Coronavirus (COVID-19) has been ruled a pandemic by the World Health Organization (WHO).1 "Pandemic is not a word to use lightly or carelessly," said WHO director-general Tedros Adhanom, in his opening remarks at a media briefing about coronavirus. "It is a word that, if misused, can cause unreasonable fear," he said. Though a pandemic sparked by a coronavirus has never been seen before, he added, the world has also "never before seen a pandemic that can be controlled," implying that this may be possible with COVID-19. As I write this, much of the U.S. has been shut down with people asked to remain in their homes except for performing essential errands — a provision that no one can recall in recent memory. However, a look at pandemics throughout history verifies Adhanom's optimism, as never before did we have the communications systems and medical abilities available now. Many Have Heard Scary Plague StoriesMany of you reading this may have grown up exchanging scary stories you had heard about the plague and the "Black Death," perhaps around a campfire. You may also know of Edgar Allan Poe's 1845 frightening short story, "The Masque of the Red Death,"2 in which nobles try to escape a plague by locking themselves in an abbey and holding a masquerade ball. A ghoulish stranger finds his way into the abbey, according to the story, and even though the stranger proves to be an empty costume with no person inside, all the nobles die of the Red Death. While the Red and Black Deaths scared schoolchildren for ages, scholars think the Red Death that Poe fabricated for his story was actually tuberculosis (TB), which his wife was suffering from at the time.3 The disease, also called consumption, took other close members of Poe's family including his mother, foster mother and brother.4 The empty visitor is now seen as a symbolic narrative device. The sudden death that the plague and tuberculosis posed in Poe's day and their spread were indeed frightening and interpreted, like other pandemics, as divine punishment. But we now know that both diseases, as well as leprosy, which was also pandemic in the Middle Ages,5 are caused by bacteria and therefore treatable with antibiotics. Plague,6 TB and leprosy, now called Hansen's disease,7 still exist today but no longer terrify people because we understand microbial pathogens and transmission. We know the plague is caused by the Yersinia pestis bacterium,8 TB by the Mycobacterium tuberculosis bacterium9 and Hansen's disease by Mycobacterium leprae.10 Certainly, the age of jet travel has heightened the spread of pandemic-capable diseases, and excessive antibiotic use has created resistant versions of many bacteria. But unlike in Poe's day and the epochs before him, our understanding of microbial pathogens and ways to address them has removed much of the fear of pandemics. There Were Several Plagues, Not Just One"The plague" occurred centuries ago and decimated entire populations. The bubonic strain of the plague, the most common, was characterized by swollen lymph nodes called "buboes" and killed from 30% to 60% of its victims.11 However, not everyone realizes there were actually several plagues over the centuries.12 The Plague of Justinian started in Constantinople in 541 AD and rapidly spread across Europe, Asia, the Middle East and North Africa taking the lives of 30 million to 50 million people. At the time, that would have equaled half the world's population.13 In 1347, 800 years later, the plague reared its ugly head as the Black Death in Europe, claiming 200 million lives in four years, one-third of the world's population.14 The Black Death was so devastating that it changed politics forever: England and France declared a truce to their ongoing war and the British feudal system collapsed. During the Black Death and subsequent pandemics there was no scientific understanding of disease transmission, but there was a growing awareness that proximity somehow heightened the problem — a first nod to the concept of social distancing.15 That is why it was decided in Venice during the Black Death that arriving sailors had to stay on their ships for 30 days until it was clear they were disease-free in an early demonstration of the concept of quarantine, called "quarantino" at the time.16 Still, outbreaks of the plague continued unabated despite early quarantine efforts, according to History.com:17
Two hundred years after London's 1665 Great Plague, a third plague surfaced in 1855, which was concentrated in China and India, and killed an additional 15 million people.18 Finding the Cause of the Plague Reduced the TerrorPanic and suspicion of others is the hallmark of pandemics like the plague because transmissibility isn't known and people are terrified. In England, dogs and cats were suspected of spreading the disease and slaughtered by the hundreds of thousands,19 which only intensified the pandemic since rats, which no one knew were spreading the disease, had no predators.20 Finally, the cause of the plague was revealed. According to research published in Clinical Microbiology and Infection:21
The plague still exists today but no longer strikes panic in the public because its etiology from rat fleas is now known.22 The Smallpox Pandemic Was Also TerrifyingJust like the plague, many have heard frightening stories about historical smallpox pandemics. After a high fever and pain, smallpox causes cratered pockmarks all over the body, disfigurement and occasional blindness, and kills as many as 30% of its victims.23 As with the plague, millions died from smallpox over the centuries, and fear and mistrust were rampant until the virus that causes it, variola, was identified and treatments were developed. Historians now believe that what may have been termed the plague in early pandemics was actually smallpox. According to History.com:24
Smallpox was initially treated with "variolation," in which pus from stricken patients was introduced into healthy people, but the disease continued to spread. According to History.com:25
In 1796, Edward Jenner, an English doctor, developed a vaccine against smallpox. While it's often said that this is what defeated the disease, there is evidence that it wasn't vaccines but, rather, isolation and sanitation that overcame smallpox. Influenza Pandemics Have Also Been DeadlyCompared with plague and smallpox, influenza or "flu" pandemics occurred much later in recorded history, but they have been just as devastating. According to Business Insider, in 1889:26
Unlike plague, TB or Hansen's Disease, influenza is caused by a virus, arguably harder to treat than the bacteria that cause diseases. According to the News Observer:27
The 1889 flu that originated in Russia was followed by the Asian flu of 1957-1958, which killed 1.1 million globally and 116,000 people in the U.S.28 Just 10 years later in 1968, the Hong Kong flu, an adaptation of the Asian flu, surfaced killing 1 million globally and about 100,000 in the U.S.29 The granddaddy of all flu epidemics and the one that is most on people's minds during the coronavirus pandemic is the Spanish flu epidemic of 1918. According to the U.S. Centers for Disease Control and Prevention:30
Disease Pandemics Have ContinuedThe 1968 Hong Kong flu was not the last influenza pandemic. Many will remember the 2009 H1N1 flu pandemic that surfaced a little over a decade ago. According to the CDC:31
Another recent pandemic was the HIV/AIDS outbreak, which exploded in the 1980s. According to the CDC:32
Then in 2003, SARS (Severe Acute Respiratory Syndrome) erupted in China. According to the CDC, SARS:33
According to research from the National Institutes of Health, the current coronavirus is a form of SARS but with greater communicability:34
From the original plague to the 1980s "plague" of AIDS, eventually the "codes" of the pathogens have been cracked and treatments and other measures, like increased sanitation and personal hygiene, found to end the pandemics — and history will likely continue to repeat itself. from http://articles.mercola.com/sites/articles/archive/2020/04/01/pandemics-that-changed-history.aspx
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