Pandemics: History and Future

Let’s jump right in with a little background on pandemics.

According to the WHO, a pandemic involves the worldwide spread of a new disease. While an epidemic remains limited to one city, region, or country, a pandemic spreads beyond national borders and possibly worldwide.

 

A new virus strain or subtype that easily transmits between humans can cause a pandemic. Bacteria that become resistant to antibiotic treatment may also be behind the rapid spread. 

 

Animals carry some viruses that rarely spread to humans. Sometimes, these viruses can mutate and become transmissible to and between people. When an animal virus first passes to humans, health authorities focus on it as a potential pandemic. This transmission indicates that a virus is mutating and might become highly contagious and harmful. In recent years, there has also been concern about viruses that experts have linked to camels (Middle East Respiratory Syndrome, or MERS-CoV) and monkeys (Ebola).

 

Over the past 15 years, there has been no shortage of articles and white papers issuing dire warnings that a global pandemic involving a new respiratory disease was only a matter of time. On BBC Future in 2018, it was reported that experts believed a flu pandemic was only a matter of time and that there could be millions of undiscovered viruses in the world, with one expert telling us, “I think the chances that the next pandemic will be caused by a novel virus are quite good.” In 2019, US President Donald Trump’s Department of Health and Human Services carried out a pandemic exercise named “Crimson Contagion”, which imagined a flu pandemic starting in China and spreading around the world. The simulation predicted that 586,000 people would die in the US alone.

 

 

Let us take a closer look at some statistics,

Take the mosquito-borne disease malaria. It has stalked humanity for thousands of years, and while death tolls have dropped significantly over the past 20 years, it still snuffs out nearly half a million people every year. The plague of Justinian struck in the 6th century and killed as many as 50 million people. Smallpox may have killed as many as 300 million people in the 20th century alone, even though an effective vaccine – the world’s first – had been available since 1796. If these numbers shock, it’s because today epidemics are rarely discussed in history classes, while in the not so distant past, they were simply a terrible fact of life. By 1962, the Nobel Prize-winning virologist Sir Frank Macfarlane Burnet noted that “to write about infectious diseases is almost to write of something that has passed into history”.

 

What Marc Lipsitch (Harvard T.H. Chan School of Public Health, Boston), one of the most influential epidemiologists in the United States, had to say in 2018? A drastic decline, from around 800 deaths from infectious diseases per 100,000 people in 1900 to about 60 deaths per 100,000 by the last years of the century. There was a brief spike in 1918 – that would be the flu – and a slight and temporary upturn during the worst of the AIDS epidemic in the 1980s. But, Lipsitch told me, “death rates from infectious disease dropped by nearly 1% a year, about 0.8 % per year, all the way through the century.”

 

The bad news, as COVID-19 reminds us, is that infectious diseases haven’t vanished. There are more new ones now than ever: the number of new infectious diseases like SARS, HIV and COVID-19 has increased by nearly fourfold over the past century. Since 1980 alone, the number of outbreaks per year has more than tripled.

 

 

COVID-19 will not be the last pandemic in our deeply interconnected world, and sadly it won’t be the worst. Throughout history, nothing has killed more human beings than infectious disease. Medical science has advanced rapidly in recent years, but it is unlikely ever to offer full protection from a possible pandemic because of the novel nature of the diseases involved. The history of emerging diseases and likely future demographic changes suggest that we are in for many outbreaks of infectious disease by 2050.

 

The world’s growing and increasingly mobile human population, packed ever more closely together in cities and encroaching on the territory of wild animals, will have even more opportunity to pick up and spread viruses in future.

 

 

Pathogens make such effective mass killers because they are self-replicating. This sets them apart from other major threats to humanity. The symptoms created by an infectious pathogen – such as sneezing, coughing or bleeding – put it in a position to spread to the next host, and the next, a contagiousness captured in the replication number, or R0 of a pathogen, or how many susceptible people one sick person can infect. And because human beings move around – interacting with other human beings as they do so in every manner from a handshake to sexual intercourse – they move the microbes with them. 

 

Antibiotics have saved hundreds of millions of lives since the serendipitous discovery of penicillin in 1928, but bacterial resistance to these drugs is growing by the year, a development doctors believe is one of the greatest threats to global public health. In fact, 33,000 people die each year from antibiotic resistant infections in Europe alone, according to a 2018 study.

The World Health Organization, which performed so well under the stress of SARS, has botched more recent outbreaks so badly that experts have called for the entire organisation to be overhauled.

 

Even human psychology is at fault. The spread of vaccine scepticism has been accompanied by the resurrection of long-conquered diseases like measles, leading the WHO in 2019 to name the anti vaccination movement one of the world’s top 10 public-health threats.

 

 

We need to strengthen the antennae of global health, to ensure that when the next virus emerges — which it will — we’ll catch it faster, perhaps even snuff it out. The budget of the WHO, the agency ostensibly charged with safeguarding the health of the world’s 7.8 billion citizens, is somehow no more than that of a large urban hospital in the US.

We also need to double down on the development of vaccines, which will include assuring large pharma companies that their investments won’t be wasted should an outbreak end before one is ready.

 

We tried to bring to you some basic things on pandemics, their history and what they have in store for us in future. We hope it was helpful. This content has been brought by collaborating data from the websites we have credited in the references below.

 By: Ishan Jain

References

https://www.bbc.com/future/article/20200325-covid-19-the-history-of-pandemics

https://www.ft.com/content/8521d81e-1c0f-11ea-81f0-0c253907d3e0

https://time.com/5820607/nathan-wolfe-coronavirus-future-pandemic/

https://www.medicalnewstoday.com/articles/148945

 

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