The Wuhan coronavirus outbreak could soon be declared a pandemic — here's how the world has handled global outbreaks in the past

  • The Wuhan coronavirus is still spreading, and experts are saying it may get declared a pandemic.
  • A pandemic is the worldwide spread of a new disease, according to the WHO. It is defined by the lack of available treatment and ability to spread from person to person.  
  • There have been many other pandemics, from the 1918 Spanish Flu outbreak to Zika in 2015, and we've dealt with many of them by using quarantines and rushing vaccine trials.
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As the Wuhan coronavirus continues to spread, experts are predicting that the virus will end up being declared a pandemic.

The World Health Organization recently called the coronavirus, which has killed at least 362 people and infected over 17,000 other people, a "public-health emergency of international concern," which isn't exactly a pandemic, but may lead to one.

The WHO defines a pandemic as "the worldwide spread of a new disease."

From the 1918 Spanish Flu outbreak to Zika in 2015, there have been a number of pandemics in recent years. Here's how we dealt with them. 

Before the BCG vaccine, kids with tuberculosis were left to sleep outside.

Tuberculosis was incredibly common in the 1800s and early 1900s, killing one in seven people who had ever lived.

People sought cures in sanatoriums, and children were left to sleep outside at night to get fresh air, which was thought to stop the disease. Before antibiotics were invented, sanatoriums, which isolated people and gave them proper nutrition, were the best medicine for tuberculosis.

Robert Koch’s 1882 discovery of the tubercule baccilum showed tuberculosis could be prevented with good hygiene. Massive public health campaigns launched by the US government helped raise awareness of how to prevent the disease, but it took decades until the disease was fully eliminated. In 1953, there were still 839 sanatoriums in America.

It was only after World War II that the Bacillus Calmette–Guérin (BCG) vaccine received widespread acceptance and wholly stopped the disease — although some drug resistant strains of the disease still persist. 

States banned large funerals, weddings, and other social gatherings during the Spanish Flu outbreak of 1918, still the deadliest pandemic in history.

The 1918 Spanish flu epidemic killed 50 million people globally, after infecting one-fifth of the world’s population at the time. More people actually died from the flu than in fighting World War I. The flu, which lasted a year, lowered the average life expectancy in the United States by more than 12 years.

Cities like St. Louis saved people by quickly imposing restrictions on social gatherings and using quarantine methods, buying time while researchers worked to develop vaccines.

Schools, theaters, churches and dance halls were closed. Kansas City banned weddings and funerals if more than 20 people were on the guest list. New York staggered shifts at factories so there wouldn’t be as much rush hour commuter traffic. Seattle’s mayor ordered people to wear face masks. 

Researchers think the avian-borne disease originated in China and was spread by Chinese laborers on their way to Europe. It was called the Spanish flu because of a wire report declaring one of the first major flu outbreaks, which was in Madrid, Spain.

The CDC called it “the deadliest pandemic of the 20th century,” though it has yet to be outpaced in the 21st.

Ebola outbreaks struck in 1976, the 1990s, and 2014. Doctors had to burn hospital beds after patients died, and communities were urged to change burial rituals.

The first Ebola outbreak occurred in Sudan and Zaire in 1976. Since then, Ebola, one of the deadliest viral diseases, had remained confined to Africa, with another devastating outbreak in the 90s.

Between 2013 to 2016, another Ebola outbreak devastated Western Africa, and became the focus of global attention, largely because diagnoses spread to the US and Europe. 

There was particular concern over the high percentage of healthcare workers in Africa that Ebola infected.

Doctors Without Borders were flown in to treat people, decked in haz-mat suits. They were forced to burn beds after victims died. Communities were also urged to adopt safe, sanitary burial practices, by not touching the deceased, or any of the fluids of the deceased — a painful directive for many communities of Western Africa where funerals are sacrosanct.

The WHO issued guidelines on handwashing and how to find clean water in a bid to prevent human-to-human transmission of disease. 

The 2014 outbreak ended with more than 28,600 cases and 11,325 deaths, according to CDC estimates.

 

 

The 1976 swine flu outbreak led to the vaccination of 48 million Americans in 10 weeks.

In 1976, a virus jumped from pigs to humans and killed an army recruit. In 10 weeks, some 48 million people g0t vaccinated out of fear that another global outbreak was coming. The government granted vaccine makers’ requests to lower the manufacturing standards for the vaccines, so they could be made quicker, and with less federal oversight.

