This isn't the first global pandemic, and it won't be the last. Here's what we've learned from 4 others throughout history

The course of human history has been shaped by infectious diseases, and the current crisis certainly won’t be the last time.

However, we can capitalise on the knowledge gained from past experiences, and reflect on how we’re better off this time around.

Read more: Four of the most lethal infectious diseases of our time and how we're overcoming them

1. The Plague, or ‘Black Death’ (14th Century)

While outbreaks of the plague (caused by the bacterium Yersinia pestis) still occur in several parts of the world, there are two that are particularly infamous.

The 200-year long Plague of Justinian began in 541 CE, wiping out millions in several waves across Europe, North Africa and the Middle East and crimping the expansionary aspirations of the Roman Empire (although some scholars argue that its impact has been overstated).

Then there’s the better known 14th century pandemic, which likely emerged from China and decimated populations in Asia, Europe and Northern Africa.

Perhaps one of the greatest public health legacies to have emerged from the 14th century plague pandemic is the concept of “quarantine”, from the Venetian term “quarantena” meaning forty days.

The 14th century Black Death pandemic is thought to have catalysed enormous societal, economic, artistic and cultural reforms in Medieval Europe. It illustrates how infectious disease pandemics can be major turning points in history, with lasting impacts.

For example, widespread death caused labour shortages across feudal society, and often led to higher wages, cheaper land, better living conditions and increased freedoms for the lower class.

Various authorities lost credibility, since they were seen to have failed to protect communities from the overwhelming devastation of plague. People began to openly question long held certainties around societal structure, traditions, and religious orthodoxy.

This prompted fundamental shifts in peoples’ interactions and experience with religion, philosophy, and politics. The Renaissance period, which encouraged humanism and learning, soon followed.

The Black Death also had profound effects on art and literature, which took on more pessimistic and morbid themes. There were vivid depictions of violence and death in Biblical narratives, still seen in many Christian places of worship across Europe.

How COVID-19 will reshape our culture, and what unexpected influence it will have for generations to come is unknown. There are already clear economic changes arising from this outbreak, as some industries rise, others fall and some businesses seem likely to disappear forever.

COVID-19 may permanently normalise the use of virtual technologies for socialising, business, education, healthcare, religious worship and even government.

2. Spanish influenza (1918)

The 1918 “Spanish Flu” pandemic’s reputation as one of the deadliest in human history is due to a complex interplay between how the virus works, the immune response and the social context in which it spread.

It arose in a world left vulnerable by the preceding four years of World War I. Malnutrition and overcrowding were common.

Around 500 million people were infected – a third of the global population at the time - leading to 50-100 million deaths.

A unique characteristic of infection was its tendency to kill healthy adults between the ages of 20 and 40.

At the time, influenza infection was attributed to a bacterium (Haemophilus influenzae) rather than a virus. Antibiotics for secondary bacterial infections were still more than a decade away, and intensive care wards with mechanical ventilators were unheard of.

Clearly, our medical and scientific understanding of the ‘flu in 1918 made it difficult to combat. However, public health interventions, including quarantine, the use of face masks and bans on mass gatherings helped limit the spread in some areas, building on prior successes in controlling tuberculosis, cholera and other infectious diseases.

Australia imposed maritime quarantine, requiring all arriving ships to be cleared by Commonwealth Quarantine Officials before disembarkation. That likely delayed and reduced the Spanish flu impact on Australia, and had secondary effects on the other Pacific Islands.

The effect of maritime quarantine was most striking in Western and American Samoa, with the latter enforcing strict quarantine and experiencing no deaths. By contrast, 25% of Western Samoans died, after influenza was introduced by a ship from New Zealand.

In some cities, mass gatherings were banned, and schools, churches, theatres, dance and pool halls closed.

In the United States, cities that committed earlier, longer and more aggressively to social distancing interventions, not only saved lives, but also emerged economically stronger than those that didn’t.

Face masks and hand hygiene were popularised and sometimes enforced in cities.

In San Francisco, a Red Cross-led public education campaign was combined with mandatory mask-wearing outside the home.

This was tightly enforced in some jurisdictions by police officers issuing fines, and at times using weapons.