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Representation of an ancient pandemic. Deriv: ‘Plague in Rome.’ 1869. Paris Orsay. (jean louis mazieres/CC BY NC SA 2.0) Woman in a mask worried about novel coronavirus. (Yasser Alghofily/CC BY 2.0)

Learn From History: Don’t Panic, But Prepare For Coronavirus Pandemic

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The world is asking are we on the edge of the next pandemic?” as the new coronavirus looks set to go global and case numbers rise. But looking back at ancient pandemics, what have we learned about how to prepare for a Coronavirus (2019-nCoV) pandemic?

A pandemic is an epidemic of disease that has spread across international boundaries; but differs from a widespread endemic disease that affects much fewer people. Throughout history there have been many  smallpox and tuberculosis pandemics. But perhaps the most devastating pandemic was the  Black Death , which took the lives of an estimated 100 million people in the 14th century.

The people of Tournai bury victims of the Black Death. (Public Domain)

The people of Tournai bury victims of the Black Death. ( Public Domain )

Today, while news outlets already have their headlines written and top shelved with the word pandemic” ready to sell, they are greatly failing to explain exactly how a disease becomes a pandemic - generally they’re more focused on the drama of the death toll. But looking back into history it all seems to come back to hygiene, and the lack of it. While rats so often get blamed for the Black Death you are about to discover the real origins - it came from us humans .

What is a Global Outbreak?

In May 2009 Dr. Keiji Fukuda, Assistant Director-General  ad interim  for Health Security and Environment, WHO, said at a virtual press conference regarding the influenza pandemic, that an easy way to think about pandemic ”is to say: a pandemic is a global outbreak. Then you might ask yourself: 'What is a global outbreak'? Global outbreak means that we see both spread of the agent and then we see disease activities in addition to the spread of the virus.”

But we must be careful in how we think about diseases and pandemics for we would be wrong to classify cancer as a pandemic, even though the disease kills many people, because according to Dr. Dumar s 2009 book  Swine Flu: What You Need to Know , a pandemic must also be infectious or contagious. And, if the history books of all nations on Earth have one thing in common that is just when everything was on the up, pandemics bring things right back down again.

Plagues of the Ancient World

From 430 to 426 BC the Plague of Athens weakened the city's dominance during the Peloponnesian War as typhoid fever killed one quarter of the Athenian troops and another quarter of the general population over the preceding four years. But in this case the virulence of the disease meant that it killed off its hosts at a rate faster than it could multiply which prevented its wider spread. The origins of this plague remained a mystery until January 2006 when Scientific American published news that researchers from the University of Athens had analyzed teeth recovered from a mass grave in Athens and confirmed the presence of the bacteria responsible for the outbreak of typhoid.

Between 165 to 180 AD the lives of  5,000 Romans a day were being lost to the Antonine Plague, thought to have been a smallpox virus carried from the Italian peninsula by soldiers returning from the Near East; and when it finally died off so had five million people, according to a 2005 BBC article titled Past Pandemics That Ravaged Europe .

Plague in an Ancient City (1652-1654) by Michiel Sweerts. (Public Domain)

Plague in an Ancient City (1652-1654) by Michiel Sweerts. ( Public Domain )

A second outbreak known as the Plague of Cyprian (251–266 AD) was the first recorded outbreak of the bubonic plague which had started in Egypt, and according to the Byzantine chronicler Procopius of Caesarea within less than a year it had spread to Constantinople killing 10,000; an estimated 40% of the city's inhabitants. According to the book Plague and the End of Antiquity by Lester K. Little, this pandemic collapsed Europe's population by 50% between 550 AD and 700 AD and decimated between a quarter to a half of the human population.

Spanish Flu Caps Them All

A 2014 Guardian article informs that between 1331 and 1353 AD the Black Death killed 75 million people worldwide and more than 100 plague epidemics affected Europe between this period and the 18th century. The disease recurred in England every two to five years from 1361 to 1480 and by the 1370s, England's population was reduced by 50%. When the Great Plague of London struck between 1665–66 AD it killed approximately 100,000 people, 20% of London's population.

The San Francisco plague of 1900–1904 , which started in China in 1855, spread to India where it killed 10 million people. But worst of all, Spanish flu , which struck from 1918 to 1920, infected 500 million people around the world.

And while in most cases of influenza disproportionately kill the very young and the very old, the Spanish flu had an unusually high mortality rate for young adults. According to a 2013 paper published on PLOS ONE , Spanish flu killed “more people than World War I” and furthermore, it killed more people in 25 weeks than all of the people who died of AIDS in its first 25 years.

Prepare for Pandemic

On January 30, the Emergency Committee on the novel coronavirus under the International Health Regulations (IHR 2005) declared the outbreak to be a public health emergency of international concern.” And while it is not within my purview to tell you how to wash your hands and nails properly, if you are in any way worried about being infected with the novel coronavirus then the WHO are here to help with a guide to preventative measures published as recently as two days ago.

This is a 3D medical illustration of 2019 Novel Coronavirus, derived from a CDC released image. It explains the ultrastructural morphology. (CC BY SA 4.0)

This is a 3D medical illustration of 2019 Novel Coronavirus, derived from a CDC released image. It explains the ultrastructural morphology. ( Scientific Animations  / CC BY SA 4.0 )

To help the public best prepare for any escalation in the novel coronavirus the WHO have published recommendations to reduce risk of transmission from animals to humans and updated advice for international traffic in relation to the outbreak of the novel coronavirus 2019-nCoV.

Furthermore, before logging into Netflix this evening perhaps have your family take a quick online course providing a general introduction to emerging respiratory viruses, including novel coronaviruses, because one thing is for sure folks, with a 7.5 billion population and rising, rapidly, there have never been more hosts available for viruses and things will only get better if we are educated and clean.

Distribution of 2019-nCoV cases as of 31 January 2020. (WHO)

Distribution of 2019-nCoV cases as of 31 January 2020. ( WHO)

Top Image: Representation of an ancient pandemic. Deriv: ‘Plague in Rome.’ 1869. Paris Orsay. (jean louis mazieres/ CC BY NC SA 2.0 ) Woman in a mask worried about novel coronavirus. (Yasser Alghofily/ CC BY 2.0 )

By Ashley Cowie

References

A. M., Dumar (2009). Swine Flu: What You Need to Know. Wildside Press LLC. p. 7

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