The History of Viral Pandemics from Smallpox to COVID-19


Every major epidemic since the start of the 20th century has been caused by a virus. A new book, Viral Pandemics: From Smallpox to COVID-19, looks at these outbreaks from their detection to their explosion. The authors  examine the biological properties of each virus, the history and progression of each epidemic, and the public health response–which, as the current pandemic illustrates, requires a partnership between government officials, the public, and medical science to be effective. In addition to smallpox and COVID-19, the book covers yellow fever, polio, HIV/AIDS, West Nile virus, SARS, Zika, and Ebola.

The book is an unusual collaboration between Allison Kavey, a professor at John Jay College and The Graduate Center, and her mother, Rae-Ellen Kavey, M.D., M.P.H., who teaches at John Jay as an adjunct. Allison Kavey holds a Ph.D. in the history of medicine from Johns Hopkins and provides the historical perspective at the end of each chapter in the book. Rae-Ellen Kavey is a distinguished physician who specializes in pediatric cardiology and spent five years at the National Institutes of Health.

The authors were finishing up the book when COVID-19 broke out a year ago, and quickly revised the manuscript to include it. 

One theme of the book is that the spread of modern epidemics is not all that different from the way the plague unfolded in the 14th century, killing millions. A contagious disease is introduced to a population with no resistance; general deficiencies in health and hygiene exacerbate individual vulnerability and the spread of the disease; and there’s little effective treatment. In the 20th and 21st centuries, additional interrelated factors contributing to viral outbreaks include population density, deforestation, urbanization, global travel, poverty and substandard living conditions, recurrent global conflicts, and climate change.

The authors also point out that since 1940, “60% of human infectious diseases have been caused by pathogens that originated in animals,” including, of course, HIV, SARS, Zika, and now COVID-19. Long before the current pandemic, “disease experts predicted the next major outbreak would be caused by a virus that had jumped from an animal to infect humans.” COVID-19 “proves how right they were.”

Each chapter in the book begins with a personal narrative “to bring home the concept that no matter where we live, no matter how privileged our circumstances, we are all at risk for viral epidemic disease.”

By exploring pandemics, the context in which they occur, and the response, the authors hope that “lessons of the past” might help us “see how to best achieve a timely and effective response in the future.”