Cases of Guillain-Barre syndrome, a rare side effect of the vaccine, were uncovered, and after two-and-a-half months the mass vaccination program was put to a stop. The program was an embarrassment to the US government and cost the CDC director his job.

The scandal led to mounting distrust over the government’s ability to handle pandemics.

In 2009, 900 cases of another swine flu, caused by the H1N1 virus, were reported in Mexico and the WHO declared it a pandemic. US President Barack Obama called the virus a national emergency, and all 50 states, as well as 30 summer camps, declared outbreaks. The virus is now preventable by a newer vaccine, first produced in 2009.

Protesters had to shake the government into action over the HIV/AIDS epidemic, which killed hundreds of thousands.

First spotted in 1981, researchers theorized that the disease was developed from a West African chimpanzee virus.

AIDS (acquired immunodeficiency syndrome) is caused by HIV (human immunodeficiency virus), which depletes immune cells, making people more susceptible to diseases the immune system would ordinarily be able to fight off.

As the death toll mounted, and the government withheld experimental drugs from victims, grassroots activist group ACT UP staged protests at places like the FDA and Wall Street. Lack of government action spurred underground networks like the Dallas Buyers Club, which supplied people with unapproved drugs. In 1987, an enormous quilt, with panels for each person who had died from AIDS, was laid out on The National Mall.

It took until 1985 for Reagan to publicly utter the word “AIDS.” In his second term, after a flurry of bad press, Reagan allocated $500 million to AIDS research, only after it became clear that the disease wasn’t just affecting gay men. Eventually, special HIV/AIDS departments at the NIH and the CDC were created.

By the time a treatment was discovered in 1987, 40,849 people had died.

A cure for AIDS has yet to be found, though HIV positive people who religiously take anti-retroviral therapy, a daily pill, can suppress the virus to such an extent that it’s undetectable in the bloodstream, and untransmittable. For people who are HIV negative, there is PrEP (pre-exposure prophylaxis), which reduces the risk of getting HIV by 99%.

 

SARS first appeared in 2002, and triggering debates about whether countries should seal their borders during pandemics.

This illness, which has symptoms of severe pneumonia, first appeared in Guangdong, China in 2002. Since then it’s killed about 774 people, according to the WHO.

Infected people were isolated and quarantined to stop the spread of the disease, and the discussion inspired debates about how to deal with global pandemics. Some thought countries should seal their borders to prevent the virus’ spread, while others thought countries should coordinate with one another to stop the disease. The Wall Street Journal ran an op-ed calling for a ban on travel to and from China. 

Researchers stopped SARS by publishing the genetic code of the disease on the internet and letting epidemiologists everywhere apply their collective expertise into stopping it. Researchers traced the outbreak to a colony of cave-dwelling bats.

 

 

Tens of thousands of people were quarantined during the outbreak of the Middle East Respiratory Syndrome (MERS) in 2012.

MERS, which was first reported in 2012, causes severe respiratory illness and kills three out of every four patients that report MERS. 27 countries have reported cases, with 858 confirmed dead, mostly in Saudi Arabia.

The South Korean government handled the disease’s spread to South Korea by quarantining nearly 17,000 people, and tourism levels plummeted.

All cases of MERS are linked to the Arabian Peninsula, according to the CDC. MERS, short for Middle East Respiratory Syndrome, is an illness caused by a coronavirus called Middle East Respiratory Syndrome Coronavirus. 

MERS was spread from live camels to humans, researchers later discovered.

Pregnant women were told to were long-sleeved clothing and avoid Latin America during the Zika outbreak.

Aedes aegypti mosquitoes carried Zika, a virus which can cause stillbirth, pre-term birth, Guillain-Barré Syndrome, and a group of birth defects known as congenital Zika syndrome, which is a group of birth defects associated with Zika infection during pregnancy. One of those birth defects is microcephaly, a condition where the head is smaller than normal. 

In 2016 and 2017, large Zika outbreaks occurred in America, prompting panic.

Panic centered on pregnant woman and travel. Doctors told women to wear long-sleeved tops, even though it was unclear how effective that would be.Women had questions the doctors couldn’t answer, about the risks to their unborn children if they contracted Zika.

The governments of El Salvador, Brazil, and Jamaica all recommended that women avoid getting pregnant, while the CDC recommended that pregnant women avoid travel over 30 countries. At a Congressional hearing, one doctor declared poor pregnant women to be most at risk.

The FDA focused on creating diagnostic tests to detect the presence of Zika, on developing vaccines, and on protecting the nation’s blood supply in the case of an emergency. 

Researchers are still working on creating a vaccine for Zika.

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