Death Paled:-Excerpts From The Deadliest Pandemics Of History
At some point in the past, a man turned from a gipsy to a farmer and with that, kick-started the era of stable food supplies, permanent dwellings, and disease outbreaks. The further we proceeded towards civilization – larger cities, more exotic trade routes, and increased contact with different populations of people, animals, and ecosystems – further escalated were disease outbreaks.
This article focuses on those deadly pandemics that would make you wonder if the entire COVID scenario is just another historical deja-vu.
A JOURNEY THROUGH DEATH
Credit: Visual Capitalist
There is perhaps no longer-lasting historical relationship than that between humans and disease, especially epidemic disease. From the earliest times to the present, epidemics have affected human history in myriad ways: demographically, culturally, politically, financially, and biologically.
Trade can be severely affected by concerns overspread. The bans imposed by the European Union on exports of British beef lasted 10 years following the identification of a mad cow disease outbreak in the United Kingdom, despite relatively low transmission to humans. The tourism industry in regions affected by outbreaks is also likely to decline. For instance, the cholera outbreak in Peru in 1991 cost the country US$ 770 million due to food trade embargoes and adverse effects on tourism. Some long-running epidemics, such as HIV and malaria, deter foreign direct investment as well.
Nevertheless, some economic sectors may even benefit financially, while others may suffer. Pharmaceutical companies that produce vaccines, antibiotics, or other products needed for outbreak response benefit while health and life insurance companies are likely to bear the burden, at least in the short term.
HISTORY RINGS THE KNELL
More has been written about Black Death than perhaps any other epidemics in history. The black death of the 14th century completely razed the human race and civilization affecting almost all of Europe, the Ottoman Empire and much of middle-east. 500 million people were affected and around 150-200 million people with 50% of the European population, unfortunately, succumbed to this pandemic. Widespread death caused labour shortages across feudal society and often led to higher wages, cheaper land, better living conditions, and increased freedoms for the lower class.
Such drastic economic shifts are expected to follow the current outbreak too. There are already clear economic changes arising from this outbreak, as some industries rise, others fall and some businesses seem likely to disappear forever. COVID-19 may permanently normalize the use of virtual technologies for socializing, business, education, healthcare, religious worship, and even government.
However, the more vindictive social effects of the bubonic plague were felt immediately after the worst outbreaks petered out. There were peasant revolts throughout Europe. Distrust in God and the church, grew as people realized that religion could do nothing to stop the spread of the disease and their family's suffering.
PANDEMICS FORGOTTEN (?)
Undoubtedly, the deadliest pandemic in recent history, the havoc of 1918 /Spanish flu wiped off approximately one-third of the world population(5% of the Indian population).
The flu eventually killed 50 million people worldwide. A unique feature of the strain was the high mortality(death rate) in individuals between 15-34 years of age, which was a trait never seen before.
Our medical and scientific understanding of the 'flu in 1918 made it difficult to combat. However, for those questioning the use of quarantine and public health interventions the use of face masks and bans on mass gatherings helped limit the spread in some areas, building on prior successes in controlling tuberculosis, cholera, and other infectious diseases. Face masks and sanitation were popularised and sometimes enforced in cities. In San Francisco, a Red Cross-led public education campaign was combined with mandatory mask-wearing outside the home. This was tightly enforced in some jurisdictions by police officers issuing fines, and at times using weapons.
No such specific cure could be developed in time for the flu. However, it finally came to an end in the summer of 1919 as those who had contracted it was either dead or had developed an immunity.
Another char in history, the smallpox outbreak, which lasted 3000 ravish years; blinded and scarred humans of all races and ages.
In the 1500s, The disease spread along trade routes in Asia, Africa, and Europe, eventually reaching the Americas. With no natural immunity, about 90 per cent of indigenous casualties during European colonization were caused by the disease.
