COVID-19 has us all thinking about public health,
but looking back, there have been many pandemics before, and we persist in spite
of them.
As of April
15, the Centers for Disease Control (CDC) has reported 605,390
cases of COVID-19 in the United States. These have occurred across all 50
states and have resulted in 24,582 deaths. We are all feeling the effects of
the pandemic. Schools are closed, businesses have shut their doors, and nobody
knows what’s coming next.
While COVID-19 is one of the largest pandemics of the 21st
century, you might be wondering how it stacks up to the terrible pandemics of
the past. Let’s look at the 10 worst pandemics in human history.
10. The Great Plague of
Milan: Italy (1629-1631)
Death
Toll: 1 million
The Great
Plague of Milan was a series of outbreaks of the bubonic plague (featured later
in this list) that happened between 1629 and 1631. While numerous plague
outbreaks occurred in Europe during the 17th century, this was one of the
worst. The disease is thought to have been brought into
the city of Mantua by French and German soldiers in the Thirty Years’ War, and
it spread from there.
While the plague ravaged the country, some towns were spared.
Ferrara in northern Italy did not experience a single death from the plague
because it implemented strict border controls, sanitation laws, and personal
hygiene practices. It even built state-funded plague hospitals outside the
city’s walls to prevent larger outbreaks from single cases (although the
disease was thought to be caused by corrupted air rather than a bacterium).
This is a rare example of effective disease control in history and
is eerily reminiscent of what the world is going through with
COVID-19. The Great Plague of Milan was so deadly, it is thought to be a
major contributor to the decline in power of the Republic of Venice, which had
risen to prominence during the Renaissance.
9. Hong Kong Flu: China
(1968-1970)
Death
Toll: 1-4 million
Influenza A
pandemics have occurredmultiple
times throughout history when new, deadly strains of the influenza A virus
evolved. The adaptability of the flu is why flu shots change each year.
The Hong
Kong flu (H3N2) originated in
China and was the second-worst flu pandemic of the 20th century, behind the
famous 1918 Spanish flu featured later on this list. While this pandemic was
much less deadly than the one in 1918, the virus was especially infectious,
contributing to its spread around the world. Within two weeks, the virus had
moved throughout southeast Asia, and within two months it had made its way
across the ocean into the Americas, later spreading to Europe, Africa, and
Australia.
Although we are no longer in the midst of a flu pandemic, H3N2 has
stuck around as one strain of seasonal flu we see every year.
8. Cholera:
India/Indonesia (1817-Present)
Death
Toll: 95,000/year (more
than 1 millionhistorical
total)
The cholera pandemic consists of a series of smaller pandemics
that have been occurring on and off since 1817. We are now within the seventh
cholera pandemic. Six of the seven major cholera pandemics have originated in
India. However, the current pandemic originated in Indonesia. Trade and
military routes over the years have contributed to spreading this disease
throughout the world.
Although
cholera today does not majorly affect developed nations due to their access to
clean water, the disease thrives in developing areas that lack reliable water sources and
solid sanitation systems.
Cholera is caused by the bacterium Vibrio cholerae. The virus
causes severe diarrhea and is spread through raw sewage, which creates a
vicious cycle of infection in areas experiencing an outbreak.
7. Antonine Plague: Rome
(165-180)
Death
Toll: 5 million
This ancient
pandemic swept through the Roman Empire in the late second century. While it’s
not certain which disease caused this pandemic, it’s thought to be measles, smallpox, or a
combination of both.
At that time, the Roman Empire spread far beyond Italy into the
Mediterranean region, as well as parts of Africa and Asia. Active trade and
military movements contributed to the disease’s quick spread.
The plague
was so deadly that today it is thought to contribute to the eventual fall of the Roman Empire,
making this plague one of the major events of Western history.
6. Third Plague: China
(1885 – 1950s)
Death
Toll: 12 million
The Third
Plague refers to the most recent pandemic outbreak of bubonic plague, which
began in 1885 in the Chinese province of Yunnan. This
pandemic lasted many years. By the beginning of the 20th century, there were
cases on all six inhabited continents, although its most devastating effects
were in China and India.
Interestingly,
this pandemic led to much quality scientific research about
this and the previous plagues. Because this outbreak occurred in the modern era
(at least relative to the original Black Death), scientists had access to
better research tools and methods. For example, studying this plague led to the
discovery of the bacteria responsible for historical plagues, Yersinia pestis.
5. HIV/AIDS: Sub-Saharan
Africa (1981-Present)
Death
Toll: 25-35 million
Human
immunodeficiency virus (HIV) first emerged in the Democratic Republic of the
Congo in the late 1970s. The accepted hypothesis is
that the virus jumped from chimps to humans through bush hunting in central
Africa.
