The potential for a major pandemic with the COVID-19 virus remains high. The virus, which began in China, spreads daily around the world and the death rate seems to be higher than the seasonal flu.

This isn't the first epidemic or pandemic we've seen. A look at the past could provide a roadmap for how this virus will play out:

• The last pandemic we faced was in 2009 with the H1N1 flu virus. While it seemed serious at first, it turned out to be like a strong seasonal flu. There were deaths — around 81 in the state of Georgia — but the overall rate was around .02 percent of those infected. The infection rate was thought to be around 20 percent of the worldwide population. Locally, schools didn't close, but did take some precaution with cleaning and warning parents to keep sick children at home. A vaccine was created and given late in 2009 and the virus went into hiding.

• The 2003 SARS virus (also in the class of Coronaviruses) was terrifying. Like COVID-19, it began in China and spread to a number of other countries. SARS had a high death rate of around 10 percent, but it eventually fizzled out. Nobody in the U.S. died of SARS and there were only three confirmed cases in the state of Georgia. While it was more deadly, it may have been less contagious than COVID-19. More people have gotten COVID-19 and died in two months than did with SARS over eight months.

• The 1968 Hong Kong flu scared people and killed around one million around the world. But the overall death rate was low, around .5 percent. The Hong Kong flu hit local schools pretty hard, peaking here around early January 1969.

• The 1957 Asian Flu killed around 69,000 people in the U.S.

• The 1918-1920 Spanish Flu killed 50-100 million world wide and is the standard by which all other pandemics are measured. It was highly contagious infecting 33-50 percent of the population and it had a death rate of 10-20 percent in some places. The unusual thing about the Spanish Flu was that it tended to kill young, healthy people; most flu types tend to kill the old and the very young. It also came in waves over three years, killing then receding only to get bad again.

One of the lessons learned from 1918 is that communities which acted quickly to slow the flu had a lower overall mortality rate than those that didn't act as firmly.

In 1918, the response in Jackson County was mixed. Jefferson officials closed schools and churches for a few weeks and were pretty vocal about limiting other public gatherings. Of the 93 deaths we know of in Jackson County, 12 were in Jefferson. We don't know how aggressive the more rural communities were in 1918-1920 in limiting public gatherings, but some communities seemed to have a lot of deaths. A lot of children died here; those over age 50 who died were rare.

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Medical officials don't know a lot yet about COVID-19 or its outlook. It could become less intense as warmer weather increases; it could mutate to become less lethal, or to become more lethal; it could simmer slowly and then hit hard in a few months; or it could come in several waves as the 1918-1920 Spanish Flu did.

A best case scenario would be for the virus to mutate to a less contagious and less lethal form, or for it to subside as warm weather starts in the Northern Hemisphere.

Locally, a mild outbreak of the virus could force the closure of schools and day care centers for a short time. School officials said they would use their online capabilities to continue with some classes so that students could study from home.

School and recreation programs could also be affected for a short time with a mild outbreak.

School and daycare closures would have a ripple effect, however, with parents unable to work due to a lack of childcare.

A mild outbreak might also affect local restaurants as people could avoid large gatherings. Churches might also suspend services for a short time to help prevent the spread of the virus.

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In a worst-case scenario, all of the above would be mandated by an emergency order from the state or local government. All large gatherings would be prohibited in an effort to slow the spread of the virus. Many stores would close; businesses and industries might have to work in shifts to minimize exposure to large numbers of people.

The county would open its emergency command center to coordinate local needs. Likely, there would be locations available where people could be tested for the virus so that local officials could have a sense of how widespread the problem was and how it was expanding or contracting.

At the first signs of a major outbreak, local stores would probably see run on supplies as people prepared to shelter in place. Restocking those supplies might be difficult since that situation would be happening in many communities at the same time. Sickness could sideline distributors and truck drivers needed to deliver and restock food and other supplies.

If there were a food shortage, the county's EMA would try to coordinate a supply chain to distribute food in different locations around the county.

In a worst-case major outbreak, local hospitals and medical facilities could quickly be overwhelmed. A lack of beds would be one problem, as would a lack of ventilators needed to treat a large number of people seriously sickened by the virus.

Hospitals crowded with a highly-contagious virus could also lead to the spread of the disease to other sick patients and cause hospital mortality rates to rise. (The virus seems to hit older people with other underlying medical problems the hardest.)

If hospitals became overrun with virus patients, the county could open local shelters to house and provide some medical care. Providing a medical staff — nurses, doctors, etc. — might prove difficult and the level of care would have to be basic. Keeping medical personnel from getting sick is another problem in pandemic situations; keeping the shelters clean and supplied with food would be additional challenges.

Based on past pandemic data, a serious outbreak could infect around 30-40 percent of the population; how quickly that happened would be critical in how the county responds. If the infection took place over a period of weeks, the medical response would be eased. If it happened quickly, medical facilities could be overwhelmed.

While the exact mortality rate of the COVID-19 is still being investigated, it seems to be 1-to-3-percent rate of those infected. 

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The goal locally should be to slow the rate of spreading by acting quickly if the virus begins to show up in the community. The virus may still eventually infect a large number of people, but if that's done over several weeks or months, it could allow the local healthcare systems to absorb the shock better and in more manageable stages.

Nobody wants to close schools, daycare facilities, churches, sporting events and other public gatherings, but that appears to be the most effective way to slow down the spread of any disease.

As citizens, it's our responsibility to be prepared to deal with that kind of situation, if it should happen.

Let's hope it doesn't.

Mike Buffington is co-publisher of Mainstreet Newspapers, based out of Jefferson. He can be reached at mike@mainstreetnews.com

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