The History of Pandemics and Its Possible Impact on Improving Public Health Outcomes
Opinion Piece
Pandemics and infectious diseases have existed since the beginning of human civilization. In fact, when human civilization shifted to agrarian lifestyles from hunter-gatherer lifestyles, highly communicable diseases such as malaria, leprosy, tuberculosis, influenza, and smallpox started to appear in communities. Furthermore, the likelihood of pandemics also started to increase with increasing levels of human contact spanning across wider geographic areas such as building cities, facilitating trade, and waging wars.
The earliest recorded pandemic was in Ancient Greece during the Peloponnesian War. An infectious disease suspected to be typhoid passed through what is now known as Libya, Ethiopia, and Egypt and reached Athens, which was at war with Sparta. The disease killed two-thirds of Athens’s population and its symptoms included fever, thirst, and bloody throat and tongue. Ultimately, this pandemic was a crucial factor in the defeat of Athenians by the Spartans.
Fast forwarding to one of the world’s most well known pandemics, the 1918 Spanish Flu was the most severe pandemic in recent history. It was caused by the H1N1 virus, believed to have originated from birds. Over the course of a year, the disease spread throughout the globe and infected about one-third of the world’s population or about 500 million people. In the United States alone, there were almost 675,000 recorded cases. In fact, a unique feature of this pandemic was the high mortality rate of healthy people, especially in the age range of 20–40 years old. Furthermore, the dangers of the pandemic were exacerbated with no flu vaccine or antibiotics to treat bacterial infections associated with the viral infections of the flu.
During the 1918 Spanish Flu, similar disease control techniques to the recent COVID-19 pandemic were observed. For instance, American government and municipal health agencies advised techniques related to isolation, quarantine, good personal hygiene, use of disinfectants, limitation of public gatherings, and mask-wearing, albeit such practices weren’t consistent in many towns and communities. Additionally, such a widespread public health crisis spurred greater development of prominent health organizations such as the Red Cross.
Another striking parallel between the 1918 Spanish Flu and COVID-19 was the widespread racism towards certain racioethnic groups exacerbated by the spread of the disease. For instance, World War I and the Russian Revolution played a crucial role in instigating social conflict during the Spanish Flu as it was nicknamed “German Plague” or even “Bolshevik Disease” by the Allied Powers against the Axis power Germany and communist Russia. In fact, in the Allied Nations, many accused the German pharmaceutical company Bayer of deliberately contaminating aspirin tablets with the pathogen that caused the Spanish Flu. Likewise, the COVID-19 crisis has been associated with drastic increases in anti-Asian sentiments and hate crimes. After all, COVID-19 was labeled the “Chinese virus.” By late April of 2020, the reporting center created by a coalition of Asian-American social justice organizations called “STOP AAPI HATE” stated that it received nearly 1500 reports of racist and violent attacks against people of Asian origin.
But, why does knowing the history behind various pandemics and outbreaks of communicable diseases matter?
One can argue that knowing the parallels between public health practices during different pandemics throughout time as well as the social impacts of such crises has the potential to increase a positive public reception to disease prevention and mitigation practices as well as initiatives to tackle social stigma caused by such widespread events. The United States still lacks a comprehensive public health education system, and this has been linked to poorly educated communities being the most susceptible to catching the disease due to a lack of awareness of proper public health measures. Education is a social determinant of health outcomes as a number of studies, including controlled trials, have shown a strong positive correlation between increased levels of education and the quality of health outcomes in a dose-response fashion. Health history should be at the heart of public health education as learning history is ultimately about gauging human connections across time and experience. When individuals are able to make such connections between what they know from past public health crises and their present situation, they are able to better understand the purposes of various public health measures. Thus, once they believe in the credibility of even the simplest measures such as wearing masks, they are more inclined to follow them. Not to mention, as the saying goes, one can learn from the past to understand the present and prepare for the future. So, by reflecting on the history of pandemics, various public health agencies as well as national governments can improve their mobilization for future pandemics.
Furthermore, documenting the history of pandemics and infectious disease has the potential to combat social unrest and stigma by raising greater awareness of health disparities throughout communities as well as instances of hatred and violence against marginalized racioethnic groups. By sparking key developments in the societal atmosphere during future public health crises, one can improve the outcomes of yet another crucial aspect of public health: mental health. As stated in the brief research report article, “The Mental Health Impact of COVID-19 Racial and Ethnic Discrimination Against Asian American and Pacific Islanders,” scientists “analyzed data from the Healthy Minds Study, and found that COVID-19 related racial/ethnic discrimination was associated with greater odds of having depression, anxiety, non-suicidal self-injury, binge drinking, and suicidal ideation among AAPI university students” (Zhou et. al.). The lack of understanding of the AAPI experience during COVID-19 played a key role in racism causing such a severe impact on AAPI people, especially the younger generation. This lack of understanding also amounted to a significant lack of mental health resources for AAPI victims of hate crime. A major element of understanding history is comprehending the human experience behind any large-scale event, whether it be a war or even a pandemic. Thus, by properly documenting health history so that the greater public can engage with it, we are able to fight against racism more effectively and provide victims of social unrest with better resources for improving their health outcomes.
All in all, learning about the history of pandemics and infectious disease as well as adequately documenting it can significantly improve public health outcomes during major health crises. There are still many questions to be addressed regarding this issue. For example, greater research is yet to be conducted on the logistics of implementing health history in the curriculums of health classes in American schools, colleges, and even graduate schools of public health and medicine. Additionally, we must work to further understand how to present the social nuances of health history in an unbiased and equitable manner so that everyone can benefit from its dissemination. If such issues are properly addressed, then we have the potential to make history as the vehicle for positive social and scientific advancements in our societies.
Sources:
https://www.history.com/topics/middle-ages/pandemics-timeline
https://www.cdc.gov/flu/pandemic-resources/1918-commemoration/1918-pandemic-history.htm
https://www.hrw.org/news/2020/05/12/covid-19-fueling-anti-asian-racism-and-xenophobia-worldwide#
https://blogs.icrc.org/law-and-policy/2020/04/23/spanish-flu-covid-19-1918-pandemic-first-world-war/
https://nam.edu/poor-education-predicts-poor-health-a-challenge-unmet-by-american-medicine/
https://www.frontiersin.org/articles/10.3389/fpsyt.2021.708426/full
