2018-01-09 From nytimes.com

The influenza season is just getting started in the United States, and it already promises to be more severe than usual. Hospital emergency rooms are filling up with flu sufferers, and pharmacies have reported medicine shortages. Twelve children had died as of last month. To make matters worse, in Australia, which experienced its flu season four to six months ago, the current vaccine appeared to be only about 10 percent effective against this year’s dominant strain.

Yet as bad as this winter’s epidemic is, it won’t compare with the flu pandemic that is almost certainly on the horizon if we don’t dedicate energy and resources to a universal vaccine.

Influenza pandemics occur when a novel animal flu virus acquires the ability to infect humans and they, in turn, transmit it to other humans. The 1918-19 Spanish flu epidemic (which despite the name may have originated in the American Midwest) killed 50 million to 100 million around the globe. Accounts at the time described people falling ill in the morning and dying that night.

Given the century of medical progress since then, one might conclude that we are far better prepared today to deal with such a worldwide catastrophe. Unfortunately, the opposite is true.

The world has about four times the number of inhabitants it did in 1918, including hundreds of millions of people, poultry and pigs living close together. This provides a potent biologic mixing bowl and natural influenza virus mutation factory. What’s more, nearly any point on the planet is accessible to any other point within hours, and there are more than a billion international border crossings each year. The virus will spread rapidly. 

When a pandemic does strike, we’ll be in trouble in part because American hospitals and pharmacies keep in stock no more than a few days supply of most lifesaving drugs, almost all of which are made in Asia. Worldwide manufacturing and shipping are highly susceptible to disruption, which could mean shortages in many areas.

A 1918-type influenza pandemic could cause ruin on the order of what the Black Death did to 14th-century Europe, but on a global scale. Like the Black Death, such a pandemic would alter the course of history.

Read more here