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Visualizing the History of Pandemics

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The History of Pandemics

Pan·dem·ic /panˈdemik/ (of a disease) prevalent over a whole country or the world.

As humans have spread across the world, so have infectious diseases. Even in this modern era, outbreaks are nearly constant, though not every outbreak reaches pandemic level as COVID-19 has.

Today’s visualization outlines some of history’s most deadly pandemics, from the Antonine Plague to the current COVID-19 event.

A Timeline of Historical Pandemics

Disease and illnesses have plagued humanity since the earliest days, our mortal flaw. However, it was not until the marked shift to agrarian communities that the scale and spread of these diseases increased dramatically.

Widespread trade created new opportunities for human and animal interactions that sped up such epidemics. Malaria, tuberculosis, leprosy, influenza, smallpox, and others first appeared during these early years.

The more civilized humans became – with larger cities, more exotic trade routes, and increased contact with different populations of people, animals, and ecosystems – the more likely pandemics would occur.

Here are some of the major pandemics that have occurred over time:

NameTime periodType / Pre-human hostDeath toll
Antonine Plague165-180Believed to be either smallpox or measles5M
Japanese smallpox epidemic735-737Variola major virus1M
Plague of Justinian541-542Yersinia pestis bacteria / Rats, fleas30-50M
Black Death1347-1351Yersinia pestis bacteria / Rats, fleas200M
New World Smallpox Outbreak1520 – onwardsVariola major virus56M
Great Plague of London1665Yersinia pestis bacteria / Rats, fleas100,000
Italian plague1629-1631Yersinia pestis bacteria / Rats, fleas1M
Cholera Pandemics 1-61817-1923V. cholerae bacteria1M+
Third Plague1885Yersinia pestis bacteria / Rats, fleas12M (China and India)
Yellow FeverLate 1800sVirus / Mosquitoes100,000-150,000 (U.S.)
Russian Flu1889-1890Believed to be H2N2 (avian origin)1M
Spanish Flu1918-1919H1N1 virus / Pigs40-50M
Asian Flu1957-1958H2N2 virus1.1M
Hong Kong Flu1968-1970H3N2 virus1M
HIV/AIDS1981-presentVirus / Chimpanzees25-35M
Swine Flu2009-2010H1N1 virus / Pigs200,000
SARS2002-2003Coronavirus / Bats, Civets770
Ebola2014-2016Ebolavirus / Wild animals11,000
MERS2015-PresentCoronavirus / Bats, camels850
COVID-192019-PresentCoronavirus – Unknown (possibly pangolins)848K (Johns Hopkins University estimate as of 10:28am PT, Aug 31, 2020)

Note: Many of the death toll numbers listed above are best estimates based on available research. Some, such as the Plague of Justinian and Swine Flu, are subject to debate based on new evidence.

Despite the persistence of disease and pandemics throughout history, there’s one consistent trend over time – a gradual reduction in the death rate. Healthcare improvements and understanding the factors that incubate pandemics have been powerful tools in mitigating their impact.

Wrath of the Gods

In many ancient societies, people believed that spirits and gods inflicted disease and destruction upon those that deserved their wrath. This unscientific perception often led to disastrous responses that resulted in the deaths of thousands, if not millions.

In the case of Justinian’s plague, the Byzantine historian Procopius of Caesarea traced the origins of the plague (the Yersinia pestis bacteria) to China and northeast India, via land and sea trade routes to Egypt where it entered the Byzantine Empire through Mediterranean ports.

Despite his apparent knowledge of the role geography and trade played in this spread, Procopius laid blame for the outbreak on the Emperor Justinian, declaring him to be either a devil, or invoking God’s punishment for his evil ways. Some historians found that this event could have dashed Emperor Justinian’s efforts to reunite the Western and Eastern remnants of the Roman Empire, and marked the beginning of the Dark Ages.

Luckily, humanity’s understanding of the causes of disease has improved, and this is resulting in a drastic improvement in the response to modern pandemics, albeit slow and incomplete.

