What is a pandemic? A pandemic is a disease outbreak that is global in nature.
Pandemics are well-documented in the recorded history of humankind. The evolution of the coronavirus, or COVID-19, as a pandemic, represents a first. A brief review of other pandemics sets the stage for our current challenge while also providing lessons to inform an appropriate societal response.
A pandemic of the plague helped to end antiquity and escort in the Middle Ages. Another documented pandemic, referred to as the Black Death, emerged in Central Asia in the 1330s. It spread to ports all around the Mediterranean and further inland than it had 800 years before — reaching Scandinavia and far into the Arabian Peninsula. It occurred for over 150 years, but then slowly faded to irregular outbreaks, disappearing in Europe in the 1770s and a few decades later in the Near East. A third pandemic occurred in China in the latter half of the 1800s. This nameless pandemic reached significant proportions as it devastated Canton and Hong Kong. The disease made its way to the rest of the world, excluding, for the most part, Europe and the polar regions, but including the U.S.
Residents of the U.S. and the St. Louis region may possess greater name recognition with the four pandemics caused by the emergence of four novel influenza viruses over the past century. Caused by shifts in genetic identity, the first major strain, H1N1, is the name of the virus strain associated with the so-called Spanish flu pandemic of 1918. The 1918–1919 pandemic was the worst natural catastrophe of the 20th century, with an estimated mortality worldwide of 40–100 million. One report estimated that more than 200 million people were affected. H1N1 was the dominant strain found in humans until 1957.
H2N2, or Asian influenza, replaced H1N1 in 1957; it ignited a pandemic that killed an estimated one million people across the world. In 1968, a third virus shift appeared in Hong Kong as the H3N2 strain, which also resulted in approximately one million deaths worldwide. H3N2 is the strain presently spreading in human populations today.
Finally, in 1977, the fourth shift was a reoccurrence of an H1N1 strain. The 2009 pandemic warnings were associated with H1N1. These warnings may be impacting how many view the COVID-19 pandemic.
Let’s go back to the predictions in 2009. Some cautioned that one plausible scenario of the H1N1 virus included 30-50% of the U.S. population affected in the fall of 2009 and winter of 2010. Advisors warned that between 60-120 million people might produce symptoms with half of them seeking medical attention, and the latter pushing healthcare providers beyond their capacity to serve. We were fortunate and the outbreak was far less severe. And it would be natural for us to assume the COVID-19 pandemic will suffer the same fate. I join you in that hope.
