Pandemic Paranoia

Scientists, teachers, and researchers have differed for years over the exact definition of the term "pandemic". When does an epidemic become a pandemic? remains the unanswered question. But one thing is certain, the word describes the widespread occurrence of a disease, in excess of what might be expected normally in a geographical region. Cholera, bubonic plague, smallpox, and influenza have all been some of the most diabolical killers in human history. And outbreaks of these disasters across international borders have been well documented as being pandemic. Especially smallpox, which throughout its history has killed between three and five hundred million people in its global reoccurrence. The current outbreak of the Novel Coronavirus, also known as COVID-19, which is fast approaching pandemic proportions, is still being considered an epidemic, and is, therefore, not included in the following historic list: HIV/AIDS Pandemic (at its peak, 2005-2012) Death Toll: 36 million. - Cause: HIV/AIDS. Was first identified in the Democratic Republic of the Congo in 1976, HIV/AIDS has repeatedly proven itself to be a global pandemic, killing more than thirty-six million people since 1981. Currently, there are between thirty-one and thirty-five million people living with HIV, and the vast majority of these are in Sub-Saharan Africa, where five percent of the population is infected, or roughly twenty-one million people. But as awareness has grown, new treatments have been developed that make living with HIV far more manageable, and many of those infected go on to lead productive lives. Between 2005 and 2012 the annual global death rate for HIV/AIDS dropped from 2.2 to 1.6 million. Flu Pandemic (1968) Death Toll: 1 million - Cause: Influenza. A category 2 Flu pandemic, sometimes referred to as "Hong Kong Flu", the 1968 flu pandemic was caused by the H3N2 strain of the influenza A virus, a genetic offshoot of the H2N2 subtype. From the first reported case on July thirteenth, 1968 in Hong Kong, it took only seventeen days before outbreaks of the virus were reported in Singapore and Vietnam. And within three months it had spread to The Philippines, India, Australia, Europe, and North America. While the 1968 pandemic had a comparatively low mortality rate of 0.5 percent, it still resulted in the deaths of over a million people, including a half-million residents of Hong Kong alone. Approximately fifteen percent of its entire population at the time.

Asian Flu (1956-1958) Death Toll: 2 million - Cause: Influenza. Asian Flu was a pandemic outbreak of Influenza A of the H2N2 subtype, that originated in China in 1956, and lasted until 1958. In those two years, Asian Flu traveled from the Chinese Provine of Guizhou to Singapore, Hong Kong, and the United States. Estimates of the death toll from the Asian Flu vary depending on the source, but the World Health Organization (WHO), places the final toll at approximately two million, with sixty-nine thousand, eight hundred of those in the United States alone. Flu Pandemic (1918) Death Toll: 20-50 million - Cause: Influenza. Between 1918 and 1920 an unusually deadly outbreak of influenza tore across the world, infecting over a third of its population and causing the deaths of twenty to fifty million people. Of the five hundred million people infected, the mortality rate was estimated at between ten to twenty percent, with up to twenty-five million deaths in the first twenty-five weeks alone. What differentiated the 1918 flu pandemic from other influenza outbreaks was the victims. Whereas influenza had always previously only killed juveniles and/or the elderly; or already weakened patients, this one began striking down the hardy and healthy young adults, while leaving children and those with weakened immune systems alone. 6th Cholera Pandemic (1910-1911) Death Toll: 800,000+ Cause: Cholera. Like its five previous incarnations, the Sixth Cholera Pandemic originated in India, where it killed over 800,000 before spreading to the Middle East, North Africa, Eastern Europe, and Russia. The sixth Cholera Pandemic was also the source of the last American outbreak of Cholera, which occurred in that same period. American health authorities, having learned a lesson from the past, quickly isolated the infected, and in the end, only eleven deaths occurred in the U.S. And by 1923, Cholera cases had been dramatically reduced worldwide, although it still remained a constant in India. Flu Pandemic (1889-1890) Death Toll: 1 million - Cause: Influenza. Originally known as "Asiatic Flu", or "Russian Flu", as it was also called, this strain was thought to be an outbreak of the Influenza A virus, subtype H2N2, though recent discoveries have instead indicated the cause to be the Influenza A virus subtype H3N8. The first cases were observed in May 1889, in three separate and distant locations; Bukhara in Central Asia, aka Turkestan, Athabasca in Northwestern Canada, and in Greenland. Rapid population growth in the nineteenth century, especially in urban areas, only helped spread this flu, and before long the outbreak had spread across the globe. Though it was the first true pandemic in the era of bacteriology, and much was learned from it; in the end, it claimed the lives of over a million people.

