be considered as the closest epidemic for comparison, as both are viral infections that primarily affect the lungs with similar mortality rates. The Spanish Flu had infected 33% of the world’s population. This time the spread is much slower due to better precautions are taken by people. Taking Spanish Flu as a benchmark we can assume that the impact of COVID-19 will reduce to a great extend in about 12-24 months’ time. Let’s hope for the best.

 

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