What do the Black Death, the bubonic plague, cholera, polio, the flu, and COVID-19 all have in common? They’re all pandemics (or epidemics, in some cases) that have significantly impacted our way of life. Read on to learn more about how we have handled pandemics throughout history, and how it relates to current events.
The Difference Between a Pandemic and an Epidemic
Outbreaks of disease have been occurring throughout history for thousands of years. In fact, the first recorded pandemic took place in Athens, Greece, during the Peloponnesian War in 430 B.C.
A ‘pandemic’ is an outbreak of disease that has spread across several countries or continents, affecting a very wide geographical area. An ‘epidemic’, on the other hand, is an outbreak of disease that occurs within one location. While many people use the term ‘plague’ when talking about a pandemic, a plague refers to the spread of an infectious disease caused by a specific bacterium, Yersinia pestis.
A pandemic follows six key phases, as outlined by the World Health Organization:
How We Have Responded to Pandemics in the Past
Viral pandemics can spread incredibly quickly, infecting millions of people around the world. Here are some examples of how we’ve navigated them in the past.
The 1918 Influenza
Caused by an H1N1 influenza virus, the 1918 influenza was a devastating pandemic that infected an estimated one-third of the world’s population, killing approximately 20–40 million people by 1920. The flu vaccine was not developed and distributed until 1930, so control efforts were limited to non-pharmaceutical interventions, such as social distancing, quarantine, personal hygiene, and limitations on public gatherings.
The 1968 Pandemic
1968 was notable for a multitude of reasons—including manned space travel, the military conflict in Vietnam, and even innovations in heart transplant surgery—but it was also the year of the H3N2 influenza pandemic in the United States. Although the infection and mortality rate was not as high as during the 1918 pandemic, it was responsible for an estimated 100K deaths in the US. Schools were closed across at least 23 states, and ‘normal’ life was significantly disrupted, including delayed package deliveries, economic slowdown, and widespread closures.
The 2009 H1N1 Pandemic
First detected in the US in April 2009, the H1N1 pandemic is perhaps our most recent memory of a viral outbreak. Before the pandemic even reached phase 6, the CDC was recommending social distancing measures and school closures to slow the spread of the disease.
Following the 2009 H1N1 pandemic, the CDC established the Pandemic Influenza Preparedness (PIP) Framework to improve the global response to mitigating the effects of a pandemic, including providing access to resources such as vaccines and supplies.
How We Are Responding to the COVID-19 Pandemic is No Different
Although the world is no stranger to pandemics and outbreaks of disease, COVID-19 took many of us by surprise. The rapid spread and severity of symptoms brought the world to a halt—businesses and schools were closed, and we were all encouraged to social distance and isolate to slow the spread. Face masks have become a fashion statement and hand sanitizer is readily available at the entrance of public buildings.
While the rush to stockpile toilet paper was perhaps a bit out of the ordinary, it’s important to note that the way we are responding to the COVID-19 pandemic is in line with how we have handled pandemics in the past. And just like we’ve seen in our history, the way back to ‘normal’ is by getting vaccinated and following the CDC’s guidelines.
Husband. Father. Sinusitis Nerd.
There have been more than 37 million cases of COVID-19 in the United States, with over 620 thousand deaths since March of last year. The world came to a halt in 2020 as we were urged to stay home in an effort to slow the spread of the highly contagious coronavirus. Now, halfway through 2021, hope is on the horizon: major pharmaceutical companies—such as Pfizer, BioNTech, Moderna, and Johnson & Johnson—have developed and distributed vaccines to countries around the world. Here’s what you need to know.
The Benefits of Being Vaccinated
The COVID-19 vaccine will not make you immune to the coronavirus, but it can significantly reduce the severity of symptoms if you do get sick. The vaccine may also prevent you from spreading the virus to others. The virus replicates as it spreads, increasing the risk of vaccine-resistant mutations, so it’s important that we do what we can to stop the spread.
At the time of writing this, more than 4.74 billion doses of the vaccination have been administered worldwide, with over 350 million doses given in the United States. Approximately 51% of people in the United States have been fully vaccinated, with around 77% of the population having received at least one dose. Health officials are aiming to reach a total of 70% of Americans fully vaccinated in an effort to achieve herd immunity, which helps protect those in our community with serious medical conditions that prevent them from being able to be vaccinated.
Is the Vaccine Safe?
Vaccine safety has been a popular topic in recent years, with many people expressing concern and spreading misinformation regarding potential side effects or risks associated with vaccinations in general. The hurried release of the COVID-19 vaccination has led many people to question whether or not it is safe, however, it has been fully approved for emergency use by the Food & Drug Administration (FDA).
Healthcare professionals and government officials have gone to great lengths to assure people that the vaccine is safe for use. While vaccines—and most medications, for that matter—do carry a risk of side effects, the overall risk is quite low. For example, the Johnson & Johnson Janssen vaccine carries an increased risk of blood clots (otherwise known as thrombosis with thrombocytopenia syndrome or TTS) but this occurred in only 0.0003% of cases or 42 out of the 13 million people who received the J&J vaccine. Comparatively, the average birth control pill carries a 0.3% risk of blood clots.
Get Your Vaccination Today!
Everyone 12 years of age and older is eligible to receive a COVID-19 vaccine free of charge. Visit the CDC’s website to find a vaccination provider near you, or to learn more about the benefits of being vaccinated.
The case rates are climbing again, with an average of 140 thousand new cases every day over the past week. I truly believe that the way back to ‘normal’ is by getting as many people vaccinated as possible. Speak to your doctor or a trusted healthcare professional to learn more about the COVID-19 vaccine, including the risks and potential side effects.