Third Cholera Pandemic (1852-1860) Death Toll: 1 million - Cause: Cholera. Generally considered the most deadly of the seven cholera pandemics, the third major outbreak of Cholera in the nineteenth century lasted from 1852 until 1860. Not unlike the first two, the third Cholera pandemic originated in India, spreading from the Ganges River Delta before sweeping through Asia, Europe, North America, and Africa, and ending the lives of over a million people. The British physician John Snow, while working in a poor neighborhood in London, tracked cases of this cholera, and eventually succeeded in identifying contaminated water as the means by which the disease was transmitted. Unfortunately, the very year of his discovery (1854) went down as the worst year of the pandemic in which twenty-three thousand people died in Great Britain alone. The Black Death (1346-1353) Death Toll: 75-200 million - Cause: Bubonic Plague. From 1346 to 1353, an outbreak of the Plague ravaged Europe, Africa, and all of Asia, with an estimated death toll of between seventy-five and two hundred million people. Though it was thought to have originated in Asia, this Plague most likely jumped continents on the backs of the fleas living on the rats that so frequently lived aboard the merchant ships that connected ports worldwide. Ports, being major urban centers at the time; were perfect breeding grounds for the rats and fleas, and thus the insidious bacterium flourished while devastating three continents in its wake. The Plague of Justinian (541-542) Death toll: 25 million - Cause: Bubonic Plague. Thought to have killed perhaps half the population of Europe, the Plague Of Justinian was an outbreak of bubonic plague that afflicted the Byzantine Empire, and Mediterranian port cities, killing up to twenty-five million people in its year-long reign of terror. Generally regarded as the first recorded incident of the Bubonic Plague, the Plague Of Justinian left its mark on the world by killing up to a quarter of the population of the Eastern Mediterranian and devastating the city of Constantinople, where, at its peak, it was killing an estimated five thousand people every day; and eventually resulted in the deaths of forty percent of that city's population.

In 2011, at the height of the HIV/AIDS pandemic, a Congress member from Indiana helped pass federal legislation to strip funding from Planned Parenthood, a service-oriented, non-profit organization. Two years later, the last Planned Parenthood affiliate in Scott County, Indiana, closed its doors because of budget cuts. It was also the last HIV testing center in the county. And by 2015, an HIV outbreak was brewing in the state. At the peak of this outbreak, twenty new cases were being diagnosed every week, with a total of nearly two hundred cases eventually reported, according to HuffPost. But that congress member, who became Indiana's governor, didn't want to authorize a needle-exchange program to help stop the spread of the virus. "I don't believe effective anti-drug policy involves handing out drug paraphernalia", he said. That Indiana governor was, of course, Mike Pence. Now he's the vice president, and on Wednesday, President Trump put him in charge of fighting the coronavirus in the U.S. "He's got a certain talent for this", Trump said. But others say the opposite is true. In Indiana, cuts to Planned Parenthood meant that "when the state experienced an HIV outbreak, they were unprepared to respond to it", Mary Alice Carter, a senior advisor at Equity Forward, a reproductive health watchdog group, told Vox. Pence's role in cutting Planned Parenthood funding showed a "short-sightedness" that makes Trump's decision to put him in charge of the coronavirus response concerning. Carter said. And the White House has not responded to a request for comment from Vox on the selection of Pence for the position. Moreover, Pence and his history are part of a bigger problem in the Trump administration, Carter and others say. In general, the administration has sought to restrict funding for Planned Parenthood and other groups, reproductive health services advocates say, without regard to public health implications. The administration's policies have already made it harder for low-income Americans to get screening for conditions like breast cancer and cervical cancer. And some fear that, especially with Pence at the helm, the administration could put politics over science when it comes to the coronavirus response too. "The ongoing concern is whether you let science and medicine lead an effort, or whether you let ideology run your policy", Carter said.

