How Does Coronavirus Stack Up Compared to Other Pandemics?
Learn the similarities and differences between COVID-19 and past epidemics and pandemics.
In the fall of 2019, the idea that the global economy would essentially grind to a halt due to a highly contagious virus would have seemed like something out of a science-fiction movie rather than real life. But as unprecedented as all this seems—and, in many ways, is—it is far from the only deadly disease to rip through the world in our lifetimes. It's not even the only epidemic of the past decade, and at this point, it's far from the deadliest the world has ever seen. Understanding how public health crises of the past impacted the world and the toll they took helps us put the current surreal moment in perspective. Here are nine other pandemics and epidemics that the world has experienced, and how coronavirus looks compared to these precedents. And if you're looking to stay healthy, discover 7 Subtle Ways You Could Get Coronavirus Without Realizing It.
The Zika virus epidemic: 2015-2016
The most recent virus epidemic is very different from the influenza and influenza-like outbreaks (including COVID-19) that we've seen in decades past. A mosquito-borne infection that can also be sexually transmitted, Zika causes mild illness in most people but presents a specific danger because it affects pregnancies and causes major birth defects.
While Zika still persists, its primary spread was across Latin America and the Caribbean from 2015 to 2016. "At its peak in the United States in 2016, there were 5,000 diagnosed persons; among pregnant women, about 10 percent had birth defects," explains Michael Stein, MD, chair of Health Law, Policy, and Management at the School of Public Health at Boston University.
He points out how different the focus of discussions around the illness and its victims was, since it was afflicting mainly women and their children. It also created some controversial issues related to reproductive health care.
"State legislature passed laws that prevented women from having abortions for major fetal malformations," Stein says. "But while Zika made us aware of the particular risks of pregnancy, COVID is disproportionately affecting the disadvantaged, the chronically ill, the elderly, and the poor, and making us aware of the societal conditions which make some Americans far more vulnerable to poor outcomes."
The West African Ebola epidemic: 2014-2016
Ebola spreads through contact via broken skin or mucous membranes in the eyes, nose, or mouth.
While 11 people were treated for Ebola in the United States and 1 person died during the most recent epidemic, the virus took a much greater toll on the West African region, with 28,600 infected and 11,325 deaths, according to the Centers for Disease Control and Prevention (CDC), making it deadlier but less widespread than COVID-19. While efforts continue to find a vaccine for Ebola, there is currently no cure.
The H1N1 swine flu pandemic: 2009-2010
While the origins of COVID-19 are still being debated, most experts believe it was transmitted from an animal (most likely a bat) to a human. Swine flu, on the other hand, is believed to have begun in pig herds where two or more influenza viruses evolved into a distinct new virus. According to the CDC, "The mixing of influenza genes in pigs can result in the emergence of viruses with pandemic potential in humans. Improved surveillance of influenza in pigs and other animals may help to detect the emergence of influenza viruses with the potential to cause illness and spread among people, possibly resulting in a pandemic."
The H1N1 pandemic led to 1.4 billion infections across the globe, and anywhere from 151,000 to almost 600,000 deaths, according to the CDC. It had a relatively modest mortality rate of 0.02 percent, compared to the 2 percent or higher many experts give to COVID-19. In H1N1's case, it disproportionately impacted young people, with 80 percent of deaths occurring in those younger than 65 years old.
"Most think this is due to some older people having protective immunity from the older influenza variants," says Stein. "The available vaccine was not effective in preventing infections, and medications for flu had limited utility."
The World Health Organization declared the end of the virus in Aug. 2010, though it continues to circulate as a seasonal flu virus. And if you want to learn about the difference between COVID-19 and the flu, read our guide—Coronavirus vs. the Flu: Which Is Deadlier and Which Spreads Faster?
The AIDS pandemic: 1981-
The first case of COVID-19 is believed to have occurred on Nov. 17, 2019, and by Jan. 12, Chinese authorities had identified and shared the full genome sequences of the novel coronavirus. As a result, the virus spread for weeks before it was taken seriously. But compared to the global spread and response to AIDS, everything about COVID-19 has happened at breakneck speed.
Human Immunodeficiency Virus (HIV) is believed to have crossed from chimps to humans in the Democratic Republic of Congo around 1920, and sporadic cases were documented in the decades that followed. But it wasn't until 1981 that the first official reporting of what would later be known as Acquired Immunodeficiency Syndrome (AIDS) was reported in an article published by the CDC. In 1985, after more than 12,000 Americans had died from AIDS complications, President Ronald Reagan publicly said the word "AIDS."