Importing Disease

The practice of quarantine began during the 14th century, in an effort to protect coastal cities from plague epidemics. Cautious port authorities required ships arriving in Venice from infected ports to sit at anchor for 40 days before landing — the origin of the word quarantine from the Italian “quaranta giorni”, or 40 days.

One of the first instances of relying on geography and statistical analysis was in mid-19th century London, during a cholera outbreak. In 1854, Dr. John Snow came to the conclusion that cholera was spreading via tainted water and decided to display neighborhood mortality data directly on a map. This method revealed a cluster of cases around a specific pump from which people were drawing their water from.

While the interactions created through trade and urban life play a pivotal role, it is also the virulent nature of particular diseases that indicate the trajectory of a pandemic.

Tracking Infectiousness

Scientists use a basic measure to track the infectiousness of a disease called the reproduction number — also known as R0 or “R naught.” This number tells us how many susceptible people, on average, each sick person will in turn infect.

Measles tops the list, being the most contagious with a R0 range of 12-18. This means a single person can infect, on average, 12 to 18 people in an unvaccinated population.

While measles may be the most virulent, vaccination efforts and herd immunity can curb its spread. The more people are immune to a disease, the less likely it is to proliferate, making vaccinations critical to prevent the resurgence of known and treatable diseases.

It’s hard to calculate and forecast the true impact of COVID-19, as the outbreak is still ongoing and researchers are still learning about this new form of coronavirus.

Urbanization and the Spread of Disease

We arrive at where we began, with rising global connections and interactions as a driving force behind pandemics. From small hunting and gathering tribes to the metropolis, humanity’s reliance on one another has also sparked opportunities for disease to spread.

Urbanization in the developing world is bringing more and more rural residents into denser neighborhoods, while population increases are putting greater pressure on the environment. At the same time, passenger air traffic nearly doubled in the past decade. These macro trends are having a profound impact on the spread of infectious disease.

As organizations and governments around the world ask for citizens to practice social distancing to help reduce the rate of infection, the digital world is allowing people to maintain connections and commerce like never before.

Editor’s Note: The COVID-19 pandemic is in its early stages and it is obviously impossible to predict its future impact. This post and infographic are meant to provide historical context, and we will continue to update it as time goes on to maintain its accuracy.

Update (March 15, 2020): We’ve adjusted the death toll for COVID-19, and will continue to update on a regular basis.

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Politics

Animated Map: U.S. Presidential Voting History by State (1976-2016)

With this map of U.S. presidential voting history by state, discover patterns that have emerged over the last eleven elections.

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U.S. Presidential Voting History by State

U.S. Presidential Voting History by State

As Americans go to cast their votes, considerable uncertainty remains about which candidate will be elected president. However, history can provide some clues as to how voters may act.

While some states have consistently seen Democrat or Republican victories, other “swing states” have flipped between the two parties depending on the year.

In this graphic, we use data from the MIT Election Data and Science Lab to show U.S. presidential voting history by state since 1976.

Each State’s Winning Party

To calculate the winning ratio, we divided the votes for the state’s winning party by the total number of state votes. Here’s another look at the same data, visualized in a different way.

U.S. Presidential Voting History by State

This graphic was inspired by this Reddit post.

As the voting history shows, some states—such as Alaska, Oklahoma, and Wyoming—have consistently supported the Republican Party. On the other hand, Hawaii, Minnesota, and the District of Columbia have been Democrat strongholds for many decades.

The District of Columbia (D.C.) is a federal district, and is not part of any U.S. State. Its population is urban and has a large percentage of Black and college-educated citizens, all of which are groups that tend to identify as Democrat.

Swing states typically see a close contest between Democrats and Republicans. For example, Florida’s average margin of victory for presidential candidates has been just 2.6% since 1996, by far the lowest of any state. It’s often seen as a key battleground, and for good reason: the candidate who wins Florida has won every election since 1964.

