Why do we have pandemics?
Novel viruses have been a constant companion to the human race. With repeated exposure to a virus, however, our immunity often increases, providing protection against subsequent infection. The first time that we catch a virus, we have no immunity to the new illness, so sometimes severe symptoms can occur. In fact, when a novel virus emerges - for example with COVID-19 - millions of individuals can potentially be infected, causing symptoms in many.
It is not just our immunity that determines whether a virus will flourish, however. The characteristics of the virus itself will dictate how easily transmissible it is. Some recent viruses, such as the bird flu H7N9, are very poorly spread from human to human, making an epidemic in humans extremely unlikely. Other infections, such as the recent MERS virus, can be transmitted from human to human, but when that occurs a milder disease results. This is not true for those with various chronic diseases, however, as they can still be severely affected. It’s important to know that the general health of the person infected is a factor in whether they experience a more severe form of an infection. This is true of many illnesses, but is also presently seen with COVID-19, which is particularly severe in those with diabetes, severe lung diseases, and individuals with compromised immune systems.
It’s not just biological factors that determine whether a pandemic will occur. If new infections start in countries that have few public health resources, then they are unlikely to be efficiently controlled or treated. Conversely, resource-poor countries may have limited access to international travel, and a population generally unable to afford expensive air-fares: both these factors can lead to the virus having a delayed transmission to regions further afield, reducing the risk of a pandemic.
In general, if an outbreak of a highly infectious new virus, rapidly emerges in a technologically advanced country, the disease can quickly establish itself in several centres, possibly leading to infections in many countries and causing a pandemic - as has been seen with COVID-19.