In the midst of the COVID-19 outbreak, the question on everyone’s mind is: How will the pandemic end? Dozens of companies and public labs around the world are racing towards the finish line, hoping to develop a vaccine that would render everyone immune to the virus. In spite of the efforts put into finding a treatment, no clear outcome is in sight and the future remains prone to speculation.
As the number of cases is starting to recede in Europe, there are tentative hopes that the outbreak could be slowing down. Yet what the future holds remains unclear—the coronavirus could turn out to be seasonal, which means that it is likely to return this time next year, or one pharmaceutical company could save the day and develop a vaccine to treat and prevent the infection.
Has History Taught Us Anything?
Looking back in history, the COVID-19 is not the first pandemic to wreak havoc on the world. In fact, worldwide disease transmissions have been recurring in history and they’ve brought along massive illnesses, fatalities, and economic disruptions. Smallpox, tuberculosis and HIV/AIDS were among the worst, while the Black Death is still seen as the most devastating pandemic in human history. The plague killed somewhere between 75 and 200 million people in Eurasia. Even though the exact number of plague victims is still unknown, one thing is certain: the Black Death carried important lessons for the future.
If you think that “flattening the curve” is a measure specific to the COVID-19 outbreak, you might want to gain a historical perspective on the situation. The measure, largely enforced to prevent new cases from rising too sharply, has been successfully employed in St. Louis during the 1918 influenza pandemic. As other large cities were throwing parades to celebrate the armistice after World War I, St. Louis imposed social distancing measures. The result: death rates spread over a longer but very much lower curve than the deadly spike in mortality experienced by other cities.
Triage in health centers, respiratory hygiene, epidemiological investigation, infection control, and isolation are just some of the lessons that have been learned from past pandemics and still in use today. Not to mention the importance of proper training and equipment for healthcare workers because they need to stay healthy and care for their patients.
Lessons Learned from the Tuberculosis Outbreak
While we may consider Tuberculosis (TB) an unwelcome companion, we learned a lot about it in the last century. And with that knowledge, we also gained important insights into Mycobacterium tuberculosis, the pathogenic bacteria that cause the disease. Despite the fact that treatments (and even a cure) have been developed, TB is currently making a resurgence. However, even this resurgence will provide us with more information that may help us fight both TB and other epidemics.
Tuberculosis Today
TB may have been responsible for more deaths than any other contagious disease, but that doesn’t mean research focusing on treatments succeeded in attracting sufficient funding. One possible reason is the tendency to associate TB either with those suffering from HIV/AIDS or with the poor and marginalized. As a result, TB has been ignored by science communities around the world, which gave the bacteria time to grow and evolve. Because microorganisms are constantly mutating, the respite made it more dangerous. It didn’t take long for a new and multidrug-resistant TB to appear, a strain that can’t be cured by using conventional antibiotics. A new, more expensive treatment was necessary, but many people are still dying today without proper diagnosis and care.
In short: The cure to the COVID-19 pandemic cannot be a one-time undertaking. Ongoing research and prevention are necessary to ensure that the outbreak does not re-emerge or affects less privileged members of society.
Lesson Learned from the Black Death
Just like the new coronavirus pandemic, the bubonic plague changed human relations and imposed new social rules in the Middle Ages. Businesses suffered then as they do now, important cities were isolated, and ships were quarantined for a long period of time. Even the term ‘quarantine’ appeared as a consequence of the Black Death, from the Venetian term ‘quarantena’ meaning ‘forty days.’ This equals the time that ships and their crew spent isolated before going ashore. However, when talking about the new coronavirus and the Black Death, distinctions are just as important as similarities. After all, the bubonic plague may have killed 30% to 60% of Europe’s population, making COVID-19 a mild disease by comparison.
The Plague Today
Just like tuberculosis, the plague reappeared from time to time, with the most recent outbreak taking place in November 2017, in Madagascar. According to the World Health Organization (WHO), 2,348 plague cases were suspected and confirmed in Madagascar, while 202 people became contemporary victims of the disease. The mortality rate of the plague in recent times was calculated at 8.6 %, after the Madagascar outbreak. The WHO also provided the public with key information about the correct measures applied during the crisis. Isolation and treatment of all pneumonic and bubonic cases were among the first health measures to be advised, as well as active epidemiologic investigation and provision of free prophylactic antibiotics.
In Short: Actively reporting recurring cases and being aware of the scope of the issue is the fastest route towards prevention. The impact of COVID-19 has been largely underestimated until the fatality rates began to spike. Isolation and containment is often the best approach.
Final Thoughts
Raising public awareness regarding prevention and treatment has been extremely important in both tuberculosis and plague management. With the old diseases making new victims, and a new coronavirus pandemic overtaking the world, awareness is necessary for the public, but also among health care workers and policymakers. But increasing public awareness and imposing isolation early and firmly may yet prove a lesson we can learn from studying old pandemics, one even more important than prevention. The continuous search for a cure is a must, and so is the development of a successful vaccine.
