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  • If you've spent any time at all on the internet in the last few months, you probably feel

  • very well-educated about how outbreaks start, how diseases spread, and even how to protect

  • yourself during a pandemic.

  • But what about how pandemics end?

  • How do we know when we're in the clear and it's safe to go back to life as normal?

  • Or, are we destined to spend the rest of our lives in quarantine?

  • To find out, let's take a look back in time at how some past pandemics have ended and

  • see if there's any hope of easing up on social distancing before summer is over.

  • Before we can talk about how pandemics end, we first have to understand what theend

  • of a pandemic actually means.

  • How do we know when it's over, and who exactly is it over for?

  • What specific criteria or milestones are we aiming for before we can declare a pandemic

  • over?

  • And who actually decides that the pandemic has ended?

  • According to medical historians, pandemics actually have two types of ending - a medical

  • ending and a social ending.

  • A medical ending happens where there are no people left to get sick.

  • That doesn't necessarily mean that everyone is dead - although that's certainly one

  • way a pandemic can end.

  • An outbreak can be ended medically when the infection can no longer spread, either because

  • a significant percentage of people are immune or have been vaccinated, or even because of

  • strict social distancing measures making it impossible for the infection to find new victims.

  • The dreaded Bubonic Plague is the perfect example of a pandemic ending medically because

  • the disease ran out of victims.

  • There have been 3 major outbreaks of the Plague in history.

  • The first one, called The Plague of Justinian, wiped out nearly half the world's population

  • in the 6th century.

  • It only ended when there was no one left to die - the death rate was so high, and some

  • experts theorize that the survivors must have been largely immune, so eventually the outbreak

  • ended when it ran out of new victims.

  • The second and most famous outbreak was started in China in 1331, killing half the population

  • there before spreading to Europe, North Africa and the Middle East.

  • The disease killed 200,000,000 people in just 4 years, wiping out up to one third of the

  • European population.

  • Fun fact - we have this particular pandemic to thank for the whole idea ofquarantine”.

  • During the medieval outbreak people were still clueless about how diseases really spread,

  • but they were starting to catch on to the idea that being in close proximity to an infected

  • person was a great way to get sick.

  • The city of Venice started making newly-arrived sailors stay on their ships for a period of

  • time after arriving in port before they could enter the city.

  • At first, it was 30 days, but it was eventually increased to 40 days, a period of time called

  • a “quarantino”.

  • During later flare-ups of the disease in the 1500s, England imposed the first quarantine

  • laws - any home with an infected person in it was required to mark their house with a

  • white pole, and carry the pole with them in public so that other people could avoid them.

  • England took things a step further during another flare up in 1665 and banned all public

  • entertainment and gatherings.

  • That sounds awfully familiar...

  • On top of these new quarantine measures, the medieval Plague outbreak also planted the

  • early seeds of social distancing.

  • As the plague spread and the death toll continued to climb, many people took shelter in their

  • homes and hid out from the disease.

  • Of course, we also saw the first glimpses of the difficulties of getting people to stay

  • at home - as the Plague ravaged Italy, many were determined to live it up before the end.

  • Defiant revelers took to the streets, drinking, dancing and singing even as the bodies piled

  • up around them.

  • The last major outbreak of the Plague started in China in 1855 and once again spread across

  • the world.

  • After it killed 12,000,000 people in India, entire neighbourhoods were burned to the ground

  • in a desperate effort to stop the disease - even though no one knew at the time if that

  • would even help.

  • Experts aren't sure exactly why each outbreak ended - perhaps the Plague ran out of victims,

  • or the colder weather weakened it, or it could have mutated and become less deadly.

  • Each of these outbreaks eventually did end, but the disease wasn't gone.

  • In fact, it's still around today.

  • Plague outbreaks are endemic among prairie dogs in the southwestern US, and from time

  • to time it even makes its way to humans.

  • Dr. Frank Snowden, a Yale historian, has a friend who contracted the plague in the US

  • a few years ago from a dog that had been infected with Plague-ridden fleas.

  • Remember earlier when we said that there are two ways that a pandemic can end?

  • We just talked about the many ways that a pandemic can medically end, but pandemics

  • can also have a social ending.

  • According to Dr. Jeremy Green, a historian of medicine at Johns Hopkins, “When people

  • ask, 'When will this end?', they are asking about the social ending.”

  • A social end to the pandemic doesn't mean the disease is gone - it just means that people

  • have learned to live with it.

  • A pandemic can end socially when people stop fearing the disease, become sick of quarantine

  • restrictions, and decide they are willing to risk getting the disease to go on with

  • daily life.

  • The infamous Spanish Flu outbreak of 1918 is a great example of a social end to a pandemic.

  • The aggressive and deadly strain of the flu virus that tore across the globe and killed

  • millions, prompted one doctor to say that itdemonstrated the inferiority of human

  • inventions in the destruction of human life” - and that's saying a lot, considering the

  • world was in the midst of the bloody trench battles of World War 1 at the time of the

  • outbreak.

  • The virus eventually mutated into a less severe form of the flu, and medically the pandemic

  • slowly tapered off, even though the disease definitely hadn't gone away.

  • But the pandemic ended socially even while the disease continued to wreak havoc.

  • By the time World War 1 was over, people everywhere were sick of death and tragedy, and they were

  • ready for a fresh start.

