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Before coronavirus: How Canada tackled outbreaks in the past

What is the Spanish Flu? This year marks 100 years since the deadly influenza pandemic
The year 2018 marks 100 years since the 1918 Spanish flu pandemic, one of the deadliest disease outbreaks in history.

As the novel coronavirus continues to have an impact worldwide, countries are grappling with the outbreak and trying to contain the illness. 

In Canada, there are four confirmed cases of the coronavirus, three in Ontario and one in British Columbia. 

Globally more than 20,000 people have been infected and 362 have died. In Hubei province in China — the core of the outbreak — 325 people are asking the Canadian government for help leaving the country. 

READ MORE: Canadians with coronavirus symptoms won’t be allowed onto evacuation flight from China, officials say

The respiratory disease first appeared in December 2019 in Wuhan, China and is believed to have originated at a wild game market.

While health officials continue to battle misinformation about the coronavirus, along with racism directed towards Asian communities, historically, Canada has been through widespread epidemics before.

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“When you look at most epidemics in the past… I don’t see the same level of panic,” said Heather MacDougall, an associate professor of history at the University of Waterloo in Ontario. 

It’s important to know that most people do not die during these pandemics and overreacting is counterproductive, she said.

As well, the coronavirus is not yet a pandemic, the World Health Organization said on Monday.

MacDougall adds that Canada has come a long way in terms of how we handle disease. 

The outbreaks of the past century and how they were handled often changed Canada’s health-care system. 

1918-19: The Spanish flu 

Death count in Canada: Around 55,000 people

Worldwide death count: Between 50 and 100 million people

The most infamous pandemic of the 20th century is the Spanish flu, due to its high death count and the fact that it plagued almost every country, said Esyllt Jones, a history professor at the University of Manitoba who specializes in health and disease. 

“In the 20th century, it’s extremely unusual to have an outbreak on that scale,” said Jones. “It is a very rare event, that particular outbreak.” 

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The virus spread through modern ships and the quick movement of armies across the globe for the war, according to NPR in the U.S.

The symptoms of the Spanish flu included nausea, aches and more grotesque symptoms like the lungs filling with bloody fluid, according to NPR.

It was also odd as it primarily killed Canadians between the ages of 20 and 40, those in the prime of their lives, as opposed to infants and the elderly, who are usually the most vulnerable, according to the federal government. 

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“There really isn’t an equivalent in the history of the modern world,” Jones said. 

Only the Black Death is comparable, as that killed more than 50 million people in the 14th century — 60 per cent of Europe’s population, according to History Today.

The pandemic was incorrectly called “Spanish” due to media coverage that focused on Spain, also not to cause panic about its existence in other allied European countries during the First World War, explained Jones.

Lack of treatments along with failed co-ordination efforts between health authorities created chaos, according to the federal government. 

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“There was a lesson that they pulled out of what happened… It was the importance and value of co-operation within the community,” Jones said. 

The disaster is one factor that led to the creation of the federal Department of Health in 1919, increasing the Canadian government’s responsibility in citizens’ health one step of many that led to the creation of our health-care system, according to the federal government. 

“We have a much more effectively organized health-care system than we did at the time,” Jones said. 

1957-58: Influenza pandemic

Death count in Canada: 7,000 people
Worldwide death count: Between one and two million people

This virus was first reported in Singapore in February 1957 and eventually reached the United States by the summer of that year, according to the U.S. Centers for Disease Control and Prevention.

Symptoms included wobbly legs, a sore throat, nose bleeds and a high fever, according to Pub Med.

READ MORE: Built in just 10 days, coronavirus hospital in China accepts first patients

It was the first pandemic that the World Health Organization was able to study using a worldwide network of laboratories that were set up globally, said MacDougall — a sign of the increased connectivity and communication between nations.

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The death count in Canada, although sizable, isn’t far from the typical death count from the flu every year, which is about 3,500 people, she said. 

1981-present: HIV/AIDS

Death count in Canada: Around 26,000 people (data from 2014)

Worldwide death count: Around 35 million people since its discovery

The HIV/AIDS epidemic brought with it not only sickness and death but also increased stigma towards marginalized communities, explained MacDougall. 

“Its biggest impact was to get patient voices front and centre,” she said.

“As a worldwide pandemic, it changed things in that it made it clear that it is one world — we’re all affected by this. And that’s probably what pandemics do, it’s the globalization of disease, but also ways of dealing with the disease.”

READ MORE: Canada is offering medical assistance to China as it combats coronavirus spread, MP says

Virtually every country on earth has been impacted by HIV/AIDS, according to Health Canada.

It’s a disease that often impacts those who are historically discriminated against, including gay men, injection drug users, Indigenous people, youth, women and those from countries where HIV is endemic, Health Canada says. 

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The most recent data from the Public Health Agency of Canada shows that the number of people with HIV in Canada increased by about five per cent between 2014 and 2016.

HIV/AIDS has become more manageable for those in the Western world, but remains a crisis globally and needs continued resources and attention, said MacDougall. 

2003: SARS

Death count in Canada: 44 people

Worldwide death count: Around 900 people

SARS (severe acute respiratory syndrome) is a coronavirus thought to have emerged from an animal reservoir and first infected people in Guangdong, China in 2002.

READ MORE: How the new coronavirus compares to SARS, MERS, Ebola and other diseases

More than 8,000 people were infected globally and Ontario declared SARS a provincial emergency in March 2003. The racist rhetoric that emerged against the Asian community during SARS has had a lasting impact since the outbreak 17 years ago, said MacDougall.

Some mistakes were made during the outbreak, including quarantine, as it turned out SARS was only infectious when people got sick, Allison McGeer, an infectious disease consultant at Sinai Health System, said in a previous Global News report.

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2009: H1N1 flu epidemic

Death count in Canada: 428 people

Worldwide death count: More than 18,000 people

The H1N1 influenza epidemic, sometimes called the “swine flu,” infected Canadians across the country.

Unlike the seasonal flu, H1N1 was contracted by many Canadians in the spring and summer of that year. Some were at first hesitant to be vaccinated against it, said MacDougall. 

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“In terms of Canadians accepting the idea of vaccination, it took ages for the vaccine to be ready,” she said, adding that it was available by the fall of that year. 

It took the death of a 13-year-old boy from Toronto to encourage more people to get vaccinated, she said. 

What’s clear from how Canadians have behaved if they believe they are infected with any kind of virus since SARS is that they will follow instructions from health officials to protect others, she said.

“All of the confirmed cases that have come to this country have taken precautions, sought medical help and have done whatever was asked of them.”