Ever since the COVID-19 pandemic has spread over the world and impacted our daily lives, there has been a certain unease as to how and when we can return to normalcy. Many simple things that we normally take for granted, such as spending time with family and friends, have been made more difficult as we progress through the pandemic. However, these issues are not entirely foreign – in fact, there have been numerous times in the past where we have faced and recovered from serious global pandemics as well. As such, it may be beneficial to examine past pandemics, how we have responded to these experiences, and how they may be applicable to the current COVID-19 pandemic.
SARS (SARS-CoV-1)
One pandemic that COVID-19 (alternatively named SARS-CoV-2) bears similarity to would be the SARS-CoV-1, or simply SARS, pandemic that took place in 2003.This SARS outbreak was one of the first pandemics faced by Canada in modern times, and exposed critical downfalls in the Canadian healthcare system; Canada was the most heavily impacted country by SARS outside of Asia, where the virus had first appeared, resulting in 44 deaths and more than 400 probable cases. Furthermore, the toll on health care workers was similarly shocking–100 workers fell ill and three died. Tony Dean, a senator who was at the time responsible for co-ordinating the response to SARS, recounts how their response was akin to “wandering around in the dark”, where hospitals were underprepared and official communications were contradictory.
As such, no one would argue that the 2003 SARS outbreak caught Canada heavily underprepared. However, since then Canada’s response towards future pandemics has considerably improved. Senator Dean mentioned how today “every one of those gaps has been filled”, with “better training, better hospital protocols, and faster testing”, while Dr. David Naylor, one of Canada’s top epidemic control experts, chaired a report of recommendations titled Learning from SARS, and detailed how the SARS outbreak left public health officials with many lessons learned. Furthermore, not only has our response to viral epidemics improved, but the current state of research has also progressed significantly. This is supplemented by the similarities shared between the COVID-19 virus and the past SARS virus –most notably, both are coronaviruses and share recognition for the same surface protein in human cells3.When combined with the large advancements in science since 2003, this shows us how far our medical preparedness has come, which Dr. Allison McGeer notes as representing “huge differences” in the scientific response that is taking place between the current pandemic compared to SARS.
H1N1
In April 2009, a new strain of influenza made its appearance in North America, quickly spread worldwide, and was declared a pandemic (termed H1N1) one month later when 74 countries had confirmed cases. While many of these countries struggled with containing H1N1, Canada’s response to H1N1 largely came from adjustments made since the SARS outbreak–this time hospitals were more prepared and had made appropriate changes, including increases in ventilator capacities, patient accommodation, and intensive care unit capacity. Furthermore, Canada also reacted swiftly with an approval for the H1N1 vaccine arriving in October that was recommended to the elderly and essential workers, a response that has been carried forward during the current response with COVID-196.As a result, in April 2010 around 41% of Canadians aged 12 or older had received an H1N1 flu shot, and Dr. David Butler-Jones, the Chief Public Health Officer at the time, also detailed that Canada was leading the world in percentage of population vaccinated.
Looking Forward
Although these comparisons to prior outbreaks have given us an understanding on how our pandemic response has changed and developed, one thing that still remains uncertain is how life will proceed once the pandemic situation resolves – will it ever return to “normal”? Or will our current life become the new normal? Given the large amount of adjustments during the pandemic, it is hard to imagine a sudden shift back to pre-pandemic habits. Some positive changes that are likely to persist include the increased sanitation standards and hygiene habits that sprung into place in response to COVID-19–for instance, surgical masks may still remain a common sight in crowded areas, and the use of hand sanitizers will likely be just as prevalent. The fact that these measures have become so ingrained into our daily lives demonstrates the shift in public attitude that a pandemic such as COVID-19 has on society, and this can best be seen in Hong Kong following the SARS pandemic, in which the country faced 1,755 cases and a 17% fatality rate. Even prior to COVID-19 appearing, surgical masks were still in use by the general public, where people suffering from even mild signs of sickness used them to prevent transmission to others, and areas of frequent interaction (e.g. elevators, stairs, seating, areas) maintained a regular disinfection schedule. While it might be seen as excessive hygiene by some, this merely demonstrates how society betters itself following the trauma that pandemic experiences may impart. Another positive outcome related to the pandemic involves the drastic changes in work habits –namely, the increased efficiency for selected tasks in working remotely. For example, now that virtual meetings have become commonplace, flexibility can be prioritized in future meetings to allow participants to tune in and reach the meeting wherever you may be. Although maintaining changes that took place due to COVID-19 after the pandemic may seem odd, there is no doubt that many of these adaptations are helpful and can better daily life even after the pandemic ends.
However, despite there being positive adaptations, COVID-19 has also left lasting negative changes to many other aspects of life, such as schools and businesses. As an unfortunate consequence of the isolation that was recommended in combating COVID-19, schools stretching from kindergarten to higher education saw a majority of teaching take place virtually, reducing the overall quality of instruction and providing students with more challenges for learning. Furthermore, parents with younger children faced difficulties in helping them adjust to virtual classes as well, with tasks such as assignment submission and technical difficulties, which subsequently disrupted their own day-to-day workflow. This same isolation also caused small businesses to suffer, as the Canadian Survey on Business Conditions reported that that 15.6% of smaller businesses no longer had the ability to take on more debt and were forced into tougher financial constraints, and nearly three-quarters of these businesses had less of an optimistic outlook over the next 12 months. As such, while it is important to focus on reducing COVID-19 cases and improving healthcare for those infected, an equally important part of the pandemic response involves attention to other aspects of day-to-day life to prevent long-lasting negative changes once the COVID-19 pandemic ends.
Without a doubt, all of us are eager to move past COVID-19, and thankfully this response is being expedited due largely in part to the vaccine effort taking place throughout Canada, which has led to the slow but gradual resume of normal activities. However, having looked at how past pandemics have impacted our society, it would be remiss if we did not pay close attention to the impact COVID-19 has brought and how we responded to it, in order to better adjust our lives once the pandemic is over, and to better prepare ourselves for future pandemics should they arise.
References
- Naylor, C. (2003).Learning from SARS. National Advisory Committee on SARS and Public Health.2.Barton, R. (2020).
- In 2003, Canada failed the pandemic test. Here’s what we’ve learned since. CBC News
- Rossi, G. A., Sacco, O., Mancino, E., Cristiani, L., & Midulla, F. (2020). Differences and similarities between SARS-CoV and SARS-CoV-2: spike receptor-binding domain recognition and host cell infection with support of cellular serine proteases.Infection, 1-5.
- Bogart, N., Forani, J. (2020). Then and now: The “huge differences” between SARS and Wuhan coronavirus. CTV News
- Canadian Institute for Health Information (CIHI). (2010). The impact of the H1N1 pandemic on Canadian hospitals.
- CTV News(2009). Health Canada approves H1N1 swine flu vaccine. CTV News.
- Statistics Canada (2010). Health Reports. Vol 21, no. 4.
- The Canadian Press (2009). One quarter of Canadians immunized for H1N1. Toronto Star.
- World Health Organization (2015). Summary of probable SARS cases with onset of illness from 1 November 2002 to 31 July 2003.
- Tam, S., Sood, S., Johnston, C. (2021). Impact of Covid-19 on small businesses in Canada, second quarter of 2021. Statistics Canada
Martin Mak
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