History Is No Stranger to Pandemics

COVID-19 has spread to 180 countries and territories and includes and caused more than 44,000 so far, but this is not the first time a pandemic has occurred.¹

Data show that the disease is mild in 80% of patients, severe in 13%, and critical in 6%. Major signs and symptoms of COVID-19 include aches and pains, dry cough, fatigue, fever, runny nose, shortness of breath, and sore throat.

After China reported several pneumonia cases on December 31, 2019, identified a new virus on January 7, 2020, and the first death there occurred on January 11, 2020, COVID-19 started spreading like a wildfire to neighboring countries and then all over the world.¹

Of course, history repeats itself.

About 5000 years ago, an epidemic wiped out a prehistoric village in China, now called Hamin Mangha. The killed many people, both young and old. There is also historical data and evidence for other epidemics and plagues, such as the Plague of Athens in 430 BC, the Antonine Plague from 165-180 AD, the Plague of Cyprian from 250-271 AD, the Plague of Justinian from 541-542 AD, the Black Death from 1346-1353, the Cocoliztli Epidemic from 1545-1548, the American Plagues in 16th century, the Great Plague of London from 1665-1666, the Great Plague of Marseille from 1720-1723, the Russian Plague from 1770-1772, the Philadelphia Yellow Fever Epidemic in 1793, the Flu Pandemic from 1889-1890, and the American Polio epidemic in 1916.²

From 1918-1920, the Spanish Flu, was the most severe pandemic in recent history. It was caused by the H1N1 influenza virus with genes of avian origin. It is estimated that about 500 million people, or one-third of the world’s population, became infected with this virus, and about 675,000 died in the United States and at least 50 million died worldwide.²

In February 1957, a new influenza A virus called H2N2 emerged in East Asia, spreading another pandemic called Asian Flu. This was first reported in Singapore, then Hong Kong, and then later in United States. H2N2 caused about 1.1 million deaths worldwide and 116,000 in United States.²

In 1968, H3N2 Influenza A virus caused another worldwide pandemic. First noted in the United States, this pandemic caused over 1 million deaths worldwide and about 100,000 deaths in the United States, mostly in patients 65 years and older.²

In 2003, the SARS coronavirus (SARS-CoV) was identified. There were about 8000 cases in 26 countries. This virus is thought to have originated in 2002 in the Guangdong province of Southern China in animals, perhaps bats, which then spread to civet cats and then to humans.

In 2009, the H1N1 virus (pdm09) emerged, also called the Swine Flu, and it was first detected in the United States and then quickly spread all over the world. This new H1N1 virus, which contained a unique combination of influenza genes not previously identified in animals or people infected more than 60 million people in the United States, resulting in 274,000 hospitalizations and 12,469 deaths. The CDC estimated that more than 500,000 people died worldwide after being infected.^2,3

From 2014-2016, there were about 28,000 cases of West African Ebola worldwide, and 11,000 people died. The Zika Virus spread in 2015 from Central and South America and continues to spread to this day.^2,3

Whatever the origins of these different pandemics, disease and deaths caused by such viruses have changed the course of history, and at times, have come close to signaling the end of human civilization.

Even though we can now prevent many of these diseases because of medical and technological advancements, the COVID-19 crisis is showing that lessons learned now and from the past will allow us to be smarter and better-equipped to deal with pandemics in the future.

Saro Arakelians, PharmD, is the general manager and pharmacist in charge at BioScrip Infusion in Burbank.

References

1. Johns Hopkins University and Medicine. Coronavirus resource center. coronavirus.jhu.edu/map.html. Accessed April 1, 2020.

2. CDC. Past pandemics. cdc.gov/flu/pandemic-resources/basics/past-pandemics.html. Updated August 10, 2018. Accessed April 1, 2020.

3. World Health Organization. Coronavirus disease (COVID-19) pandemic. who.int/emergencies/diseases/novel-coronavirus-2019. Accessed April 1, 2020.