Unleashing unbridled chaos across the world
The word pandemic is derived from the Greek pandemos, meaning “pertaining to all people; public, common,” in turn made up of pan- (”all”) and demos (“people”).An epidemic spreads rapidly and extensively by infection, but a pandemic threatens everyone, not just in a limited region, and causes a high level of mortality. So the Ebola virus, though it killed thousands of people, remained confined to West Africa and never reached pandemic status. And when what we today know as Covid-19 seemed to be confined to China, experts spoke of it as an epidemic; when it crossed borders and affected all countries, the WHO labelled it a pandemic.
Covid-19 is by no means the only pandemic the world has had to cope with. Influenza has often reached pandemic proportions, most notoriously in 1918-19, when the misnamed “Spanish flu” killed more people around the world than both World Wars combined! There have been several lethal pandemics of flu – one million died in the “Russian Flu” in 1889-90, the “Asian Flu” killed 2 million in 1956-58, and the “Hong Kong Flu” accounted for 1 million fatalities in 1968. There have been alerts in recent years about avian or bird flu, swine flu, the 2003 severe acute respiratory syndrome (SARS), and other threats of pandemics that have placed the world on high alert.
Cholera,bubonicplague,andsmallpoxhave produced deadly pandemics in the past. None, perhaps, has been as persistent, devastating and recurrent as smallpox, which killed between 300 to 500 million people in its 12,000 year existence – a much higher proportion of the world population in earlier times – and whose eradication by the 1970s is one of the truly great medical achievements of humankind.
HIV/AIDS, because it spread around the world and caused 36 million fatalities since 1981, can be called a pandemic. Cholera no longer is thought of as a contender, but what is known as the Sixth Cholera Pandemic was: it originated in India where it killed over 800,000, before spreading to the Middle East, North Africa, Eastern Europe and even the USA, where it caused the last American outbreak of cholera in 1910–1911.
The most feared pandemic scourge of humanity in ancient and mediaeval times was, of course, the Plague. The Bubonic Plague of 1346-53 lasted seven years and killed an incredible 75 – 200 million people, out of a world population perhaps three times that size. It ravaged Europe,Africa,andAsia,travellingaroundthe world most probably on rat-infested merchant ships. Its toll was so widespread and horrific that it was known as the “Black Death”. But therehadbeenearlierbubonicplagues,though labelling them pandemics might suggest a certain European ethnocentricity, since Europe was all that people knew of the world in those days. The “Plague of Justinian” in 541-542 AD wiped out some 25 million people, which was half the population of Europe, killed up to a quarter of the population of the Eastern Mediterranean and devastated the city of Constantinople, where 40% of the population died. Even earlier, in 165 AD, the “Plague of Galen”, also known as the “Antonine Plague”, affected Asia Minor, Egypt, Greece, and Italy. Historians attempting to understand what happened surmise that it must have been either smallpox or measles, brought back to Rome by soldiers returning from battle in Mesopotamia. Whatever it was, this plague killed over 5 million people and decimated the Roman army.
Pandemics, of course, have become more frequent in our times because of increased global travel and integration, population growth and environmental damage. The increasingemergenceofviraldiseasefromanimals, whether because of the eating habits of some humans or as a result of environmental deformations, has seen an increase in zoonotic diseases, in which pathogens cross the boundary between animal to animal transmission and affect human beings as well by transforming into diseases that are transmitted from human to human.
Pandemics cause significant economic, social, and political disruption, prompting the international community, notably through the World Health Organization, to undertake efforts to prepare to mitigate the impact of pandemics. There are still many gaps and shortfalls related to the timely detection of disease, availability of basic care, tracing of the spread of infection, the quarantine and isolation procedures adopted by various countries, and major challenges of global coordination and response, as well as the mobilisation of resources to fight pandemics, particularly in poor developing countries.
The worst pandemic threats are those that transmit easily and rapidly between humans, have long asymptomatic infectious periods (which means that infected persons can infect others while their infections are still undetected), and are easily confused with lesser threats (a cold or a flu, for instance, in the case of Covid-19). Others, like Nipah virus and bird flu, are deemed a moderate global threat since they have not demonstrated sustained human-to-human transmission. Developing countries are always the most at risk, because of their higher levels of malnutrition, insufficient access to good medical care, and higher rates of disease transmission , as well as lower medical infrastructure capacity, less access to modern medical techniques, and greater density of population.
The world is going through a severe pandemic right now in which relatively developed countries seem to be the worst sufferers. We will have to wait and see if that remains the case for long, and what lessons we must derive from it.