  • After the horrors of war, people were willing to risk disease to return tonormal

  • life as soon as possible.

  • The fact is, it's not an either-or situation.

  • Pandemics don't end medically or socially - most end socially before they end medically,

  • and a true medical ending is actually nearly impossible.

  • In most cases, we learn to live with the disease and manage its spread to prevent widespread

  • outbreaks, but it's rare that a disease is truly medically eradicated.

  • Smallpox is one of the very few exceptions.

  • Smallpox had plagued the world for more than 3,000 years, and 30% of those who contracted

  • the dreadful illness died a painful death.

  • In 1633, shortly after the first European explorers arrived in the New World, a Smallpox

  • epidemic devastated the native populations.

  • The disease had arrived with the explorers, and since none of the native people had any

  • kind of immunity against the disease, it spread like wildfire, killing up to 90-95% of the

  • native population in some of the hardest hit areas.

  • There are a few different reasons why our efforts to fight Smallpox were so successful.

  • The most important development was the discovery of a successful, lifelong vaccine.

  • The disease's unusual symptoms - a rash that turns into pus-filled spots which crust

  • and then fall off - also made it easy to identify the illness, and infected people could be

  • quarantined quickly, limiting the spread of the disease.

  • Another thing that helped defeat Smallpox was the fact that it can't be transmitted

  • by animals, meaning that once the disease was eliminated in humans, we no longer had

  • to worry about it continuing to circulate and mutate in animals and reemerging as a

  • threat in the future.

  • All of these factors combined to make Smallpox one of the few diseases that we can now confidently

  • say has been medically eradicated.

  • The last person to contract Smallpox naturally was a man named Ali Maow Maalin, a hospital

  • cook in Somalia in 1977.

  • Ali thankfully recovered from the Smallpox infection and went on to live a long life.

  • He died in 2013 of Malaria, another extremely problematic infectious disease.

  • The social aspect of a pandemic can be just as dangerous as the disease itself - sometimes

  • moreso!

  • Back during the Ebola outbreak in West Africa, an epidemic of fear about the disease spread

  • faster than the disease itself.

  • Dr. Susan Murray, who worked in a hospital in Ireland during the outbreak, recalls the

  • atmosphere of fear and panic, even as the outbreak was tapering off.

  • She remembers some health professionals refusing to treat potentially infected patients, and

  • people beginning to look at foreigners with suspicion.

  • Dr. Murray said: “If we are not prepared to fight fear and ignorance as actively and

  • as thoughtfully as we fight any other virus, it is possible that fear can do terrible hurt

  • to vulnerable people, even in places that never see a single case of infection during

  • an outbreak.”

  • The fear generated by each new outbreak also amplifies the fear of the next one.

  • Since a next outbreak is inevitable, it's important that we learn to deal with the fear

  • that surrounds a pandemic to minimize the social harms caused by outbreaks.

  • Pandemics are one of the biggest threats we humans face in modern times.

  • EndingPandemics.org has projected that the next big pandemic could cost upwards of $60

  • billion and could kill 30 million people in just 6 months.

  • They explain that because the number of new infectious diseases is rising, and people

  • are travelling further and faster than ever before, the risk of a major global pandemic

  • continues to climb.

  • This might sound daunting, but don't worry - EndingPandemics.org has a plan for how to

  • minimize the impact of the next outbreak.

  • Because most outbreaks in humans start in animals, they believe that better monitoring

  • of disease outbreaks in animal populations, as well as better communication and a faster

  • response to new infections, will help prevent future outbreaks and give countries time to

  • prepare for the next one.

  • So, that brings us to the million dollar question - when and how will this particular pandemic

  • end?

  • Well, it won't medically end at least until we have a vaccine - and then it will take

  • time to vaccinate the whole world and be able to say that the pandemic is medically over.

  • Even then, we'll still need to be watching out for new strains of the virus.

  • Socially, though, it looks like this pandemic could end quite soon, regardless of whether

  • it's medically safe or not.

  • People are getting frustrated with social distancing and quarantine measures, and the

  • economic and social impacts of months of shut down are starting to scare people more than

  • the disease itself.

  • The end of the pandemic won't be a sudden victory.

  • Even if a vaccine is developed, it will take time to get the whole world vaccinated.

  • Before that happens, the pandemic will likely start to end socially, as communities and

  • countries begin to ease up on quarantine measures.

  • Another factor that makes it tricky to pinpoint the end of a pandemic is the fact that the

  • outbreak affects different areas differently.

  • Even when an outbreak spreads all around the world, some areas might experience intense

  • outbreaks and high death rates, like what we saw in New York, while other areas might

  • not see any cases at all.

  • At some point, the World Health Organization will declare the global pandemic emergency

  • to be over, but individual countries might have already beaten them to the punch, while

  • some others might still be battling the outbreak.

  • Whatever happens, we're going to need to learn to live with the disease and manage

  • its spread while we wait for a medical ending to the pandemic.

  • And, since the next pandemic might be just around the corner, we'd be wise to keep

  • our quarantine and social distancing skills sharp for the future.

  • If you liked this video, be sure and check out our other videos, like this one called

  • Coronavirus COVID-19 vs. H1N1 Swine Flu - How Do They Compare?”.

  • Or, maybe you'll like this other one instead.

If you've spent any time at all on the internet in the last few months, you probably feel

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How Pandemics End

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    Summer posted on 2020/08/14
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