People resisting the transport of patients to hospitals in Milwaukee. Credits: History TV
Smallpox contributed to the decline of the Aztec Empire, in today’s Mexico, following the virus's arrival with Spanish conquerors in 1519. In the 1800s, the only correlation that people of the time could find was that the survivors of the disease did not contract it again.
DOGMAS IN SOCIETY
Earnestly, the symptoms of the diseases were as disastrous as the racial stigmas which they rooted in the society. In 1901, a plague epidemic in Cape Town produced a very aggressive racial segregated quarantine that became the precursor for apartheid in South Africa. Influenza in 1918 did nothing but add fuel to it, precipitating the first legal steps towards apartheid. The dangerous framing of this particular pandemic as a "Chinese virus" or the "Wuhan virus" leads to a similar stigma for anyone from China or of Asian descent. It leads to violence, harassment, hatred, and bigotry, as history registers. How this pandemic has exacerbated these particular practices of bigoted and racist ideology is not surprising during an epidemic, but it's a serious threat to effective health responses.
CURRENT COVID CRISIS
Like an "x-ray", Corona has revealed the fractures in the fragile skeleton of the societies we have built. Entire regions that were making progress on eradicating poverty and narrowing inequality have been set back years, in a matter of months.
Perhaps one of the most relevant public health legacies to have emerged from the 14th-century plague pandemic is the concept of "quarantine" from the Venetian term "quarantine" meaning forty days.
During the Spanish flu, cities that implemented early NPIs(NPIs refer to Non-Pharmaceutical Interventions like Quarantine and lockdown)suffered no adverse economic outcomes(in long term) and enjoyed lower mortality rates.
Even now, governments of Taiwan and Singapore, that implemented NPIs at the earliest, have, apart from limiting infection growth in the COVID-19 outbreak, saved the economy. Singapore, Hong Kong, and Taiwan boast a total of just 600 cases.
Marc Lipsitch, an epidemiologist at the Harvard TH Chan School of Public Health concluded that SARS-CoV-2 will not go away on its own and that with control measures in place we can protect health care capacity but then move more slowly to herd immunity if herd immunity is possible For this reason it will be many months and likely several years before the virus moves through the population in a region with significant transmission and significant control measures.
While Michael Osterholm of the University of Minnesota and colleagues published three potential scenarios of the future. He clearly stated that the end of 2020 won’t be the end of COVID-19 and that we are likely to be dealing with it for at least the next 18-24 months. The three likely scenarios explained by him include:
- The first scenario predicted mini-waves of smaller outbreaks every few months, with periods of only a few cases in between. The location of the outbreaks would depend largely on regional variations in the sort of mitigation measures that are in place.
- In the second scenario, the current outbreak shall be followed by a massive second wave that is twice as large and long-lasting. This is exactly what happened with the 1918 Spanish flu pandemic; a moderate wave in March 1918 was followed by an explosion in cases that September, followed by smaller peaks until early 1919.
- In the third scenario, there will be continued COVID-19 outbreaks similar to what we are currently experiencing, until the end of 2022.
So far, 5% of the world is estimated to have been infected. The only thing that will prevent all of these potential scenarios is the development of a vaccine, and if one doesn’t become available, then we are likely to have continued outbreaks until at least half of the world has been infected.
All in all, it is too soon to be hopeless as significant progress has been made in the vaccine preparation sector and the recovery rate has been improving lately. Lessons from the past preach that humanity has warded off loads of viruses in the past, though the methods varied largely. While diseases like black death ended through extensive quarantines, Spanish flu and The Great Plague of London ended on a ‘develop immunity or die’ note and still, diseases like Smallpox were warded off with vaccines and extensive immunization programs (In 1980, After almost a decade of efforts and the death of almost 300 million people globally). However, with economic constraints and mitigation factors, that’s easier said than done.
We have battled worse pandemics with poorer resources. The current tension will also come to an end, sooner or later, one way or another. Till then, we need to make sure that we use this knowledge for good and make NPIs a way of life while placing our trust in medical science and cooperating with the frontline workers.