About 32 million people would eventually die of HIV-related illnesses from the start of the pandemic to the end of 2018. Globally, 37.9 million people are now living with HIV, with the majority (especially in the U.S.) using treatments that allow them to live normal lives. People living with HIV who have an undetectable viral load cannot transmit the virus to others.
The H2N2 Asian flu pandemic: 1957-1958
This pandemic, which surfaced in East Asia before spreading throughout the globe, was caused by a virus originating from strains of avian and human influenza, identified as influenza A subtype H2N2. As with COVID-19, it spread throughout China before reaching the United States, with many infected individuals experiencing only minor symptoms. Unlike COVID-19, it particularly affected young children and pregnant women, in addition to the elderly.
It would eventually claim the lives of more than 1 million people—including 116,000 deaths within the U.S.—according to the CDC. Compared to COVID-19, it was less contagious, but also showed up in infected individuals much more quickly, allowing it to be identified rapidly.
"The reproductive number (average number of people infected by one person spreading the illness) for the Asian flu was between 1.4 and 1.6, while for COVID-19, it is up to 2.5," says Dimitar Marinov, MD, of the Medical University of Varna, Bulgaria, who is on a research team studying the COVID-19 outbreak. "COVID-19 can also stay undetected for much longer, as the incubation period is 5 days—up to 14—on average, while for the Asian flu it was just 24 hours."
The Spanish flu pandemic: 1918-1920
This influenza pandemic, the most severe in modern history, was caused by an H1N1 virus of avian origin, spread in part by soldiers returning home from World War I. It took a major toll on the world, infecting about 500 million people (one-third of the global population) and resulting in the deaths of at least 50 million people (675,00 of them in the U.S.), according to the CDC.
Unlike the COVID-19 virus, which has had a relatively mild effect on younger people, mortality from the Spanish flu was high in those younger than 5 years old, and those between 20 and 40 years old.
As with the novel coronavirus, the Spanish flu reached some of the most powerful people in the world, including Spain's King Alfonso XIII, as well as the healthcare workers charged with treating the flu's victims.
Similar to the COVID-19 lockdowns, the pandemic resulted in theaters, schools, and other gathering places to be shuttered, and citizens were required to wear masks. It eventually died out on its own, with infected populations either developing immunity or dying from the contagion. And to learn more about COVID-19, learn these 13 Coronavirus Facts You Don't Already Know.
The American polio epidemic: 1916
Just a couple years before the Spanish flu began its devastating path across the globe, the U.S. was battling a polio epidemic. Starting in New York City, some 27,000 cases of polio were recorded, including 6,000 deaths, according to the Smithsonian. Many of those who survived were left with permanent disabilities.
The disease would continue to torment the nation for decades. In 1946, a Time article read, "For many a parent who had lived through the nightmare fear of polio, there was some statistical encouragement: in 1916, 25 percent of polio's victims died. This year, thanks to early recognition of the disease and improved treatment (iron lungs, physical therapy, etc.) the death rate is down to 5 percent."
It was not until 1955 that a vaccine, developed by Jonas Salk, MD, finally became widely available.
The Russian Flu pandemic: 1889-1890
This influenza pandemic was first documented in May 1889 in three distant locations of Central Asia, northwestern Canada, and Greenland. But it rapidly spread to urban areas throughout the globe, particularly St. Petersburg, Russia (hence its moniker) and then major European cities.
Within a few months, it had arrived in the U.S. As with COVID-19, even as cases began to appear in major American cities, the response was slow, with many dismissing its severity. But as the death toll rose in early 1890, attitudes shifted.
It would eventually kill 1 million people worldwide, and just under 13,000 in the U.S. (more than 2,500 of those in New York City alone).
The Black Death: 1347-1351
The Black Death (also known as the bubonic plague) gives some perspective on just how bad a global health crisis can get. This pestilence ravaged Europe and Asia in the mid-14th century, killing as many as 125 million people globally. While that's a jaw-dropping number by any measure, it's especially astonishing considering that at the time, the global population was less than 500 million people. Europe, which lost as much as 60 percent of its population in the pandemic, is said to have taken 200 years before it had returned to its pre-plague population levels.
The plague was spread by fleas living on infected rats. Its devastation to public health was matched only by its impact on the economy, wiping out Europe's labor force and destroying countless businesses before things finally recovered in the late 1400s.