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Pandemics are worldwide outbreaks of disease that greatly effect a population socially, economically and politically (Gallivan et al. 2017). They are different to epidemics in the way that pandemics impact globally, while epidemics are often contained inside one community.
The most devasting pandemic is the influenza virus. Also known as the flu, this virus is constantly spreading throughout the world, but as each person grows more immune to it, the effects of the flu are generally mild and non-life threatening.
However, every 20-40 years the influenza virus mutates and can cause deadlier infections in humans. This is called antigenic shift, and one way of this occurring is when a virus exclusive to animals is now able to also infect humans. When this occurs, most people have no immunity to the mutated influenza and become sick very easily.
History
Pandemics can spread many ways through touch, air or bodily fluids. During the stone age, humans lived in small communities and moved around often, so contracting and passing on viruses was difficult. As humanity modernised, the spread of bacteria and viruses was much easier. Transportation such as trains, boats and planes made transferring a disease from one community to another simple. This is only becoming easier as new technologies occur and transportation is upgraded, turning epidemics into pandemics.
The most famous example of a pandemic was the Black Death, occurring in Eurasia with its peak during 1347-1351. By 1400, 34 million Europeans had died. This plague was caused by the bacillus Yersina pestis and infected people by travelling through the air, or from the bite of an infected flea or rat. Ships harboured many rats and fleas, and so the plague was spread rapidly through transportation.
In more recent times, the 2009 influenza pandemic (known as Swine Flu) greatly impacted the world. Caused by the H1N1 virus, it has been estimated to of killed between 123,000 to 203,000 people worldwide (Flemming et al. 2013), 10 times the amount of the World Health Organisations (WHO) confirmed deaths. The H1N1 virus isnt new, it also caused another massive pandemic; The Spanish Flu (1918-1920). This hugely devastating pandemic caused 50 million deaths worldwide, with 15,000 deaths in Australia alone.
Preparedness
It wasnt until recently that countries began creating pandemic preparedness plans to outline how theyd cope with a new outbreak. The first unofficial plan was from Hong Kong in 1997, after an avian influenza outbreak (Itzwerth et al. 2017 p. 112).
Generally, countries plans outline how theyd deal with the high mortality rate and infection, as well as how theyd ensure essential services (such as water, power, transport and communication) were kept up and running. The WHO checklist for influenza pandemic preparedness planning outlines 7 main points for countries to include in their own preparedness plans. One of these points is Implementation, testing and revision of the national plan (WHO 2005), which suggests every country must kept up to date with their plans.
The Australian National Action Plan for Human Influenza Pandemic outlines the ways in which Australia would deal with another pandemic, particularly an influenza. The plan outlines the responsibilities, authorities and mechanisms to prevent and manage a human influenza pandemic and its consequences in Australia (Australian Government 2009). It focuses on prevention and preparedness, response, and recovery. It not only describes how Australia would cope with a pandemic, but also how Australia would prevent one from ever happening in the first place.
In most preparedness plans from differing countries, the level of preparation is designed for worst case scenarios, ignited by fears of what happened with the Spanish flu. This was true in Australia and was what occurred when swine flu arrived into the country. However, after observing the impact on Australian citizens, the plan was modified. It was found that Aboriginal and Torres Strait Islander people, pregnant people, and those with another serious medical condition had the highest rates of morbidity for swine flu. Instead of focusing on limiting the spread of disease across the whole population, attention was drawn to specific groups of people who were vulnerable to the pandemic.
Response
When pandemics impact Australia, there is a set outline for how to deal and manage public health. The framework set out by the Australian Health Management Plan for Pandemic Influenza [AHMPPI] is utilised. There are six identified pandemic response phases: 1) alert; 2) delay; 3) contain; 4) sustain; 5) control; 6) recover.
The Delay phase has a focus on boarder control and identification of the virus. It aims to slow down the transmission rate to Australia. After this, the Contain phase commences, intending to stop the transmission within communities. During the 2009 swine flu pandemic, a new Protect phase was implemented with the goal of assisting and defending those who were of high risk to the virus.
Public crisis management is also a huge part of pandemic plans. During the swine flu pandemic, the media influence and coverage created fear and anxiety in the public. Many people went to their general practitioners and the emergency ward at hospitals due to the panic of being infected. Most of these people were not unwell or didnt have the H1N1 virus. This caused extra strain on the health care system, which was already trying to help many infected people. However, toward the end of the pandemic, the media portrayed swine flu as not such a serious concern. This caused the public to become too relaxed with the virus, and thus forgo prevention methods such as wearing masks, washing hands, and regularly using hand sanitiser.
Opinions
In todays climate there are many differing opinions on pandemics and diseases, namely relating to vaccines. Humanities pharmaceutical advancement allowed many lethal diseases to become preventable by ways of vaccination. Because of this, diseases like polio, measles and rubella are very rare nowadays.
However, scientists are finding more and more people are against vaccination. In a 2014 study by WHOs Strategic Advisory Group of Experts (SAGE), they found the main reasons for vaccine uncertainty was safety concerns, religious beliefs, doubt in health authorities, and a disbelief of any benefit from vaccines (WHO 2017).
Anthropologist Heidi Larson predicts that the next major outbreak [of a pandemic] &will not be due to a lack of preventive technologies. Instead, emotional contagion&could erode trust in vaccines so much as to render them moot (Larson, H 2018). She continues on to say The deluge of conflicting information, misinformation and manipulated information on social media should be recognized as a global public-health threat (Larson, H 2018).
Conclusion
Pandemics are a devasting display of the power of viruses and bacteria, showcasing nature at its most poisonous. The science of these outbreaks is incredibly interesting to study and learn from.
Throughout humanity, pandemics and epidemics have caused a great impact, leaving our society with deep scars. Significant advances have been made in pandemic reduction, due to humanities advancements in pharmaceutical products and hygiene.
Humans have come together to formulate plans and strategies to cope with new pandemics, learning from the past and studying to prepare for the future. However, there is still a great deal unknown about pandemics, as future matters will most likely not mimic those of the past.
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