COVID-19 compared to previous pandemics – the numbers at a glance
The number of corona cases worldwide continues to increase rapidly. As a result, people's fear of being infected with the COVID-19 is growing. This is normal, of course, especially since the corona crisis has turned our everyday lives upside down. But compared to other pandemics in our history, everything doesn't look that bad. There was, for example, the Spanish flu of 1918, which swept across the world in three waves and killed 5 percent of the world's population. More than the First World War itself. Then came other threatening viruses that appeared out of nowhere: Severe Acute Respiratory Syndrome (SARS), swine flu (H1N1) 2009 (influenza pandemic A) and Ebola. In the end, we got them all under control.
However, the impact of any disease largely depends on other circumstances – when we get infected, how contagious and deadly it is, how hygienic people are, and how quickly a vaccine or remedy will be available. The death rate isn't the only factor that decides how devastating and deadly a pandemic will be, Dr. Christine Kreuder Johnson, professor of epidemiology and ecosystem health at UC Davis and researcher in the USAID (U.S. Agency for International Development) PREDICT project on emerging pandemic threats.
Here we will take a look at how COVID-19 has developed compared to other major pandemics.
The Spanish flu of 1918
The 1918 influenza epidemic A was the deadliest flu epidemic we know and infected approximately a third of the world's population. “The pandemic flu strain from 1918 was new and novel for most people under 40 or 50, but the death rate was really high there – it's different from the usual flu,” said Dr. Mark Schleiss, a pediatric infectious disease specialist at the University of Minnesota.
At that time, the scientists did not yet know that viruses cause diseases. We had no vaccine or antiviral to prevent or treat influenza, or antibiotics to treat secondary bacterial infections. Life was also very different at the time. For one thing, we were in the middle of the war, and soldiers carried the virus with them all over the world. People also lived in very bad conditions, in crowded quarters, apartments and houses and had extremely poor hygiene. This contributed greatly to the spread of the disease.
Symptoms: Fever, nausea, pain, diarrhea
First proof: March 1918
Global cases: 500 million
Worldwide deaths: over 50 million (675,000 in the U.S., 544,000 in Germany); the mortality rate was about 2 percent
transmission: Spread through droplet infection
Most affected groups: Adults aged 20 to 40 years
Treatments available: no; There were no antibiotics or antiviral drugs yet
Available vaccines: no
End of the pandemic: Summer 1919; mainly due to deaths and a high level of immunity
Covid-19 versus normal flu
The flu strikes every year, but no two seasons are exactly the same. As the tribes mutate each year, it can be difficult to predict what will happen. Unlike COVID-19, we have effective vaccines and antiviral medications that can help prevent the flu and reduce its severity.
In addition, many people have residual immunity to the flu from the past because our body has experienced the disease before. We have no immunity to COVID-19. Corona also appears to be more infectious and deadly than normal flu, but that could change if we learn more about the new virus.
Symptoms: Fever, cough, sore throat, fatigue
Global cases annually: 9 percent of the population or around 1 billion infections (up to 5 million of them are serious)
Annual deaths worldwide: between 291,000 and 646,000. Mortality rate around 0.1 percent
Transmission: spreads through droplet infection; each diagnosed person passes them on to 1.3 people
Most affected groups: older adults and people with weakened immune systems
Treatment available: antiviral drugs (Tamiflu, Relenza, Rapivab, Xofluza) to reduce the duration and severity of the flu
Available vaccines: There are many vaccine options available that offer immunity to multiple strains of flu
2002-2004 Severe Acute Respiratory Syndrome (SARS)
SARS is another type of corona virus that came from China and spread quickly through droplet infection. Although the death rate from SARS was very high, COVID-19 has already caused more deaths.
Johnson said contact tracking – or monitoring people who were in close contact with the sufferer – was really effective in SARS, mainly because the symptoms were severe and therefore easier to identify and contain.
Schleiss also said that the human organism was resistant enough to the SARS virus, which eventually led to its end. He added that this does not appear to be the case with COVID-19, which can spread and thrive in the human body.
Although the SARS mortality rate was higher, overall COVID-19 has resulted in “more deaths, more economic and social impact than we had with SARS,” said Johnson.
