Please rotate your device to landscape mode to view the charts.

What can we learn from historical pandemics? A systematic review of the literature

Journal: Social Science & Medicine

Date: 2024

Author: Aine Doran, Christopher L. Colvin, Eoin McLaughlin

Abstract:
What are the insights from historical pandemics for policymaking today? We carry out a systematic review of the literature on the impact of pandemics that occurred since the Industrial Revolution and prior to Covid-19. Our literature searches were conducted between June 2020 and September 2023, with the final review encompassing 169 research papers selected for their relevance to understanding either the demographic or economic impact of pandemics. We include literature from across disciplines to maximise our knowledge base, finding many relevant articles in journals which would not normally be on the radar of social scientists. Our review identifies two gaps in the literature: (1) the need to study pandemics and their effects more collectively rather than looking at them in isolation; and (2) the need for more study of pandemics besides 1918 Spanish Influenza, especially milder pandemic episodes. These gaps are a consequence of academics working in silos, failing to draw on the skills and knowledge offered by other disciplines. Synthesising existing knowledge on pandemics in one place provides a basis upon which to identify the lessons in preparing for future catastrophic disease events.

Link: Google Scholar

Background and Context

Systematic Review Scope

The authors conducted a systematic review of 169 research papers on historical pandemics that occurred since the Industrial Revolution and prior to COVID-19.

Research Timeline

Literature searches were conducted between June 2020 and September 2023, exploring both demographic and economic impacts of historical pandemics.

Interdisciplinary Approach

The study incorporated literature from across disciplines to maximize knowledge, including articles from journals not typically on social scientists' radar.

1918 Spanish Influenza Dominates Pandemic Research Focus

97 papers 1918 Spanish Influenza 38 papers 2009 Swine Flu 13 papers 1957 Asian Flu 8 papers 1968 Hong Kong Flu 8 papers SARS (2002-04) 5 papers 1889-90 Influenza Research has focused primarily on 1918, creating knowledge gaps
  • The 1918 Spanish Influenza accounts for 97 of the 169 papers included in the systematic review.
  • "Milder" pandemics like the Asian Flu and Hong Kong Flu are notably understudied by comparison.
  • This overconcentration on 1918 limits our understanding of the full range of pandemic experiences.

Different Pandemics Show Distinct Age-Mortality Patterns

  • The 1918 Spanish Influenza had a distinctive "W-shaped" mortality curve with high deaths among young adults.
  • Other pandemics like the 1889-90 Influenza and COVID-19 show "J-shaped" curves with mortality increasing with age.
  • These different patterns suggest future pandemics might target different age groups, requiring flexible preparedness strategies.

Rising Interest in Historical Pandemic Research with Notable Spikes

  • Publication on historical pandemics has shown an overall upward trend over time.
  • Notable publication spikes occurred during the 2009 Swine Flu and 1918 centenary in 2018.
  • COVID-19 has sparked further interest, with renewed focus on learning from past pandemic experiences.

Academic Disciplines Working in Isolation Rather than Collaboration

Economics GDP impact focus Epidemiology Disease spread History Narrative focus Medicine Treatment focus Limited interdisciplinary collaboration despite regular calls for integration
  • Despite calls for interdisciplinary research, disciplines largely operate in separate silos with limited interaction.
  • Each discipline approaches pandemic research with different questions, methods, and datasets.
  • Greater cross-disciplinary collaboration would combine strengths from demography, epidemiology, economics, and history.

Unbalanced Research Focus Across Different Pandemic Impact Areas

  • Research disproportionately focuses on mortality impacts (65 papers) over other pandemic consequences.
  • Economic impacts (19 papers), morbidity (16 papers), and in-utero effects (17 papers) receive less attention.
  • This imbalance limits our understanding of the full spectrum of pandemic effects on society.

Contribution and Implications

  • Pandemics should be studied collectively rather than in isolation to identify common patterns and unique features.
  • Over-reliance on the 1918 Spanish Influenza as a reference point may distort pandemic preparedness policies.
  • Breaking down disciplinary silos would create more comprehensive understanding of pandemic impacts and responses.
  • More research on developing countries' pandemic experiences is needed as they differ from developed regions.
  • Historical data offers valuable lessons for current pandemic policy if approached with appropriate comparative methods.

Data Sources

  • The research focus visualization is based on Table 1, showing the distribution of papers across different pandemics.
  • The mortality curve patterns visualization is derived from Figure 6, illustrating "J" and "W" shaped mortality curves.
  • Publication trend data comes from Figure 4, showing the frequency of pandemic research publications over time.
  • The disciplinary silos visualization reflects the authors' findings about limited interdisciplinary collaboration throughout the paper.
  • The research impact areas chart uses data compiled from the 169 papers reviewed, categorized by their primary focus.