Memorable Election Years

Within U.S. Presidential voting history, some election results stand out more than others. In 1984, President Reagan was re-elected in a landslide victory, winning 49 out of 50 states. The remarkable win has been credited to the economic recovery during Reagan’s first term, Reagan’s charisma, and voters’ opposition to the Democrat’s planned tax increases.

In 1992, self-made Texas billionaire Ross Perot ran as a third-party candidate. He captured almost 19% of the popular vote, the highest percentage of any third-party presidential candidate in over 80 years. While he gained support from those looking for a change from traditional party politics, Bill Clinton ultimately went on to win the election.

Most recently, the 2016 election took many people by surprise. Despite having a strong lead in the polls, Hillary Clinton was defeated by Donald Trump. A total of 30 states saw Republican victories, eager for change after eight years of Democrat leadership.

A Look Ahead

Is it possible to predict the 2020 presidential election? As the last election showed, polls are not a perfect measure. They represent a snapshot in time, may overrepresent certain population groups, and measure voter attitudes rather than behaviors, among other factors.

While there’s no crystal ball, swing states may offer the most insight as to where things are heading. Here are nine states that have been identified as battlegrounds, and how they voted in the 2016 election.

 2016 Winning Ratio2016 Margin of Victory
Arizona48.7% Republican3.6%
Florida49.0% Republican1.2%
Georgia50.8% Republican5.2%
Iowa51.2% Republican9.4%
Michigan47.5% Republican0.2%
North Carolina49.8% Republican3.6%
Ohio51.7% Republican8.1%
Pennsylvania48.9% Republican0.7%
Wisconsin47.2% Republican0.7%

All saw Republican victories, but six out of nine states won by a margin of less than 5%. Trump and Biden’s success in these states may well determine the outcome of the 2020 election.

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Misc

The 50 Highest Cities in the World

Where are the world’s highest cities? This graphic ranks the world’s major urban centers by altitude above sea level.

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Where Are The World’s Highest Cities?

When comparing the world’s cities to one another, we often use defining characteristics—largest, greenest, most visited, highest-earning, the list goes on.

Yet elevation is often overlooked, despite the fact that thousands of cities across the globe are nestled in highlands, plateaus, and mountain ranges.

Today’s graphic looks at the top 50 highest cities worldwide, and compares their altitudes to well-known references (the differences are dizzying).

Cities in the Sky

When ranking the world’s highest cities, we specifically looked at major urban centers with a population of one million or more inhabitants, with an elevation “floor” of 1,000m.

Though you might expect less important cities to make the rankings, 22 out of the 50 highest cities are actually national capitals.

The elevation data comes from the European Commission’s database of urban centers, using Thomas Brinkhoff’s City Population dataset for updated demographics.

