Did you know you’re in danger of experiencing a global pandemic that could disrupt your life in extreme ways? Oh, that’s already happened to you? If that’s already old news, let’s delve even deeper into the history of pandemics to find out if we’ve repeated the mistakes of the past.
Pandemic? Epidemic? Same or Different?
First off, let’s figure out exactly what makes a pandemic. As we’ve learned from the WHO, Teenage Wasteland is really Baba O’Riley, and an epidemic (stage 5) is just a stop on the path to a pandemic (stage 6). So, the difference between a massive epidemic and a pandemic is that the latter is a global experience.
Since pandemics are pretty infrequent (so far), it’s possible we just don’t have enough examples to know precisely when these things begin and end. Hopefully, we’ll never become experts by way of experience!
The WHO declared COVID-19 a pandemic on March 11th, 2020. Many considered that to have been about a week too late. The point is that the threshold is fuzzy and possibly just semantic. We may have been able to save more lives with quicker action, but what’s done is done. And that goes for past pandemics as well.
Pandemics through History
We’re starting off with a pandemic that’s (spoiler alert) still active. It’s been downgraded to “global epidemic,” since community spread is under control in most countries and treatments have advanced significantly. However, Human Immunodeficiency Virus (HIV) is still infecting more than a million people every year. HIV spreads through fluids like semen or blood, usually through unprotected sex or shared needles. It causes humans to develop Acquired Immunity Deficiency Syndrome (AIDS). People can live for years with HIV, but AIDS is fairly deadly. HIV and AIDS make it more likely for people to develop severe illnesses, since they make the immune system less effective.
HIV/AIDS was first reported in the Democratic Republic of Congo in 1978. The first HIV death is assumed to be a Portuguese man, Senhor José, who died in 1978.
The AIDS pandemic was handled extremely poorly by world leaders. Research and awareness campaigns were delayed because “the gay plague” was affecting mostly minority groups. US President Ronald Reagan was already aware of AIDS in 1981, and didn’t mention it publicly until 1985. Millions of people were infected with HIV due to both stigma-induced secrecy and a general lack of awareness.
The death toll as of 2022 is just over 40 million. As treatments improve, the likelihood of developing and dying from AIDS has been reduced, and preventative medication also keeps many people safer from HIV than they would have been in the past. Unfortunately, HIV/AIDS is a slow-moving pandemic that will likely continue spreading for years to come.
Verdict: Lots of mistakes on that one! We’re slowly getting better about squashing our bigotry to save lives, though.
2. Spanish Flu of 1918
How dare Spain intentionally manufacture a disease that killed millions of people! How dare they!
Oh, they got the eponymous honors because they were the first to publicly acknowledge the flu’s existence? Sorry, Spain. The US is responsible! It should have been called Kansas Flu, since the first known case of H1N1 flu was recorded there in March 1918.
It was an exciting time for the world, with THE GREAT WAR (now known as WWI) winding down as flu cases were picking up… and being denied in the service of wartime censorship. All those soldiers moving around helped the flu to spread quickly. There were 500 million cases, and an estimated 17-100 million deaths globally. Some locations did manage to mask up and lock down as the second and third waves were recognized as being much more deadly, but community spread was off the charts and treatment at the time was woefully inadequate.
Since medicine was still in its “take some cocaine and call me in the morning” phase, vaccines did not play a part in ending the outbreak. Ultimately, that pandemic began petering out in 1919 simply because all of the people who didn’t die horribly were able to develop natural immunity. However, there were still some outbreaks to come, such as in New York City in the spring of 1920. It would be another 25 years before a flu vaccine became publicly available.
Verdict: Oh look, more egregious mistakes! More leaders ignoring spread during its early stages for purely political reasons. Looks like we didn’t learn much between 1918 and 1981.
3. The Black Death
This is probably the only pandemic you learned about in elementary school, and there’s a good reason for that. The first major outbreak of bubonic plague (Plague of Justinian, 541-549) is estimated to have killed as much as 56% of the global population at that time. The sequel (The Black Death, 1346-1353) also had great box office numbers: top estimates say 54% of the human beings on earth died.
You knew all that from elementary school, but you probably didn’t know that it’s a trilogy! Bubonic plague made a much less deadly comeback in the 1800s (Third Plague Pandemic, 1855-1960) before it fully submitted to the wonders of modern medicine.
Bubonic plague is the first plague on this list caused by bacteria instead of a virus, and it’s still around today. It’s not likely to reach pandemic status again, since we’re much better at killing rats than we were in the 1300s and we’ve had good access to antibiotics since the 1940s.
This pandemic spread mostly through rodents and fleas, both of which were extremely difficult to control at the time of the first two outbreaks. Humanity’s limited understanding of sanitation, hygiene, and medicine just couldn’t compete with the fast-moving bacteria. If they hadn’t caught some lucky breaks, bubonic plague could have meant the end of Homo sapiens; experts still don’t know why The Black Death ended, but it’s possible a change in the environment or mutation in rodents kept the bacteria from multiplying unchecked.
Verdict: We were shockingly bad at avoiding the plague. There were infinite mistakes, but science barely existed at the time, so it’s hard to hold it against our ancestors. Hundreds of years later, epidemiology has made huge leaps and we’re still talking about plague in our kids’ curriculum, so at least we’ve learned enough to keep telling the story.
4. 2009 H1N1 Swine Flu
H1N1 is back, baby! You’ll notice H1N1 was also the star of the Spanish Flu pandemic, but 2009 brought a new strain into the world. Think of Spanish Flu as Swine Flu’s great grandmother.
2009’s pandemic was a devastating global problem, but it’s also a great example of a modern pandemic response. The Swine Flu pandemic infected an estimated one billion people from 2009 to 2010. That was about 20% of the entire global population at the time, and it was only fatal for about half a million people. In the US, about 0.4% of cases ended up in the hospital, and most survived. In just 90 years, humans had developed medicines to treat a disease that could have killed many millions without those interventions.
A vaccine was quickly made available (about one year after the first cases), but most people recovered from Swine Flu on their own. It’s very possible the vaccine kept even more people from being infected, since it was a particularly contagious strain of the flu. Keeping less virulent contagious diseases from spreading limits their opportunities to mutate into more dangerous strains.
Getting your flu vaccine annually is a great way to continue building your immunity, in case another deadly flu strain makes the jump from animals to humans. Elderly people are frequently reminded to get their annual flu shots, but don’t skip your flu shot no matter your age; many cases of Swine Flu were in children and young adults.
Verdict: We do have the capacity to learn! This pandemic was milder when compared to the others on this list, but it still had responsive governments, great medical intervention, and widespread public awareness, all of which were missing in the others. We did manage to learn from previous pandemics!