Husband. Father. Sinusitis Nerd.
One of the strangest and most frustrating symptoms of COVID-19 is anosmia, or the loss of the sense of smell. Losing your sense of smell can impact many parts of your life, including your appetite. For some people, the sense of smell returns after several days or weeks - but for others, losing the sense of smell can be a persistent issue.
Anosmia From COVID-19: Can It Be Reversed?
Of all the symptoms related to the COVID-19 pandemic, losing the sense of smell can be a symptom you have to deal with for several weeks or months after you are no longer testing positive for the virus. Just like losing your sense of taste, losing your sense of smell can change the way you live your life, so it's understandable to want to know when you can expect your senses to return back to normal.
The good news is that time seems to be the answer to reversing anosmia. In a French study conducted on coronavirus patients, researchers concluded that most patients regained their sense of smell after nearly a year after contracting the virus. And yet for others, regaining the sense of smell is something that returns after about two weeks of other symptoms going away.
Why Do Some People Get Their Sense of Smell Back More Quickly?
There's a huge difference between getting your sense of smell back after a few weeks or after a year. While researchers are still trying to figure out why some patients seem to recover their sense of smell more quickly than others, new research may suggest that it has to do with the way the virus affects the cells surrounding the sensory neurons in the nose. Specifically, it has to do with how quickly the cells surrounding the sensory neuron can recover.
Viral Infections and Your Sensory Neurons
For years, physicians have been aware that viral infections can sometimes cause patients to lose certain senses temporarily, including the sense of smell. But because this phenomenon pre-COVID was somewhat rare, there hasn't been an opportunity for much research. Now, research studies about why anosmia happens to COVID patients and how to recover your sense of smell are constantly being conducted.
What scientists have discovered about this particular viral infection is that the virus appears to target specific cells in the body - and this includes the cells that surround sensory neurons in the nasal passage called support cells. Essentially, the virus attacks and damages these support cells, which prevents them from helping the sensory neuron send information to the brain. When the support cells are infected, you lose your ability to smell; when these cells are repaired, your sense of smell returns.
Do Long-Haulers Have It Worse?
Long-haulers are the people who had COVID symptoms for several weeks or even months. In general, long-haulers dealt with more exaggerated symptoms than others while their bodies battled the viral infection. Some research suggests that the longer you have symptoms, the longer it will take for some symptoms to go away. This seems to be particularly true for the loss of taste and smell.
Compared to people who had mild or asymptomatic infections, long-haulers seem to have more challenges returning to pre-COVID health. If you battled COVID for several weeks or months, then you may want to see a specialist to do a thorough health check or even participate in post-COVID studies.
Can Anosmia Be Permanent?
About 80% of patients who have COVID-19 will temporarily lose their sense of smell, and for about 5 to 10% of those patients, this symptom will continue even after patients have recovered from other symptoms and are no longer infected. And while most of those patients can regain their sense of smell after several months to a year, there are still some patients who may have a longer-lasting issue.
The trouble with regaining your sense of smell is that your sensory nerves need to be surrounded by supportive cells, otherwise the nerves die or atrophy. It's incredibly difficult for sensory neurons to repair themselves, so if you are experiencing a persistent loss of sense of smell for longer than a year, then it's possible your sense of smell may never return. That said, experts suggest that maybe patients with persistent anosmia may just need additional time for their sense of smell to return.
Can You Help Your Sense of Smell Return?
This is a question scientists have been trying to answer. Because the virus is thought to affect the function of the sensory nerves, research for how to regain the sense of smell after COVID is focusing on a blend of neurological research and ear, nose, throat experts. One study is working on the association between visual cues and scent to try to retrain the brain.
In this study, participants are asked to smell essential oils or other scents while looking at a picture that represents the scent. In doing so, researchers are trying to figure out if the sensory nerves can re-learn scent associations. According to some, this research is long overdue since a lot still isn't known about viral-associated anosmia. The novel coronavirus has opened new demands in research that can help shed light on how to recover from certain viral infections.
What Is a Good Sign Your Smell Can Return?
For patients who have regained or partially regained their sense of smell, one of the most hopeful signs to look out for is hints of scents. While you are trying to recover your sense of smell, you may only be able to detect very faint traces of certain scents. But this is a hopeful sign that your sensory neurons and support cells are still functional and that your sense of smell is returning, however slowly.
Why Does Your Sense of Smell Matter?
In the grand scheme of things, if you've survived COVID-19, then regaining your sense of smell may not be one of your top priorities, especially for long-haulers. But your sense of smell, just like any other sense, is important to lead your life safely and independently. In fact, in terms of safety, not having a sense of smell can be dangerous. If you can't smell fire, gas, or something burning without looking directly at it, then you may unknowingly be in danger.
But more than that, many patients feel nostalgic about their sense of smell. Neurologists have known for years that the olfactory senses are closely linked with memory, so the loss of smell may make it difficult to have easier memory recall. Additionally, your sense of smell and your sense of taste are closely tied, and for some people, being unable to smell food makes it difficult to have an appetite, which can negatively impact your overall health over time.
Losing your sense of smell is one of the hallmarks of the novel coronavirus. For many people, losing the sense of smell is one of the first symptoms they experience after fever and fatigue - and this symptom is, unfortunately, one that can persist even after all the other symptoms associated with the viral infection have disappeared. The good news is that time seems to be the key to regaining your sense of smell. For more up-to-date information about recovery from COVID-19, contact Dr. Thomas S Higgins, MD, MSPH at Higgins Sinus in Louisville, KY today.
Author: Thomas S. Higgins, MD, MSPH
Father. Husband. Sinusitis Nerd.
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