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Is COVID-19 a sign of things to come?

What history has taught us about deadly pathogens
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A woman with a mask on walks across View Street in Victoria. The streets of downtown Victoria are quieter than usual in the wake of physical isolation mandates from the provincial and federal governments in response to the COVID-19 pandemic. (Arnold Lim/Black Press)

Advances in science and technology have exposed the population to deadly pathogens never seen before, but theyB次元官网网址榲e also given humanity more tools to protect itself from widespread outbreaks and death.

As the novel transforms the contemporary world, similar outbreaks throughout history have shaped human society.

B次元官网网址淚t remains to be seen how it will unfold, but it will unfold in ways never seen before,B次元官网网址 said Mitchell Hammond, a historian and professor at the University of Victoria. B次元官网网址淧andemics tend to expose weaknesses and challenges in society.B次元官网网址

Historically, a single disease, such as the plague, cholera or influenza, does not necessarily create a common, shared experience, he explained. Disease outbreaks can reveal inequities between ethnic groups, social classes, dominant cultures or people who are marginalized. And a number of factors impact mortality rates, including poverty, access to health care, and lifestyle. As an example, during the Spanish flu, indigenous groups around the world were disproportionately affected with mortality rates six to seven times higher than European communities.

B次元官网网址淵es, weB次元官网网址檙e all in this together, but we also have to look at how different communities are affected,B次元官网网址 he said.

University of Victoria professor Mitchell Hammond. (Photo courtesy of the University of Victoria)

The Modern World

Hammond explained a number of factors could be shaping how the modern world is experiencing pandemics and epidemics. Advances in science and technology have seen more pathogens discovered, but theyB次元官网网址檝e also shed light on some that existed but werenB次元官网网址檛 well documented or spread. The modern world is also very different with widespread air travel, bigger cities, mass agricultural production and denser exchange networks B次元官网网址 all of which influence how pathogens can spread. With advances in communication, the general public is also being informed of outbreaks they wouldnB次元官网网址檛 typically hear about.

Matthew Little, an assistant professor at the University of VictoriaB次元官网网址檚 school of public health and social policy, noted all of those advancements come with the opportunity for spillover events, exposing expanding populations to sources they wouldnB次元官网网址檛 normally have contact with. For example, the deforestation of the rainforest to make room for farming has put people in contact with pathogens not previously seen by the general population.

Historically, Little said 70 per cent of emerging infectious diseases (that can be sourced and tracked by the scientific community) have come from animals.

B次元官网网址淥n the other hand, we have much better surveillance to prevent these episodes from becoming a global pandemic like what weB次元官网网址檙e seeing now,B次元官网网址 Little said, adding technology is advancing at a fantastic rate. B次元官网网址淎ll of these things decrease the likelihood of pandemics B次元官网网址 WeB次元官网网址檙e always trying to stay one step ahead.B次元官网网址

And while the scientific community continues to encounter new pathogens, theyB次元官网网址檙e also seeing re-emerging infectious diseases.

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Previous viruses

Coronavirus is a classification B次元官网网址 or family B次元官网网址 of viruses that can make both humans and animals sick. In humans, several strains are known to cause respiratory infections ranging from the common cold to more severe diseases, according to the World Health Organization (WHO).

By March 27, more Canadians had died from COVID-19 than severe acute respiratory syndrome (commonly known as SARS). That coronavirus, which had never been seen before in either animals or humans, was formally named SARS-CoV. WHO recorded 43 deaths and 251 cases in Canada. And during that outbreak, between November 2002 and Dec. 31, 2003, WHO received reports of 8,096 probable cases and 774 deaths worldwide. It did not declare a pandemic but took many other steps including activating emergency operation centres and limiting travel.

Healthcare workers accounted for 21 per cent of all cases and the world fatality rate for probable cases was 9.6 per cent, according to Infection Prevention and Control Canada (IPAC). There are no current cases of SARS in the world.

Hammond noted the Spanish flu of 1918 to 1919 is also in some ways a good comparison to COVID-19, as it was what many experts refer to as the first global pandemic. Both influenza and coronaviruses are respiratory diseases, he explained, which shapes how governments and individuals respond to them. Even a century ago, people used various forms of physical distancing and self-isolation. That outbreak was also the first big episode in public health history where people around the globe starting wearing masks, Hammond added. Before 1910, when a plague tore through China, people hadnB次元官网网址檛 started utilizing masks outside of surgeries.

