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March 26, 2020

What past pandemics can tell us about COVID-19

While the current global pandemic is unprecedented in our time, it’s certainly not the first that human societies have had to contend with.

From the bubonic plague to the Spanish flu, history is full of pandemics that have altered the way we live – so what can we expect from the COVID-19 pandemic? Ultimately, the biggest changes are always better hygiene, improved medical knowledge, and better preparedness for the next pandemic, the benefits of which we are already seeing today.

The biggest and most well-known pandemic is, of course, the Black Death, which killed an estimated twenty-five million people across Europe in the fourteenth century – around a third of the population. This was a time when medical knowledge was based around the four humours and microscopic causes of disease like bacteria were unknown, and because people didn’t know what caused the plague, it was difficult to avoid, cure, or contain it. It’s this pandemic that we have to thank for the word quarantine: Venetian officials at this time passed a law that required docking ships to isolate their crew members in port for thirty days – trentino – followed by an escalation to forty days – quarantino – to avoid bringing sick people into the city. One of the first theories about plague contagion was the danger of proximity, which we are very familiar with today – so heed the words of both medieval Venice and our current health authorities and adhere to social distancing!

Edward Jenner - smallpox cure / 1918 Spanish flu

Something less welcome we have to accept from plague history, however, is that pandemic-related illnesses rarely cause just a single outbreak. In fact, the bubonic plague devastated Constantinople in 541 CE, 800 years before the Black Death. Known as Justinian’s Plague, this outbreak killed up to 40% of the city’s population and nearly 25% of the rest of the Byzantine Empire, while further outbreaks of the bubonic plague persisted well after the fourteenth century. In London, the plague reoccurred almost every twenty years between 1348 and 1665, consistently killing twenty percent of the city. This is not to say that our current pandemic will result in similar figures: COVID-19 is nowhere near as deadly as the bubonic plague, not least because we are much better informed about illness, health, and medicine than pre-Enlightenment Europe. However, we do have to expect the virus to crop up again after this outbreak because that’s the nature of pandemics, though our experiences in the current situation will surely bolster our response to future outbreaks and make them less severe.

A great example of improvement in the face of a pandemic is the cholera outbreak in nineteenth-century England, when Dr. John Snow investigated the occurrences of cholera in London and tracked them back to a water pump. He realised that the drinking water was contaminated and, by convincing officials to remove access to the pump, helped to curb the outbreak in the city. This led to a major effort to improve urban sanitation and hygiene, which is a legacy that we’re still benefitting from and contributing to today. It also shows us that simple solutions can make a world of difference. Whether it’s closing a certain water pipe due to a water-borne illness or keeping our distance from others because of a person-to-person transmissible virus, drastic measures aren’t always necessary to slow the spread in a pandemic. We just have to listen to health professionals and adhere to their advice.

So, while it’s impossible to accurately predict how our current global pandemic will progress, pandemics in the past show us that we’re always getting better at coping with them. From the implementation of quarantines in plague outbreaks to systematic investigations into patterns of illness, we’ve inherited an effective public health tradition that is always improving – and now we have to make use of it, making sure to heed the advice of experts. Stay home if you don’t absolutely have to go out, keep at least 1.5 metres of space between yourself and others, and practice good general hygiene to slow the spread of COVID-19.

To learn more about the Australian Government’s advice on COVID-19, visit the Department of Health and Human Services website here.

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