1918 flu Camp Funston

An emergency hospital at Camp Funston, Kansas where nurses and doctors tended to those infected with the 1918 Spanish Flu. The pandemic killed between 50-100 million people globally.


Otis Historical Archives, Nat'l Museum of Health & Medicine

Despite medical advances since 1918, when the so-called Spanish Flu sickened one-third of the global population and killed as many as 100 million people, the world is unprepared to contain the next major pandemic, according to physician and global health expert Dr. Jonathan Quick.

In his new book, "The End of Epidemics: The Looming Threat to Humanity and How to Stop It", Quick offers a road map for local, national and international actors who could prevent killer outbreaks in the future.

Quick’s book is timely, as this year’s unusually dangerous flu season has caused nationwide concern. Influenza is widespread in 48 states and is proving particularly deadly, with 4,000 flu-related deaths in just one week in January. The high end of the predicted mortality rate from this season’s flu strain is 56,000. Quick calls this “unacceptable.”

“The flu vaccine is one of the least consistent vaccines we have, because it's made each year based on the best scientific guesses of what particular strains of flu will hit us,” Quick says. “If we're right, we get 60 percent effectiveness, at best. When we’re wrong, we've gotten as little as 10 percent. We really need a much, much better flu vaccine.”

The numbers can be frightening. One worst-case scenario run by researchers estimates a particularly bad flu epidemic could cause up to 30 million cases within 200 days, hitting every major population center.

Then there’s the economic impact. Work by the Centers for Disease Control and Prevention shows that an average flu season costs the US economy more than $80 billion per year, of which about $10 billion is health expenditures. This year, the hit will be significantly larger.

About 10 years ago, Quick points out, renowned epidemiologist Michael T. Osterholm of the University of Minnesota called for investing $1 billion per year into research on a universal flu vaccine — a fraction of the annual cost of the flu in the US alone.

In addition, Quick says, the US must “invest in making sure that we have the best public health information in communities,” Quick says. “The fact is that good, basic, public health — personal prevention — is actually highly effective — more effective this year than the vaccine, as it turns out.”

And these are simple things, Quick notes: Proper hand washing, not just wet and dab, but a good 20 seconds with soap all over the hands and fingers; covering sneezes and coughs not with one's hands, which end up touching multiple surfaces, but with the sleeves; and staying home from school or work when sick with the flu.

In his book, Quick sounds the alarm not just about a deadly flu epidemic. Other diseases, such as Ebola or severe acure respiratory syndrome, or SARS, could also cause mass fatalities. To deal with potential epidemics, Quick has come up with a preparedness plan he calls the "Power of Seven": 

  1. Leadership that is courageous and decisive, does not dither or deny, but rises to the occasion and acts quickly.
  2. Build resilient health systems that can prevent and quickly respond to infectious disease.
  3. Fortify three lines of defense against disease: prevention, detection and response.
  4. Ensure accurate and timely communication.
  5. Innovation: new vaccines, new diagnostics and an even better early warning system.
  6. Invest wisely now to prevent disease before an epidemic strikes.
  7. Mobilize citizen activism.

“The threat of major epidemics and pandemics is real,” Quick warns. “The scientific and public health community know what to do, but we're not moving fast enough, with enough leadership and enough resources to protect us.”

This article is based on an interview that aired on PRI’s Living on Earth with Steve Curwood.

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