There are two ways a pandemic needs to die before we can declare it over. First, it needs to end medically: a period where the number of cases and deaths aren’t worrying anymore. But it also needs to end socially. Until we decide as a society that the pandemic isn’t a threat anymore and until we stop fearing it, COVID-19 will never truly come to an end. 

This is not the first time humanity is faced with a life-changing pandemic. Every century has had its own share of diseases and plagues, but the spread has never been so global. What can we learn from pandemics of the past to help us predict the way COVID-19 will make its way to the end?

Plague of Justinian: Herd Immunity

The Plague of Justinian arrived in Constantinople in 541 A.D. when Emperor Justinian ruled the Byzantine Empire. It spread like wildfire across Europe, Asia, North Africa, and Arabia. It’s estimated that half the world’s population at the time died as a result of the plague. At the time, there was no understanding of the plague and certainly no way to cure it. The remaining population is believed to have survived because of a newfound immunity.

But the picture painted by COVID-19 need not be so grim. If 70% or more of a population develops immunity, the spread of the disease can be combatted. 

However, attempts to build herd immunity without a vaccine haven’t gone well. In 2020, Sweden did not implement any strict lockdown rules in wake of the pandemic. Even though large social gatherings had been discouraged, other public places like bars or restaurants were open for business. Sweden had hoped to achieve herd immunity through coronavirus antibodies, but it did not go as planned. By November 2020, Sweden’s COVID-19 death toll per capita was 10 times more than its neighboring country, Norway. 

The road to herd immunity is long and deadly. Without putting the lives of an entire population at risk, herd immunity will never be successful without vaccines. 

Influenza: Endemic Flu

The H1N1 influenza pandemic, also known as the “Spanish flu,” took as many as 50 million lives from 1918 to 1919. Although its origins have nothing to do with Spain, the deadly flu picked up the name as the Spanish media–declared neutral in World War I–was one of the few countries allowed to report on it during media blackouts. World War I only made things worse. As soldiers moved across borders and oceans, they carried the deadly flu with them. 

Even though there have been three other viral pandemics in the 20th century, none have seen death as the 1918 pandemic did. The most important aspect of this pandemic is that the disease eventually turned into a less fatal seasonal flu, taking 290,000 to 650,000 lives every year worldwide.

In a similar way, some scientists believe the coronavirus will never really go away. It’s scary to imagine a world where we’re constantly at risk of contracting this disease. But this doesn’t mean it will be just as viral or lethal as is it today. Similar to influenza, we might see COVID-19 become a part of the seasonal flu that causes the common cold and similar respiratory infections every year.

Smallpox: Vaccines

For centuries, smallpox was an endemic that plagued Europe, Asia, and Arabia, killing three out of every ten people infected by it. But when explorers landed in the Americas, this disease, along with war, wreaked havoc in the lives of the indigenous people. Lack of natural immunity among the native population wiped out 90% of their population. 

Things took a turn in the eighteenth century when Edward Jenner created the first vaccine. Eventually in 1980, WHO declared smallpox completely eradicated. 

The COVID-19 vaccine has been effective so far. But while we may outsmart the virus with a good vaccine, the immunity it provides may not be permanent. Mutations of the coronavirus are rapidly developing and it affects immunity rates. Then there’s the entire nuisance of anti-vaxxers

We cannot predict what is certain about the future of this pandemic. Medically speaking, the pandemic will come to an end when we figure out everything about this infamous disease. In the meantime, social distancing may seem to be a new reality, but we’re already seeing how isolation impacts mental health. Furthermore, businesses and companies have been pushing for reopenings. Considering the current situation of the pandemic, we may stop fearing it before it is truly eradicated.

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