A Historical Look at 3 Pandemics

This week, we combine healthcare with history as we take a look at three past pandemics. Although the COVID pandemic has still taken an enormous toll, modern medicine and a quick vaccine development program prevented it from being far worse than it could’ve been. The most devastating pandemic of all time, and probably the best known of all, is the Black Death- the bubonic plague. The black death spanned from 1346-1351, killing between 75 to 200 million people in Europe, North Africa and the Levant. The plague was caused by fleas carrying the Yersinia Pestis bacteria, fleas carried to Europe aboard rats stowing away on merchant ships. It’s now believed that the plague originated in the Crimea, from which point Genoese traders further spread it to Constantinople, and then to the rest of Europe. Another, lesser-known plague that predated the Black Death was the Plague of Justinian.


The plague of Justinian occurred from 541-549 AD, and was also caused by the Bubonic Plague. Its death toll is not as precisely known, with a wide estimate of 1-100 million. This plague affected the eastern Mediterranean, from Italy to Egypt and modern-day Israel, and worked to greatly hasten the fall of the Byzantine Empire. This was one of the first widely recorded pandemics in history, and the first instance of Bubonic Plague. Another, more recent pandemic is the Spanish flu of 1918, infected about 500 million people and killed between 20-50 million people. A perfect storm of events, the chaos and destruction of World War I (1914-1918) caused for filthy conditions throughout Europe, while the massive movements of troops throughout Europe and the U.S. allowed it to spread initially. The first known case was reported on a military base in Kansas, though other areas in Europe may have actually become infected prior to its identification. It quickly spread from central Europe and the mid-west U.S. to Russia, India, Africa, and the far-east. There has been a great deal of debate as to its initial genesis, but some believe it originated in Austria over a year before it was first identified.


Overall, poor knowledge of disease, particularly in the first two plagues discussed, allowed the plague to spread incredibly quickly, along with poor hygiene. Interestingly enough, mask use was very common during the Spanish flu, and there are many pictures of people enjoying leisure-time activities with masks on.