Matthew Cox takes a look at Covid-19 in the context of previous pandemics.
One of the biggest surprises of this Covid-19 pandemic is that we are surprised. Over recent years our world has grown much smaller, with over 50 per cent of our global population now living in urban areas. We are more crowded and more connected than ever, perfect conditions for the spread of infectious diseases.
Covid-19 or Coronavirus is an infectious disease causing respiratory illness and it derives its name from the spiky projections on the outer surfaces of the virus which resemble the points on a crown (Corona in Latin). According to the WHO the Covid-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. Covid-19 is similar to SARS (2002-3) and MERS (2015) as a virus that humans have contracted after contact with a non-human host that has allowed the virus to jump from the host to humans, Civets for SARS and Camels for MERS.
Pandemics occur when a new virus emerges which is able to infect people easily and spread from person to person in an efficient and sustained way. Because the virus is new very few people will have immunity against the virus and current vaccines might not suffice. Therefore the new virus can make a lot of people sick, and the severity of this depends on the virus, the immunity of the population, and also the health and age of the infected.
1918 ‘Spanish Flu’ Virus Pandemic (H1N1)
The 1918 Spanish Flu Pandemic was the most severe in recent history. It was caused by a virus with the avian origin and the outbreak was linked back to an American military training base and spread worldwide in a perfect storm of conditions generated by the first World War. Industrialisation and the war response from the USA led to crowding facilitated transmission. Soldiers in crowded and cramped camps, along with massive troop movement allowed for rapid transmission through 1918, and it’s estimated that about 500 million people became infected, and the number of deaths was estimated at 50 million. Symptoms started with classic flu-like symptoms before progressing to pneumonia and then ‘purple death’. The pandemic came in three separate waves between June 1918 and April of 1919.
The Centre for Disease Control and Prevention estimated in 2018 that if the 1918 virus hit today, it could result in tens of millions of deaths, with widespread disruption of transportation and supply chains, and massive economic costs– a situation which now seems very real.
2009 ‘Swine Flu’ Pandemic Virus (H1N1pdm09)
In more recent times a new virus strain of H1N1 was detected in the USA and spread across the United States and the world. This virus was very interesting as almost third of people over 60 years old already had immunity to the virus, but very few young people, suggesting that people over 60 would have developed immunity from previous exposure to an H1N1 virus earlier in their lives. It was estimated by the Centre for Disease Control and Prevention that approx. 10 to 20 per cent of the global population contracted the disease, potentially a billion people, but the number of deaths was estimated to be between 150,000 and 500,000 which is similar to the annual death rate of seasonal flu.
One of the common themes of this pandemic has been the downplaying of the virus in comparison to the seasonal flu. This has been pushed by President Trump: “Thirty-six deaths a year from the flu. But we’ve never closed down the country for the flu.” One of the key differences that have been established so far is the difference in the R0 of the seasonal flu and Covid-19. The R0 is the estimate of the average number of people who catch the virus from a single infected person. With flu the R0 is 1.3, however, estimates of the R0 for Covid-19 are between 2-3, which is why the social distancing measures enforced throughout the world are so important.
So although we have been here before, several times in this last century, we are in unprecedented times, and with a virus, we are still learning more about every day. As more is learnt about the virus, more actions will be taken and other actions reduced, however as seen by the lessons we have learnt from the Spanish Flu and the methods of transmission, worldwide movement and crowding will be key methods of the delay and control of the disease in the coming months.
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What positive lessons have you learned? Has your wellbeing improved? What will you do when this is all over and things return to ‘normal’?