By Derek Yang, edited by Elin S.
Dallas, TX
Civilizations have risen, and pandemics have struck them down. Repeatedly. All throughout history, zoonoses have transferred from animals to humans via direct contact, insect vectors, contaminated food, and contaminated water. Such diseases were then exacerbated by human living conditions or systems, traveling far beyond the origin and affecting millions more than they originally did. For example, the infamous Bubonic Plague originated somewhere in Central Asia, but due to transcontinental trading routes, the deadly disease quickly spread to Europe, causing the deaths of more than 45 million people.
Although society as a whole has improved significantly in its ability to control and manage pandemics should they arise, there are still alarming failures and gaps in current systems, as evident from international and national responses to the COVID-19 pandemic. Examining historical patterns of pandemics and identifying trends helps to summarize mistakes from past governments and can lead to improvements in current policies to prevent such pandemics from occurring again.
Human civilizations first rose between 4000 and 3000 B.C.E when agriculture was invented, and humans could settle down and diversify tasks beyond just simple survival. However, civilization was too loose and scattered for a singular disease—malaria, tuberculosis, leprosy, influenza, and smallpox were most prevalent during that time—to take hold. It was not until the 1300s (smaller, albeit notable disease outbreaks that occurred between the two periods included the typhoid fever in 430 B.C. Athens, the Cyprian Plague in 250 A.D. Carthage, the Justinian Plague in 541 A.D. Byzantine, and leprosy in 11th-century Europe) when the world’s population was approximately 450 million that the Western hemisphere saw its first major pandemic: the Black Death.
Spreading into Europe through Sicily’s port of Messina in 1347 A.D., the Black Death (also known as the Bubonic Plague) was named for the black boils and blotches that appeared on the skin of its victims. Over a third of Europe became infected and died, causing dead bodies to pile up as far as the eye could see. Bodies began rotting on the streets, creating a constant stench in cities. Fleas and rats carrying the disease ran rampant, and the close living quarters and poor sanitation systems within cities allowed the disease to infect such a large population. The disease became so bad that a war between England and France was called to a truce, and the British feudal system collapsed, changing economic and social demographics. Viking exploration of the Americas halted, and for the first time in history, they lost to native populations.
In another devastating appearance, the Bubonic Plague led to the deaths of over 20% of the London population in 1665 as part of the Great Plague of London. In conjunction with the Great Fire of London, human death tolls climbed into the hundreds of thousands. Public health responses were mainly focused on limiting mortality and preventing the spread of the disease. Unfortunately, scientific knowledge of epidemiology was limited, and hundreds of thousands of cats and dogs were slaughtered as scapegoats.
In the 19th century, the first of seven cholera pandemics occurred. Cholera affects the human small intestine and spreads through feces-infected water and food. Originating in Central India, cholera eventually spread into the British Empire, where it made its way around the world into parts of Spain, North Africa, Indonesia, China, Japan, Italy, Germany, and America. Aggravated by then-globalization and poor sanitation systems in urban areas, cholera killed a million people. Although a vaccine was eventually created in 1885, it was not widely accessible, and cholera pandemics continued to occur.
In 1918, the Spanish Flu, an avian-borne flu, was first observed in Madrid (hence being named “the Spanish Flu”). It spread swiftly and ruthlessly, exacerbated by the soldier barrack’s close living quarters and armies stuck in trenches. Military transport ships additionally allowed the disease to travel overseas. By the end of its reign, the Spanish Flu had killed between 50 million and 100 million people.
The 20th-century Spanish Flu is most similar to the COVID-19 pandemic in its public health policy responses and patterns of change throughout society. In both pandemics, leaders who used strong-arm tactics or mixed message broadcasting to force populations to conform (e.g., forced mask mandates or presidential messages that misalign with public health organizations) failed in their goals. In both pandemics, xenophobia and racism ran rampant, especially against the Chinese and Indigenous populations around the world. Minority populations were impacted the worst, having less access to public health information and quality healthcare. Supply shortages of personal protective equipment as well as other crucial resources continue to occur. A new challenge that the modern world faces is the level of government mistrust and political polarization that exists among citizens.
With each pandemic lived and experienced, national governments around the world have figured out what strategies work or don’t work for limiting the spread of diseases, and they have implemented adjustments to policy accordingly. For example, in the immediate aftermath of the Spanish Flu, Canadian officials created the first national Department of Health and named five pillars of public health responses should a pandemic ever occur again. For the Ebola Pandemic, African governments learned to create coalitions of health officials to respond to disease crises. However, some inevitable patterns continue to repeat themselves, even with many pandemics and disease outbreaks having occurred in the past two hundred years.
By examining historical patterns in public health responses during pandemics, it becomes evident that many of the challenges we face today are paralleled by those in the past. By analyzing history, public health officials can better understand what techniques work to help stem the spread of diseases and create resilient societies.
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