The Worst Pandemics to Ever Hit the Philippines

The last few months have seen an unexpected upending of the modern way of life. Countries all over the world have been instituting quarantine and lockdown efforts in order to contain the spread of the novel coronavirus, now named COVID-19 by the World Health Organization (WHO). COVID-19, first described as a “pneumonia of unknown origin,” was first discovered in Wuhan, Hubei Province in China in late December 2019.

After its spread through mainland China and other countries, it was declared a Public Health Emergency of International Concern by WHO on January 30, 2020. By March 11, WHO declared it was a pandemic, urging countries to ramp up their responses to the virus in order to curb the spread. As of April 3, 2020, COVID-19 has infected over 1 million people worldwide, causing 53,238 deaths, affecting 204 countries and territories.

Response to the pandemic has been varied, but recent weeks have seen a slew of countries all over the globe restricting travel, limiting internal movements, and increasing social distancing measures. Business Insider has collated a list of countries currently implementing lockdown measures, which includes Italy, China, France, India, Poland, the UK, and more. Additionally, Philippine President Rodrigo Duterte declared a month-long lockdown of Metro Manila from March 15 to April 14, which was later extended to include the entire island of Luzon.

The effects of the global response to COVID-19 seem likely to turn COVID-19 from a health crisis into an economic one. According to the World Economic Forum, travel restrictions and subsequent disruptions have cost the global airline industry over USD$ 880 billion. While travel restrictions may slow down the rate of infections, this slowdown in the flow of goods and people has far-reaching effects that many economists warn could last for months or years.

Harvard Business Review writes that the world is currently undergoing a global recession, which other experts fear could turn into a depression. As scientists and governments struggle to understand the disease and develop a vaccine, ordinary citizens will have to struggle to adjust to a new way of life over the coming months. But despite the shock to 21^st lifestyles and economy, COVID-19 certainly isn’t the first pandemic to hit Philippine shores. Here’s a short list of the worst pandemics to ever hit the Philippines.

Epidemic vs Pandemic

In order to understand the scale of the current situation and similar occurrences throughout history, it’s important to define pandemic as a term. A pandemic can be said to be a type of epidemic, which is more or less defined as the outbreak and spread of a disease that infects many individuals at roughly the same time. Pandemics are epidemics on a wider geographic scale, and while there may be some level of semantic ambiguity as to when an epidemic can turn into a pandemic, guidance on this will usually come from the World Health Organization.

WHO employs a pandemic meaning that includes the idea of simultaneity, meaning that a true influenza pandemic can only be called such when there is an almost simultaneous worldwide transmission. Thus, while there are seasonal flu strains that affect several countries at a time, there’s a need for widespread, simultaneous infection before it can be declared a global pandemic.

1918 Flu Pandemic

Perhaps the first and most severe pandemic to ever hit Philippine shores was the 1918-1919 flu pandemic, also known as Spanish flu. The Center for Disease Control says that while there is no universal consensus for where the 1918 influenza originated, it first emerged in the US in spring 1918 in military personnel. By the end of 1920 it was estimated to have killed anywhere from 17 to 50 million people worldwide.

The 1918 influenza is significant not only because of the high death toll, but because it occurred concurrently with the First World War. In order to keep up the morale of their troops, countries censored coverage of the spread of the disease. As Spain was neutral during World War I, journalists and newspapers were able to write freely about the scale of the influenza in the country, which led many to suppose that Spain was particularly hard hit. Although Spain wasn’t more affected than many countries, the strain was eventually referred to as the Spanish flu in popular culture.

The 1918 influenza was caused by the H1N1 influenza virus strain, which was also eventually the cause of the 2009 flu pandemic. It had three waves, starting in March 1918 and ending by around summer 1919. The second wave was considered the most fatal, with the vast majority of deaths occurring during the period of October to December 1918. Unlike seasonal influenza strains, which claim mostly the very young and the very old, the Spanish flu had a ‘W’ curve, meaning that there were high numbers of death among the young and otherwise healthy 25 to 35 year olds.

Francis Gealogo writes that the first wave of the pandemic in the Philippines originated in Manila, among laborers working along the waterfront of Manila’s ports. While evidence showed that the virus came from outside sources, the colonial American government chose to declare the virus as trancazo, implying that it was simply a more virulent strain of the local flu.

