Because people today have not lived through anything like the COVID-19 pandemic, it feels like it must be the worst in history. The reality is that this has happened repeatedly throughout history.
The short answer is no, this is not the worst pandemic in history. At least, not yet. Because we have advancements in medical research that allow us insights, we are more prepared than people were in 1918, for example.
The 1918 pandemic was the most severe in so called “recent” history. We know it was caused by the H1N1 virus that contains genes of avian origin. There is a lot of speculation about where it started, but at the time people often referred to it as “the Spanish Flu.” It was first identified by military personnel in the spring of 1918 in the United States. It is also estimated that approximately 500 million people, or one-third of the world’s population, became infected with the virus. Estimates of the human death toll, conservatively, were around 50 million people, worldwide. This illness did not discriminate much by age and in fact had a high mortality rate in children younger than 5 years old, those 20-40 years old, and those 65 and older. The death toll was exacerbated by the fact that there were no vaccines for this illness and no antibiotics to treat the secondary bacterial infections that are common following a virus like this.
Going back further in history, the bubonic plague appeared and was known as The Black Death. Estimates are that this pandemic killed about 20% of London’s population in 1665. The death toll was so high that mass graves were used, and thousands of cats and dogs were slaughtered because there was a belief that they were the cause of the illness. Interestingly, this illness still exists, and people sometimes still turn up with cases often related to contact with an animal or infected flea. Fortunately, modern-day antibiotics are successful in treating the plague today.
In 2009, another H1N1 pandemic occurred. Between April of 2009 and April of 2010, the CDC estimates there were 60.8 million cases, 274,304 hospitalizations, and 12,469 deaths in the United States due to the virus. The CDC also estimates that worldwide, over 150,000 people perished as a result of the virus.
Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) were first discovered in the early 1980s. While it was first detected within American gay communities, it is thought to have developed from a chimpanzee virus from Africa in the 1920s. This disease has grown to pandemic proportions, and estimates are that 65 million people have been infected and 25 million have died. New treatments have allowed people to live longer with HIV. About 1.1 million Americans currently have the disease, and an estimated 38,000 new infections of HIV happen each year in the U.S.
Some may remember a pandemic influenza in 1968 that was referred to as the Hong Kong Flu. It is thought to have originated in China in July of 1968. It was caused by an influenza A virus (H3N2) and caused the deaths of around one million people worldwide and about 100,000 people in the US alone.
As we face this new pandemic in 2020, it is important to remember the lessons of these past pandemics. Our medical progress and capabilities, together with our collective cooperation, give us reason to hope.