According to Dr. Gerald Evans, Chair of the Division of Infectious Diseases and a Professor in the Departments of Medicine, Biomedical & Molecular Sciences, and Pathology & Molecular Medicine at Queen's University, a pandemic is a global infection outbreak caused by a novel microbe to which most of the population is susceptible, is transmissible person to person, and has affected more than three of WHO’s six world regions.
Evans listed the 5 Deadliest Pandemics as the:
- Peloponnesian War Pestilence (pandemic typhus)
- Antonine Plague (pandemic measles)
- Plague of Justinian (Bubonic plague)
- Black Death (Bubonic plague)
- Spanish Flu (pandemic influenza)
Epidemics and pandemics have shaped world history, such as the Bubonic Plague which killed a third of Europe's population during the Middle Ages, or the Spanish Flu that killed between 20 and 40 million people worldwide between its start in 1918 and its last wave in 1928. The first documented influenza pandemic was in 1510, with at least 9 recorded outbreaks between then and 1918.
Each influenza pandemic has differences and similarities are seen in all, making forecasting tricky, but Dr. Evans suspects that H5N1 Avian Influenza, which lives in aquatic birds all around the world and has been around for 30 years with only sporadic outbreaks, may be the next one.
Dr. Evans shared a map of the spread of COVID in the US over the first 18 months of the pandemic, with the regional rates aligning closely to Trump voters, and blooms late in the second year with slackening regulation and the arrival of the Delta variant.
The official world death record for the pandemic is now at 6,574,709, which Dr. Evans considers a gross underestimate. He and his colleagues suspect 4 or 5 times that, is the true number. The chief mitigation strategies are 1.) vaccination, 2.) non-pharmaceutical interventions (hygiene, respiratory etiquette, isolation and quarantine, social distancing), and 3.) targeted antiviral treatment and prophylaxis.
Vaccines have made COVID far less lethal. A fully vaccinated 80-year-old has the same mortality risk as unvaccinated 50-year-old. Age is the primary determinant of mortality risk. However, the vaccine rollout has been very asymmetrical across the globe with poor distribution in Africa. Sadly too, the availability of COVID vaccines has led to a massive upsurge of anti-vax disinformation. mRNA vaccines were "new" allowing groups to imply they were unsafe, leading to an anti-mandates political ideology.
As well, the pandemic caused a lack of easy access to primary care physicians which resulted in an abrupt decline in routine childhood immunizations.
View and Listen to Dr Gerald Evans talk
Dr. Gerald Evans is the Chair of the Division of Infectious Diseases and a Professor in the Departments of Medicine, Biomedical & Molecular Sciences, and Pathology & Molecular Medicine at Queen's University and an attending Infectious Diseases physician at Kingston Health Sciences Centre and Providence Care Hospital in Kingston, Ontario. In addition to being Past President of the Association for Medical Microbiology & Infectious Disease (AMMI) Canada (2009-2012), he is also the Editor-in-Chief of the Journal of the Association of Microbiology and Infectious Disease Canada, affectionately known as “JAMMI”.
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