The virus
causes acquired immunodeficiency syndrome (AIDS), a disease in which the immune system gives out,
causing people to die not from HIV itself, but from a variety of secondary
infections such as pneumonia.
Unlike many of the pandemics on this list, HIV is not transmitted
from casual contact. HIV can spread through blood, sexual transmission, and
from mother to child through birth or breastfeeding. In the United States, the
virus ravaged the gay community and IV drug users.
Historically,
the prevalence of the virus among disenfranchised groups contributed to the
explosion of the pandemic because it was not as quickly addressed as other
pandemics, including modern ones such as COVID-19. Today, HIV
can be well managed in developed nations so it doesn’t progress to AIDS, but
AIDS is still incredibly deadly in developing nations without access to
adequate health care and preventative measures.
4. Plague of Justinian:
Eastern Roman Empire (541-750)
Death
Toll: 30-50 million
The Plague of Justinian is the first known outbreak of the plague
that would later become the famous Black Death, as well as the Third Plague in
the late 19th century. The bacterium, Yersinia pestis, is thought to have
originated in Africa and then migrated to Europe through fleas on rats.
By the year
541, the plague was killing up to 10,000 people a day. There were so many
victims that citizens of Constantinople could not keep up with burying
them, so bodies were crammed into buildings or simply left in the
open.
While the
bulk of the deaths occurred between 541 and 542, this pandemic was stubborn,
and did not fade entirely until 750.
Until then, there were periodic outbreaks throughout the Mediterranean world.
3. Spanish Flu: Unknown
(1918-1920)
Death
Toll: 40-50 million
A number of deadly flu outbreaks have occurred over the years, but
the 1918 Spanish flu is among the worst in history. Despite the common name of
the pandemic, scientists are not entirely sure where the virus originated,
though they do know it was caused by an H1N1 virus (similar to swine flu) that
originated in birds.
It is
estimated that 500 million people,
or one-third of the global population at the time, were infected with the
virus. Like all flus, this virus was easily transmitted from person to
person, causing it to spread rapidly throughout the world. Another deadly
characteristic of this flu was that it had high mortality in a variety of age
groups, not just the very young and old we expect to have weaker immune systems.
While
scientists have synthesized the
1918 flu virus in the lab, they are still not certain exactly why this
particular flu was so deadly. It remains one of the great medical mysteries of
all time.
2. New World Smallpox:
Americas (1520 – 1600s)
Death
Toll: 56 million
The Columbian Exchange, or
the exchange of animals and plants between Europe and the Americas as a result
of the voyages of Christopher Columbus, led to one of the great world pandemics
of all time. Because native populations of South America had none of the
immunities to Eurasian diseases that Europeans had developed over the
centuries, they were highly susceptible to these diseases upon first contact.
Among the
worst of these diseases was smallpox, caused by the variola virus. The disease swept
through South and Central America, as well as the Caribbean, killing millions.
Smallpox remained a problematic disease for centuries, with the
last natural outbreak occurring in the United States in 1949. However, nowadays
people do not get smallpox. Smallpox remains the only disease that has been
successfully eradicated worldwide as a result of intense international
vaccination and isolation efforts between the 1960s and 1980s.
1. The Black Death:
Europe and Asia (1347-1351)
Death
Toll: 200 million
By far the
deadliest pandemic of all time, the Black Death radically shaped the course of
human history, plunging Europe into the Dark Ages. The bacterium that caused
the plague, Yersinia pestis, is thought to have originated in
Asia more than 2,000 years ago and eventually moved into Europe through trade
ships.
The bacteria moved quickly through rats and fleas feeding on the
rats. When infected rats died, leaving the fleas hungry, fleas switched to
feeding on human blood, spreading the plague they had picked up from the
rodents. Trade ships moving these rats around only perpetuated the spread
throughout Europe and Asia.
In addition
to its high death toll, what made the Black Death so remarkable was the speed
with which it occurred. For example, at the start of the pandemic, 60 percent
of Florence’s population died within a
few months.
Today, bubonic plague is much rarer. However, well after the Black
Death, the plague continued to cause periodic pandemics throughout Europe and
Asia, including the Great Plague of Milan.
Final Thoughts
COVID-19 has us all thinking about public health, but looking
back, there have been many pandemics before, and we persist in spite of them.
While the devastation is real, eventually humans manage to press on. It’s
easy to forget that after the Dark Ages following the Black Death, Europe
entered its Renaissance, one of the great periods of creativity and ingenuity
in human history.
For now, we are social distancing, isolating, and worrying about
ourselves, our families, and communities. But it certainly won’t last forever.
History tells us we don’t get to choose what happens to us or what period of
history we are born in. All we can do is prepare and persist.
Dan
Carpenter is a proponent of preparedness, homesteads, and modern self
sufficiency. He is the founder and principal of Homestead Launch and SCP Survival.
Contact him at Dan@HomesteadLaunch.com.