Coronavirus: You Need to Know This is an Age-Old Struggle

Less than a month ago, no one in London had heard of Coronavirus, but now the mysterious virus from China is dominating headlines.

The city of Wuhan, China, where the Coronavirus first started, has gone into full lockdown in an attempt by the Chinese government to prevent the disease from spreading. Public transport has been suspended, lockouts imposed and foreign nationals removed.

News of this new global pandemic is dominating the headlines and Londoners are rightly worried about an outbreak in the city. And questions arise:

What will the authorities do if it happened?

Do authorities know what is best to do?

The good news is that we have experienced much worse throughout history.

In the area of infectious diseases, a pandemic is a worst-case scenario. When an epidemic spreads beyond a country's borders, that's when the condition officially develops a pandemic.

Infectious diseases existed through humankind's hunter-gatherer times, but the creation of communities made epidemics possible. Malaria, tuberculosis, leprosy, influenza, smallpox and others first emerged during this period.

The more civilised humans advanced, building cities and trade routes to connect with other cities and going to war with them, the more likely pandemics became.

Many significant diseases have struck London through its history.

Many people know about the Black Death of 1348 and the Great Plague of 1665: both horrifying outbreaks of a plague which exterminated thousands of Londoners. But, fewer people know that these notable outbreaks are only two of almost 40 that London experienced between 1348 and 1665. A significant outbreak of the plague hit approximately every 20–30 years, killing 20% of London's population per time. There were fewer outbreaks in-between the major ones and sometimes it continued for several years in a less severe form.

There is still dispute about what these 'plagues' actually were. From the 1300s to the late 1600s, the plague that struck London was bubonic plague. Bubonic plague is a disease of rodents, principally black rats. It is passed between them by fleas bites. When a black rat dies from the disease, its fleas must find a different host to live on. If the new host is a person, the infection can spread to humans too. When it happens, 60–80% of those with the disease die, most within a week. Plague can spread quickly within a household.

The French doctor Alexandre Yersin detected the bacterium that originates bubonic plague in 1894. Only in 1908 specialists understood that rat fleas spread the plague. The disease can take many forms, but the most common symptoms are headache, fever, vomiting, swellings on the neck, armpits and groin (buboes), bruises, coughing blood.

The Black Death struck London in 1348.

In 1347 news arrived in England of a horrifying and deadly disease that was spreading from Asia through North Africa and Europe. No one knew how to stop it. In 18 months, it killed half of all Londoners, around 40,000 people. In London, people had to dig mass graves (large trenches for a large number of bodies).

The Black Death, by 1350, had killed millions of people, perhaps half the population of the discovered world.

After the Black Death, the plague returned to London many times until its last main outbreak in 1665. The virus usually spread from Asia or the Middle East across Europe to England. People were terrified of the plague because its victims died so quickly, and very few recovered. The worst period of plague was in 1563 when 24% (nearly a quarter) of London's population died.

In London the first regulations to stop the plague were introduced in 1518.

For 40 days a bale of straw had to be hung on a pole outside infected houses. Those from contaminated homes had to carry a white stick if venturing out to warn other people to stay away. Over the years, more laws were gradually added, such as placing a cross at the door of plague-ridden homes, burying the dead only at night, and ringing a bell for 45 minutes for every burial. The sound of bells ringing during burials was to remind people to follow the prevention rules.

The last major plague in England was The Great Plague of 1665.

The outbreak started in London in February. In seven months, 100,000 Londoners (20% or one-fifth of the population) died. Many fled the capital. Victims were closed in their houses, and a red cross with the words 'Lord have mercy upon us' was painted on the door. Theatres and other public entertainments were banned to stop the spreading. Every week, all London parishes recorded the number of those who had perished. Numbers from all the parishes were added up and published in lists called mortality bills.

From September of that year, the number of people dying started to drop. By December, those who had fled the epidemic began to return to London, and life slowly went back to normal. People thought that animals might spread the virus. Around 200,000 cats and 40,000 dogs were slaughtered.

The Great Plague effect on Londoners' lives

People's lives and businesses suffered terribly because many people were barricaded in their homes. Many were forced to beg or steal because the plague had such an adverse impact on trade.

Between one and three people living in the city died in most infected homes. In extreme cases, whole families died. People were terrified; some threw infected servants in the streets; others denied help to sick friends and family.

In his diary, Samuel Pepys wrote 'the plague [is] making us cruel as dogs to one another.'

Once the plague was over, the London population recovered very quickly. New people came to the city of London to take over jobs, those who had died, left vacant. There was a sudden rise in marriages and births. The last reported case was in 1679.

The 1918 deadly influenza was the first of two pandemics of our time.

Several similar viruses cause influenza, but one strain (type A) is linked to deadly pandemics. The 1918-19 epidemic was caused by a type A virus now known as H1N1.

Because of wartime censorship in Europe and North America, the press couldn't report outbreaks. Only in neutral Spain, the press could speak freely, and the disease took its nickname from it. Despite being called Spanish flu, the first cases were recorded in the United States during the last few months of World War I.

The Spanish flu killed its victims with speed never seen before. In the United States, there were many stories of people waking up ill and dying on the way to work. The symptoms were severe: Victims would develop a fever and sudden shortness of breath. Lack of oxygen made their faces appear tinged with blue. Haemorrhages filled their lungs with blood and caused terrible vomiting and nosebleeds, with victims suffocating in their own fluids. Unlike many strains of influenza before this, Spanish flu hit not only the youngest and the elderly but also healthy adults between the ages of 20 and 40.

The main factor in the virus's spread was the world conflict, then in its last phase. Epidemiologists still argue the exact origins of the virus, but they agree that it was the result of a genetic mutation that took place, probably, in China. But one thing is clear: the new strain went global thanks to the large and rapid movement of troops round the world.

As the crisis reached its peak, the medical services started to be overwhelmed. Morticians and gravediggers struggled, and individual funerals became impossible. Many of those who died ended up in mass graves. The end of 1918 brought a break in the spread of the disease, and January 1919 saw the start of the third and final phase. By then, the virus was a much-diminished force.

Australia, which had swiftly enacted quarantine restrictions, managed to avoid the worst of the influenza until the beginning of 1919 when the flu finally arrived and took the lives of many thousand Australians. The pandemic left virtually no part of the world untouched.

Accurate data in the number of deaths is difficult, but global mortality figures are estimated between 10 and 20 per cent of those who got infected.

The second was the Swine flu in 2009.

In 2009, a new influenza A (H1N1) virus appeared. It was first detected in the United States and quickly spread across the country and the world. This new H1N1 virus carried a unique combination of influenza genes never before seen in animals or people.

Overall, the outbreak was not as severe as initially predicted, mainly because many older people were immune to it. Most cases in the UK were mild, although there were some severe cases.

Underestimating the new Coronavirus is dangerous.

Medicines and increased public hygiene, together with international organisations such as the World Health Organization and national bodies for Disease Control and Prevention, put the global community in a much better condition to meet the challenges of new outbreaks. However, scientists understand a deadly mutation could occur at any point, and a century on from the worst of all pandemics, its consequences on a crowded, interconnected and globalised world would be devastating.

In the new coronavirus outbreak that started in China and has since spread all over the world, experts say both under- and overestimation are at play.

Until sufficient information is available to answer questions about severity of the virus, drawing conclusions and underestimating this virus is dangerous.