Symptoms: Fever, respiratory problems, cough, feeling unwell
First proof: November 2002 in Guangdong Province, China
Global cases: 8,098 cases in 29 countries; 4 cases in Germany
Global deaths: 774; 15 percent mortality rate; no deaths in Germany
Transmission: Spread through droplet infection and infected surfaces
Most affected groups: Patients aged 60 and over had a 55 percent higher mortality rate
treatment: no treatment or cure, but antiviral drugs and steroids worked in some people.
vaccine: A vaccine was ready by the time the pandemic ended
End of the pandemic: July 2003
Swine flu 2009 (H1N1)
In 2009, a new type of flu emerged – an H1N1 strain – and people panicked because we didn't have a vaccine and the new strain quickly spread. As with COVID-19, we had no immunity to the new virus at the beginning of the outbreak. We had antiviral medication to make recovery easier, and in late 2009 a vaccine was developed that, in combination with a higher level of immunity, would offer protection in future flu seasons. However, there were over 12,000 fatalities in the United States. The number of deaths in Germany was 253.
Symptoms: Fever, chills, cough, body pain
First proof: January 2009 in Mexico; April 2009 in the USA
Global cases: about 24 percent of the world's population; 60.8 million cases in the United States, 226,000 cases in Germany
Global deaths: over 284,000; 12,469 in the United States; the death rate was 0.02 percent
Most affected groups: Children had the highest rates; 47 percent of children between 5 and 19 years of age developed symptoms compared to 11 percent of people aged 65 and over
Treatment available: antivirals (oseltamivir and zanamivir); most people recovered without complications
Vaccine Available: Research on an H1N1 vaccine started in April 2009, and a vaccine was already available in December 2009.
End of the pandemic: August 2010
Ebola from 2014 to 2016
Ebola was extremely deadly and killed up to 50 percent of those affected. However, since the virus spread primarily through body fluids such as sweat and blood in the final stages of the disease, it was not as contagious as COVID-19. And because the symptoms were so severe, the health authorities were able to quickly identify and isolate those who had come into contact with those affected.
“There are no relatively healthy people with the (Ebola) virus walking around and passing the virus on – taking the bus, going shopping, going to work – as we are doing now,” said Johnson.
Symptoms: Fever, pain, weakness, diarrhea, vomiting
First proof: first patient confirmed in Guinea in December 2013; first outbreak in March 2014
Global cases: 28,652 cases in 10 countries
Global deaths: 11,325 deaths; the mortality rate was around 50 percent
transmission: Spread through body fluids (blood, sweat, feces) and close contact; most contagious towards the end of the illness
Most affected groups: 20 percent of all cases in children
Treatment available: no; Supportive care was offered, including intravenous fluids and oral rehydration.
Available vaccines: no
End of the outbreak: March 2016
The new corona virus (COVID-19)
First indications show that COVID-19 is more contagious than the flu. And some early reports say that COVID-19 could have a higher mortality rate than seasonal flu. But statistics are not complete because many people with COVID-19 have mild symptoms or are asymptomatic and therefore do not see a doctor and are largely ignored. The corona situation is developing rapidly and the numbers and estimates are likely to change.
Symptoms: Cough, fever, shortness of breath; 80 percent of the cases are easy
First proof: December 2019 in Wuhan, China
Previous global cases: Over 491,566 cases. With this card you can track all numbers in real time.
Previous global deaths: Over 22,169; the worldwide mortality rate is estimated at 3.4 percent. But in certain areas, the mortality rate is only 0.4 percent.
transmission: spreads through droplet infection along with feces and other body fluids; each person passes them on to 2.2 others.
Most affected groups: Adults over 65 with underlying health conditions; Children seem to be spared and suffer from milder symptoms (in China children only make up 2.4 percent of cases)
Treatments available: no; Supportive care is offered, pain relievers and antipyretics can relieve symptoms, and antibiotics can help treat secondary bacterial pneumonia. Antivirals used in other viruses are used to aid recovery.
Available vaccines: none yet; a vaccine will likely be ready in about a year
So when will the situation with COVID-19 normalize?
According to Schleiss, herd immunity together with an effective vaccine is needed to slow down the spread of viruses. Herd immunity for COVID-19 only arises when around 60 percent of the population is immune. In order to achieve herd immunity, on average each infected person has to infect less than another person. As soon as the infection rate is less than one, a population has reached herd immunity.
“We really need a Corona vaccine,” he said, adding that it could take a year or two because the Food and Drug Administration needs to demonstrate that a vaccine is safe – at best.
We have a lot more to learn: the prevalence of infection (percentage of people infected within a given population), how to get infected with the virus, and all of the different modes of transmission. Until then, we need to practice social distancing to slow the spread of the virus, Johnson says.
We will need to work together to limit mutual exposure – especially in older adults and people with an underlying medical condition who are at greatest risk of developing severe symptoms.
We don't have to panic. Remember, the vast majority of COVID-19 cases are mild. But we need to take measures to slow the spread and protect those who are most at risk.
COVID-19, the disease caused by the new coronavirus, is not the first threatening pandemic to be rampant around the world – and will not be the last.
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