Today, Saturday, February 29th, 2020, marks the first death recorded from the coronavirus in the United States, and the American president, Donald J. Trump, is now cautioning all Americans not to panic, after first predicting in the previous week, that the outbreak would somehow magically vanish, and accusing the Democratic party of perpetuating a hoax. The New York Times is now reporting that two new and unexplained cases have emerged in Northern California and in Oregon on Friday, and health officials in both states quickly moved to contact people who might have been exposed. Experts warned that the cases could indicate signs of community-spread within the United States. Oregon health officials said they had identified a school employee in the Portland area who appears to have contracted the coronavirus more than a week before. The patient, who had not previously traveled to China, has had symptoms since February nineteenth, and may have exposed students and staff at a school in Clackamas County, officials said. Oregon's announcement followed one earlier Friday in Santa Clara County, California, where officials said a patient with no known risk factors had tested positive for the virus. The findings hint that the coronavirus may already be incubating locally in the United States, and passing from person to person, or through some form of community-based transmission. Earlier this week, a woman who had no known risk factors tested positive for the virus in Solano County, which lies between San Francisco and Sacramento. And hundreds of Americans who were potentially exposed to the virus in Asia, have been quarantined at military bases in California, including Travis Air Force Base in Solano County. A whistle-blower complaint made public on Thursday alleged that federal health officials were sent into quarantine areas at the bases without proper training or protective gear, and then were allowed to roam around freely, on and off the bases thereafter.

Should the coronavirus approach pandemic status in the United States, the likelihood of its affecting small neighboring nation-states like Belize will become almost inevitable. And few of these small states have the capacity to monitor, quarantine, and/or control the spread of a virus that is so readily transmitted. Though Belize has a remarkably good record of containing past epidemics, it is a different question to control a virus with no known antiviral precautions or vaccines. And though the World Health Organization, WHO, is still avoiding using the word "pandemic" to describe the burgeoning crisis today, talking instead about "epidemics in different parts of the world". Many scientists say that regardless of what it is called, the window for containment is now almost certainly closed. "It looks to me like this virus really has escaped China and is being transmitted quite widely", says Christopher Dye, an epidemiologist at the University of Oxford. "I am now feeling much more pessimistic that it can be controlled." In the United States, "disruption to everyday life might be severe", Nancy Messonier, who leads the coronavirus response for the U.S. Centers for Disease Control and Prevention, warned on February twenty-fifth. "We are asking the American public to work with us to prepare for the expectation that this is going to be bad". On Saturday, February eighth, the Government of Belize, via a press release, issued a travel ban for voyagers who had recently visited China. Specifically, all travelers who have been in China within fourteen days before arriving in Belize will be denied entry. But "border measures will not be as effective or even feasible, and the focus will be on community mitigation measures until a vaccine becomes available in sufficient quantities," says Luciana Borio, a former biodefense preparedness expert at the U.S. National Security Council, who is now a vice-president at In-Q-Tel, a non-profit venture capital firm. "The fight now is to mitigate, to keep the health care system working, and to not panic", adds Alessandro Vespignani, an infectious disease modeler at Northwestern University. "This has a range of outcomes from the equivalent of a very bad flu season, to something that is perhaps a little bit worse than that".

Howard A. Frankson -- Belize