The novel coronavirus was declared a pandemic less than eight months ago and already it is among the deadliest health crises in history. The respiratory syndrome coronavirus 2, which causes COVID-19, was first detected in early December 2019. By late October 2020, more than 40.1 million people have been infected and over 1.1 million people around the world have died.

Vaccines to prevent the coronavirus disease have been in development for months. As of Oct. 13, 2020, four vaccines have begun large-scale clinical trials in the U.S., and more than 100 others are under development worldwide, according to the World Health Organization. However, an effective vaccine may not be available before the middle of next year.

The coronavirus disease outbreak is without a doubt one of the most serious international public health emergencies in recent memory, triggering lockdowns aimed at curbing the spread of the virus in many countries and devastating economies. If not contained soon, the devastation the virus causes may come close to the devastation wrought by some of history’s worst outbreaks. COVID-19 has already killed more people than other pandemics have during their runs of several years.

From the time of the pharaohs to the present day, epidemics and pandemics of diseases like the bubonic plague, cholera, influenza, and smallpox have had a cataclysmic impact on civilizations. These scourges changed history, accelerated the decline of empires, decimated armies, and molded cultures.

Click here to see the 20 worst outbreaks of all time ranked by death toll