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COVID-19: Pandemics Past and Present

Dedicated to exploring how medical disasters of the past inform the present response to the COVID-19 pandemic, this database brings together federal government reports, hearings, and more.

Topic Overview

Another Pandemic Begins

2020 had barely begun when life as the world knew it was upended and redefined. Reports at the end of 2019 of a mysterious disease spreading rapidly through Wuhan, China made headlines in the United States, but were not met with alarm by the general American public. It was later determined that the disease that we now know as COVID-19 was caused by SARS-CoV-2, a coronavirus. Coronaviruses, which also cause diseases such as SARS and MERS, are viruses that are common in animals and are so named for the spiky halo of crowns, or corona, that appear around their structure when viewed under a microscope.

Initial symptoms of COVID-19 can be mild and when listed may sound nondescript or even unconcerning; they include cough, fever, chills, shortness of breath, muscle or body aches, loss of taste or smell, diarrhea, headache, fatigue, fever, nausea, and vomiting. But the disease can rapidly, and often without much warning, progress to severe respiratory distress that requires intubation, cause organ failure, and death. It is highly contagious, spread by aerosol droplets shed through sneezing, coughing, talking and laughing. Its highly contagious nature has overwhelmed hospitals, creating so many critically ill patients that hospitals have not had enough beds, supplies, and ventilators to support afflicted patients. In New York City, the original epicenter of the disease in the United States, refrigerated trucks were parked in the streets to hold the bodies of the dead because morgues could not accommodate the number of fatalities. Italy, which was ravaged by COVID-19 in the early months of 2020, had one of the highest number of active cases in the world; more than 35,000 people have died. 

We've Been Here Before

COVID-19 is a disease of a lifetime, a defining crisis for every man, woman, and child on Earth. But history has a long memory and a wide catalog of medical catastrophes it has hurled at humanity. Commentators have often made a connection between COVID-19 and the influenza pandemic of 1918, also known as the Spanish flu. Caused by an H1N1 virus, the 1918 flu infected one-third of the world’s population within a two year period. Its death toll is estimated at about 50 million people worldwide—a higher death toll than the total number of military and civilian deaths in World War I—with 675,000 deaths in the United States. Unlike prior influenza outbreaks, the 1918 flu was particularly fatal in young and healthy people. The reason for its deadly potency is unknown to today’s science but is attributed to a number of possibilities: immune systems depressed and stressed by malnourishment and overcrowding in people mobilized for the war effort, poor hygiene, and the nonexistence of antibiotics all likely contributed to the flu’s pandemic spread. Control and mitigation were limited to isolation, good personal hygiene, mask wearing, and limiting public gatherings—which were all as controversial in 1918 as they are in 2020.

Humanity has suffered under pandemic spread of cholera, yellow fever, tuberculosis, polio, smallpox, measles, plague—all have killed and scarred the young, old, ill, and healthy. For all of medicine’s great triumphs—the global eradication of smallpox and the near-eradication of polio worldwide, for example—there are some maladies for which such victories remain out of reach. Bubonic plague, responsible for three pandemics throughout history—including the deadliest pandemic in recorded human history, the Black Death—still has no cure or vaccine. Treatment is effective if the disease is detected early enough. Cases of bubonic plague still occur in the United States today, and globally somewhere between 1,000 and 2,000 cases of plague are reported each year.

In 2009, an old ghost of pandemics past was resurrected: the swine flu spread across the globe, the second pandemic caused by an H1N1 influenza virus, the same virus involved in the 1918 pandemic. Like the 1918 pandemic, swine flu did not disproportionately affect the very old, with 80% of the global virus-related death toll occurring in people younger than 65 years old. While the World Health Organization officially declared the swine flu pandemic as ending in August 2010, the virus still circulates as a seasonal flu virus, still causing illness, hospitalizations, and deaths worldwide every year.

Certainty through Information

As the world grapples with COVID-19, HeinOnline has launched COVID-19: Pandemics Past and Present to spread information. Compiling together publications on the various ways COVID-19 has impacted every aspect of life, from testing issues, to stimulus payments, to the quest for a vaccine, this database organizes content on COVID-19 into the following areas of focus: Economic Impact, Global Impact, Health Care Impact, and Societal Impact, with an expanding selection of scholarly articles and links to take your learning beyond HeinOnline. Importantly, this collection also features a subcollection dedicated to Past Pandemics, allowing researchers access to ways the federal government has responded to medical disasters of the past and how these previous pandemics inform today’s response. This database, much like our understanding of COVID-19, will continue to evolve over the coming months and years as new content is published and integrated with regular updates.