How Pandemics End: Lessons From the Past on How Long We Might be Living With COVID

end of pandemic 2022

It’s 2022 and that means we’re closing in on two whole god-damn years since coronavirus swept the globe and put Australia into the first of many, seemingly endless lockdowns in March of 2020.

While we’re all resolutely done with COVID-19, the virus is not quite done with us. Although we’re a highly vaccinated population, COVID keeps mutating and bringing us fun new ways to ruin our plans.

However, the world has been through plagues and pandemics before. The Black Death, brought about by fleas in the 1300s, wiped out somewhere between 75 to 200 million people from Asia to North America. The Cocoliztli Epidemic killed up to 15 million people across Central and South America in the 1500s. Then of course we had the Spanish Flu, the most deadly of all human pandemics, which saw roughly 500 million people die almost exactly 100 years ago.

It’s this last plague that researchers have been most interested in of late as we seek a way out of the current COVID pandemic and look for clues for how these things normally come to an end – and whether we might be able to speed that end up.

After all, none of these illnesses still affect humans on any significant level today, so, although it feels like COVID has dragged on forever, it’s certain that we won’t be living with this virus for the rest of our lives.

How Do Pandemics End?

The truth is that most pandemics don’t end. When we talk about the end of a pandemic or wave of some disease, we’re usually talking about the social end, when the impact of that disease stops having an effect on everyday life.

In some sense, COVID is already reaching that end. Restrictions are lifting amid calls to ‘live with’ the virus and we are a long way from the darkest days of lockdown. Although COVID is still very much on our minds and disrupting our day-to-day, it appears to be dying down in significance. The social end of this pandemic will come when we live life as we did before, without fear of infection from the disease.

The medical end of a pandemic, when the virus itself is completely eradicated so that it can never re-infect people, is very rare indeed. In fact, it’s only happened once before. Smallpox is the only disease that humans have ever managed to successfully wipe out. Though history tells us this virus swept across humanity for perhaps more than 3,000 years, a vaccine campaign started in the late 1700s was eventually able to eradicate it some 200 years later.

That’s unlikely to happen with COVID. SARS-COV-2, unlike smallpox, infects other animals, not just humans. Even if we were able to vaccinate against it to the point that no one in the world had it, it could once again jump from another species to us, reigniting the whole ordeal. This is only more likely to happen as humans continue to live in increasingly close quarters with animals.

However, we don’t need to eliminate the virus for it to disappear from our lives. Believe it or not, the Black Death is still out there and causes infection in humans from time to time. So, too, is virtually every illness that has been identified as the source of pandemics and epidemics throughout history.

Typically, when pandemics end, we either see that as a result of herd immunity, with enough people in the community getting the disease to create robust immune defences to stop the spread to others, or they simply stop infecting humans, as the Black Death did. Another way, of course, is that the virus or humans change so that we’re no longer mortal enemies.

While it’s hard to pinpoint exactly what constitutes an ‘end’ of a disease – and for whom exactly the disease has ended (think Malaria or Ebola) – we can regard the end of the pandemic as when the virus stops causing deaths beyond the norm of any other disease.

This is an idea thought up in the 1600s by British epidemiologist John Graunt, who, when studying outbreaks of smallpox, typhus, and plague, floated the idea that epidemics don’t end when the disease does but instead when death rates don’t surpass normal levels.

This is the basis of the approach taken by Oxford vaccine creator Andrew Pollard, who said that “The end of the pandemic is not the end of this virus — it’s the end of an unsustainable impact on health systems.”

“If we can convert it into something more innocuous, then we’ll have the end of the pandemic in sight,” he said.

What Can the Spanish Flu Tell Us About the End of a Pandemic?

Historians are uncertain over how exactly the Spanish Flu ended, but there are theories that suggest the virus simply mutated into a less harmful form of the flu. Although it continues to crop up, notably in Asia in 1957 and then again in Hong Kong in 1968, the flu strain that we currently deal with is manageable.

Spanish Flu, poorly named as it was merely identified and written about extensively in Spain and didn’t originate there, shares similarities with omicron, and not just in naming conventions.

Rodney E. Rohde, a virologist and professor at Texas State University, has said that “The 1918 influenza virus eventually mutated to the point of not having a high number of deaths.”

“We may very well be witnessing this process with ongoing variants of SARS-CoV-2.”

However, while there is still too much uncertainty to say for certain that this pandemic will play out in a similar way, it’s likely that we’ll see the end of it not with elimination, but instead with a lessening of its impact on daily life.

Historically, this has taken about two to three years in the cases of most endemic diseases. While we knew very little comparatively about how diseases spread back in the day, we know a significant amount more about COVID and how to control it.

With vaccines now in place across the country, and the rollout across the world speeding up, it’s likely that we’ll be able to force the disease into a point where it no longer poses a serious threat. Mask wearing, social distancing, and the ability to work from home are all going to play key parts in denying the virus a host and stamping out major outbreaks when they arise.

Of course, Spanish Flu is different to COVID in that it had a much shorter incubation period and a much shorter period during which people were infectious. This means that COVID is much better at escaping our defences like isolation and quarantine and that it could still keep circulating in the community for years to come.

That might not necessarily be a bad thing on balance. We get flu shots each year to deal with seasonal flu and the more the virus circulates, the better we will be individually at dealing with it. While we might need to keep our defences up for a bit longer, it’s looking more and more likely that this thing is going to come to a close not with a bang but with a whimper. That whimper is already beginning to sound as we see hospitalisations and death rates remain low despite the high case numbers.

Read more stories from The Latch and subscribe to our email newsletter.