Historically, world pandemics have been absolutely devastating. The outbreak of bubonic plague in medieval Europe, for example, killed approximately 25 million Europeans over the course of its initial outbreak in the 14th century. Newer diseases such as SARS (Sudden Acute Respiratory Syndrome) and swine flu have technically reached pandemic status, with cases occurring in multiple countries and affecting a large number of people. Thanks to quarantine procedures, pharmaceutical drugs, and other preventive measures, however, these conditions were kept in check. They were also considerably less virulent than the major pandemic agents, with lower communicability and mortality rates.
With the advent of advanced pharmaceutical drugs, municipal hospitals, and modern sanitation practices, it might seem that world pandemics are a thing of the past. Yet within the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), epidemiologists speak of pandemic agents in certain terms: there is no if, only when. Though many vectors of disease (such as the rats that carried the Yersinia Pestis bacterium that caused the bubonic plague) have been identified and modern quarantine procedures can isolate potential victims fairly quickly, modern medical science could potentially be at a loss to address the next serious world pandemic.
Controlling potential pandemic agents is also a growing problem. Given that hospitals utilize many different sanitizing agents during routine cleaning procedures, there are regions of hospitals where only the toughest pathogens survive. As they reproduce over several generations (and given that hospital sanitation procedures have remained relatively unchanged in certain areas), antibiotic-resistant bacteria have developed. Sometimes called “superbugs,” these antibiotic-resistant bacteria and other pathogens have the potential to drastically raise the mortality rates of previously well-controlled diseases, like tuberculosis. Antibiotic-resistant bacteria often need to be treated with a combination of drugs in order to resolve a patient’s symptoms, but in many cases these pathogens cannot be effectively treated. Healthcare providers are then somewhat reliant on low communicability—that is, the rate at which the pathogen spreads. If, through mutation or intentional manipulation, antibiotic-resistant pathogens gain high communicability, these new strains could potentially cause a pandemic on the scale of the Black Death.
Even in the modern world, many new pandemics first gain traction in densely populated areas (either animal or human) with poor sanitary conditions. Globalized economies and frequent international travel could potentially transport a pandemic beyond a potential quarantine radius before epidemiologists can even identify the associated pathogens and vectors responsible for its spread. Preventive measures like the Affordable Care Act, designed to give more citizens (particularly low-income citizens) access to healthcare services, go a long way towards reducing the size of the next world pandemic. When citizens know that they can visit the doctor without steep financial cost, they are more likely to seek treatment when a new pathogen is in its initial stages.