RankUrban CenterCountryRegionAverage Elevation (m)
#1La PazBoliviaSouth America3,869
#2QuitoEcuadorSouth America2,784
#3TolucaMexicoCentral America2,648
#4CochabambaBoliviaSouth America2,621
#5BogotaColombiaSouth America2,601
#6Addis AbabaEthiopiaEastern Africa2,361
#7Mexico CityMexicoCentral America2,316
#8XiningChinaEastern Asia2,299
#9Sana'aYemenWestern Asia2,283
#10PueblaMexicoCentral America2,176
#11KunmingChinaEastern Asia1,924
#12San Luis PotosíMexicoCentral America1,873
#13LeónMexicoCentral America1,845
#14KabulAfghanistanSouth-Central Asia1,845
#15NairobiKenyaEastern Africa1,702
#16DenverUnited StatesNorthern America1,673
#17MedellínColombiaSouth America1,651
#18JohannesburgSouth AfricaSouthern Africa1,624
#19SrinagarIndiaSouth-Central Asia1,598
#20LanzhouChinaEastern Asia1,594
#21IsfahanIranSouth-Central Asia1,587
#22GuadalajaraMexicoCentral America1,583
#23ShirazIranSouth-Central Asia1,571
#24HarareZimbabweEastern Africa1,479
#25KigaliRwandaEastern Africa1,473
#26Guatemala CityGuatemalaCentral America1,463
#27TabrizIranSouth-Central Asia1,449
#28PretoriaSouth AfricaSouthern Africa1,365
#29KermanshahIranSouth-Central Asia1,359
#30KathmanduNepalSouth-Central Asia1,353
#31UlaanbaatarMongoliaEastern Asia1,326
#32AntananarivoMadagascarEastern Africa1,271
#33LusakaZambiaEastern Africa1,257
#34LubumbashiDemocratic Republic of the CongoMiddle Africa1,252
#35TehranIranSouth-Central Asia1,239
#36KampalaUgandaEastern Africa1,187
#37GuiyangChinaEastern Asia1,185
#38BrasiliaBrazilSouth America1,184
#39Ciudad JuárezMexicoCentral America1,164
#40BeniDemocratic Republic of the CongoMiddle Africa1,149
#41TorreonMexicoCentral America1,132
#42San JoséCosta RicaCentral America1,129
#43YinchuanChinaEastern Asia1,113
#44CalgaryCanadaNorthern America1,095
#45HohhotChinaEastern Asia1,069
#46BaotouChinaEastern Asia1,061
#47DatongChinaEastern Asia1,059
#48YerevanArmeniaWestern Asia1,058
#49CaracasVenezuelaSouth America1,018
#50MashhadIranSouth-Central Asia1,011

At the top of the pantheon is Bolivia’s El Alto-La Paz metropolitan area, which houses more than two million people at an average elevation of 3,869m above sea level. That’s a city of two million people situated more than 100 meters higher than Mount Fuji in Japan.

The next four are more than 1,000m lower than El Alto-La Paz, with Ecuador’s capital Quito coming in at second place at 2,784m and Colombia’s capital Bogotá rounding out the top five at 2,601m. For reference, that’s more than 100 meters higher than the world-famous Inca citadel Machu Picchu in Peru, which sits at a height of 2,430m.

It’s notable just how mountainous Latin America is. Of the 10 highest cities, three are in Mexico’s many mountainous regions and four of the top five are adjacent to the Andes Mountains.

Asia and the Americas Tower Above

Though it might be expected that countries would have their population centers close to sea level, many instead have followed in the footsteps of past civilizations by building in higher regions.

In addition to many capitals in South America, that list of major cities includes Mexico City, easily the largest on the list as the world’s 8th largest metropolis, Addis Ababa, the capital and largest city in Ethiopia, Tehran, the capital of Iran and most populous city in Western Asia, and Johannesburg, the largest city in South Africa.

The countries with the most high cities were China and Mexico, with eight each. China specifically had the most high metropolises in Asia, and many of the world’s highest settlements, though most of its major cities lie outside the Tibetan and Mongolian Plateaus.

Regional Breakdown of Top 50 Highest Cities
Central America10
Eastern Asia9
South-Central Asia9
South America7
Eastern Africa7
Middle Africa2
Southern Africa2
Western Asia2
Northern America2
Europe0
Oceania0

As the table above highlights, while wide mountainous regions are concentrated in much of Asia, Latin America, and Africa, the Western world is largely located close to the water.

The West Sits Below

The U.S. and Canada each only had one city each crack the top 50 list: the Rocky Mountain-adjacent cities of Denver and Calgary.

Meanwhile, despite the European Alps stretching across eight countries and both Australia and New Zealand having many mountains tall enough to crack the list, both Europe and Oceania had no major city situated more than 1,000m above sea level.

But though most of humanity remains concentrated near sea level, it is impressive to remember that hundreds of millions of people live in cities higher than Dubai’s Burj Khalifa, the world’s highest tower.

In fact, studies have shown that living at higher altitudes has associated health benefits, including better cardiovascular health and lower incidence of stroke and cancer.

Regardless if future trends push more people thousands of meters into the sky, humanity has proven that it can prosper.

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