B次元官网网址淲e think about disease very differently than people did 100 years ago,B次元官网网址 Hammond said. B次元官网网址淥rdinary people didnB次元官网网址檛 have the almost unconscious recognition of microbes as we do today.B次元官网网址

Deadly illnesses

Influenza, combined with pneumonia, is one of the top 10 leading causes of deaths in Canada, killing 8,511 people in 2018, 7,396 in 2017, and 6,235 in 2016, according to Statistics Canada.

While both influenza and COVID-19 are infectious respiratory illnesses with similar symptoms, they are caused by different viruses. There are three main types of influenza viruses, influenza A, B and C. Influenza A and B are associated with seasonal flu and outbreaks, while influenza C is rare and does not usually cause epidemics or outbreaks, according to IPAC.

The 2019-2020 flu season began on Aug. 25, 2019, and as of March 28, there had been 42,355 confirmed cases of influenza in Canada, according to IPAC. Of that, 24,269 cases were influenza A and 18,086 cases were influenza B. ThatB次元官网网址檚 an increase from 39,192 total cases during the 2018-2019 season and is similar to the 2017-2018 season, which saw 55,059 cases.

Historically, counts ranged from a few thousand up to 17,000 between 1999 and 2012, with the exception of 2008-2009 which saw 23,376 cases and 2009-2010 which saw 39,018 cases due to a H1N1 virus commonly referred to as swine flu. During the 2012-2013 season, counts jumped to 31,737 and continued to range between approximately 28,000 and 43,000 until 2017.

Back in 1918-1919, the Spanish flu, which was caused by an H1N1 virus, was estimated to have infected approximately 500 million people or one-third of the worldB次元官网网址檚 population, according to the CDC, with up to 50 million deaths worldwide.

As of May 8, there were 65,399 confirmed cases of COVID-19 in Canada, with 2,288 in B.C. A total of 4,471 Canadians had died with 126 deaths in B.C. Quebec had the highest number of deaths at 2,631, followed by Ontario with 1,540. Globally, Johns Hopkins University and MedicineB次元官网网址檚 coronavirus resource centre was reporting 3,910,738 confirmed cases and 272,578 deaths as of May 8.


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Outcome

B次元官网网址淐ollectively, weB次元官网网址檙e having these events not because some of us are primitive, but because weB次元官网网址檙e all connected,B次元官网网址 Hammond explained, adding back in 1918 mass travel was done by steamship and people couldnB次元官网网址檛 move around the globe with the ease they do today.

With that has also come a shift in how the public understands the links between personal behaviour and society as a whole. B次元官网网址淏次元官网网址楩lattening the curveB次元官网网址 is something we hear almost every day B次元官网网址 That seeps into how ordinary people understand their lives.B次元官网网址

Matthew Little, an assistant professor at the University of VictoriaB次元官网网址檚 school of public health and social policy. (Photo courtesy of Matthew Little)

But unlike past outbreaks, Hammond said the world likely wonB次元官网网址檛 see a tidy conclusion to the COVID-19 pandemic. Historical narratives of epidemics and pandemics often rise and fall B次元官网网址 with early warnings, rising case counts, alarm, and death rates peaking, followed by decreasing cases and sober reckoning. B次元官网网址淲e tend to think of them as episodes,B次元官网网址 he explained, adding even the word epidemic leads people to that belief.

While he wouldnB次元官网网址檛 speculate on how a vaccine could influence the outcome, he did note with how widespread COVID-19 has become, how connected the world is, and with so many variables in play, it will be interesting to see how science will shape future decisions. With advances in technology increasing testing capacities, and case tracking and public health surveillance being shaped by what the general population will stand for, the B次元官网网址渘ew normalB次元官网网址 could continue to see limitations put on survivors and those who havenB次元官网网址檛 been exposed yet.

Little added while there has been a push from governments around the world to come up with a vaccine, it needs to be something that has gone through the rigorous protocols currently in place for testing to ensure it is safe.

B次元官网网址淭he challenging thing about this is it in some ways feels like itB次元官网网址檚 moving in slow motion for those of us working from home B次元官网网址 but research takes time,B次元官网网址 Little said. B次元官网网址淲hat weB次元官网网址檙e seeing now is not the new norm.B次元官网网址

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katie.e@blackpress.ca


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Katherine Engqvist

About the Author: Katherine Engqvist

I took on the role of Bureau Chief when we created the Greater Victoria editorial hub in 2018.
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