The situation in the Philippines during the 1918 influenza was particularly distinct, as the Health Service was in the middle of the process of ‘Filipinization’ when the virus hit. The attempted shift of the government to move from colonial American guidance to local Filipino autonomy made for a politically-charged period, which in turn affected the way that the government responded to the pandemic.

Besides this, the colonial government was also preparing for local troops to help in the war effort. Camp Claudio in particular became hotspots for the spread of the virus thanks to close quarters and poor sanitation. The virus was also not limited to Manila, and spread all over the country. In the end, the total number of deaths in the Philippines due to the 1918 flu numbered from around 70,000 to 90,000.

2009 Flu Pandemic

The 2009 flu pandemic, also known as the 2009 swine flu or A(H1N1), was the first global flu pandemic in over 40 years and eventually led to the deaths of an estimated 500,000 people worldwide, according to the CDC. The first cases of the strain in humans were picked up in Mexico around March 2009. In the same month, widespread influenza activity was reported in the USA, with several samples confirmed to be the novel virus strain A(H1N1).

By late April, WHO declared the A(H1N1) outbreak a pandemic. The virus quickly spread to Canada and countries in the European Union, before later entering the African continent and the Asia-Pacific region. By June 2009, WHO announced that the pandemic was in Phase 6, which is a pandemic phase characterized by a community-level outbreak in a different WHO region from Phase 5— otherwise known as a global pandemic. The pandemic was officially declared over by August 2010.

In the Philippines, the first case of A(H1N1) was found to have come from a 10-year-old female who had been vacationing in Texas, USA with her family. The virus entered the country on May 21, 2009, and later again by two women from Taiwan who attended a wedding in Zambales. The first death in the country, and in Asia, was of a 49-year-old female employee of the Philippine Congress on June 19, 2009.

The 2009 flu pandemic primarily affected children and the middle-aged, and was found to be less severe than previous pandemics. The Department of Health (DOH) officially counted 8 deaths due to A(H1N1). However, the European Center for Disease Prevention and Control (ECDC) counted 28 deaths, 20 additional to the DOH’s official count. The outbreak led to school suspensions, changes in religious rituals, travel advisories, and other government action.

2020 COVID-19 Pandemic

The first case of the novel coronavirus (2019-nCoV, also known as COVID-19) may have emerged in Wuhan, Hubei in China, a new report by the South China Morning Post has found. However, it wasn’t recognized as a novel disease until December 2019, and was reported to the World Health Organization China Office by the Chinese government on December 31, 2019.

The symptoms of COVID-19 include fever, cough, and shortness of breath. Like the Middle East Respiratory Syndrome (MERS) coronavirus, its incubation period is currently said to be around 2-14 days after exposure, though there are some reports of symptoms appearing up to 27 days later. COVID-19 is genetically related to the SARS coronavirus, hence its virus name SARS-CoV-2.

While 80% of COVID-19 infections are mild, the virus has a higher mortality rate than seasonal flu and can be more deadly, especially for the immunocompromised or elderly. Fears that an uptick in cases could overwhelm hospital systems all over the world has led governments all over the world to implement social distancing measures in the hopes of slowing the rates of infection. Governments all over the world have gone on lockdown, implementing school closures and work from home measures when possible.

The Philippines’ first case of COVID-19 was confirmed in Metro Manila in San Lazaro Hospital on January 30, 2020. The patient in question was a 38-year-old woman from China. ABS-CBN reported the first death in the country due to COVID-19 on February 2, which also marked the first death outside of China. The first confirmed case of local transmission was reported on March 7.

According to the DOH tracker, there are 3,108 confirmed cases of COVID-19 in the country as of April 3, 2020. Of these, there have been 52 recoveries and 136 deaths. In order to stop the spread of the virus, the Philippine government has implemented measures such as school suspensions, travel bans and restrictions. The island of Luzon was declared to be under enhanced community quarantine on March 16, up to April 12.

On March 25, President Duterte signed the ‘Bayanihan Heal As One’ Act, which grants him special powers to address the COVID-19 outbreak. There are several testing centers equipped to test for the new coronavirus, including the Research Institute for Tropical Medicine (RITM) in Muntinlupa. The DOH has instituted plans to conduct massive testing of persons suspected to have COVID-19 by April 14 thanks to an increase in available testing kits and accredited testing centers.