One hundred years ago, the Spanish flu pandemic of 1918 caused nearly 100 million deaths, killing 5 percent of the world’s population at the time. People wore face masks in cities across America. Bodies were stacked on top of each other in morgues and hospitals.
“If the epidemic continues its mathematical rate of acceleration, civilization could easily disappear from the face of the earth within a few weeks,” Victor Vaughan, the dean of the Michigan Medical School, said at the time.
That didn’t happen. The Spanish flu eventually slowed thanks to non-pharmaceutical interventions, such as quarantining those who were infected, encouraging more hygienic practices, the use of face masks to cover coughs and more.
One hundred years later, we’re still not ready for a pandemic.
That’s according to the Scowcroft Institute of International Affairs at Texas A&M University, which released a report earlier this year warning that the United States is not ready for a pandemic.
“When scientists, policy-makers, and the lay public alike ask the question: ‘Are we ready for the next pandemic?’ The answer is always a qualified ‘No,’” the report reads.
The report says lack of cooperation between nations, medical supply chain issues, and antibiotic overuse is creating a dangerous situation.
Experts on pandemics believe America and the rest of the world could be in for another crisis in the not-too-distant future—and that President Trump’s isolationist foreign policy, his reluctance to utilize tech and science experts, and lack of funding to necessary scientific research could be escalating this problem. If a pandemic starts in another country, international cooperation is important for containing it, like during the Ebola outbreak in 2014.
There are two ways a pandemic could start. One: A virus that we don’t have the vaccine for and that may be resistant to antiviral drugs could spread and cause many deaths. Alternatively, an infectious bacteria that cannot be killed by our existing antibiotics could spread, which would mean we wouldn’t have the necessary medication to treat people who contracted that bacteria.
Andrew Natsios, director of the Snowcroft Institute and former U.S. Agency for International Development (USAID) administrator, said a pandemic could hit pretty much any time. He claims increasingly isolationist policies in America and beyond are affecting our preparation.
“International cooperation in a whole bunch of areas that should not be controversial, like handling the spread of disease, is now going to be much more difficult,” Natsios said. “We haven’t been tested yet.”
Natsios said the “breakdown of international cooperation” means the U.S. and other countries will be ill-prepared for a pandemic. He cited Trump pulling out of international agreements, Trump distancing America from its allies, and isolationism spreading in other regions, like Britain, as reasons international cooperation is not where it once was.
“We won’t know until the emergency takes place, but the evidence is certainly there that [isolationism] is very dangerous,” he said.
Natsios said that if one of the influenza viruses mutated, it could start spreading before a vaccine was developed for it and wreak havoc. He claims a more lethal version of the 2009 swine flu pandemic could kill millions of Americans in a relatively short period of time. Influenza is a “highly unstable virus, and it mutates constantly,” Natsios said. “That’s the problem with it.”
Because influenza mutates so frequently, Natsios said a vaccine that was eventually developed to prevent its spread would be useless six months later, because the virus will have mutated again.
Research indicates 2018’s flu vaccine is more effective compared to years past, but less than half of Americans bother to get the flu vaccine. Natsios said anti-vaxxers have complicated the flu shot’s ability to help keep infection at bay. Furthermore, this year’s flu vaccine is only around 36 percent effective, and we don’t currently create new vaccines as quickly as we would need to to quickly stop this mutated flu virus. Recent data shows the flu killed over 80,000 last year, and while that was the worst rate in around four decades, we’re at risk of multitudes more being killed if we end up facing the situation Natsios is depicting.
The most dangerous mutations are the ones that kill at a significant but lower rate, rather than a high rate. Viruses that kill at a high rate, perhaps 70 percent of the people it infects, disappear before they spread too far, because they typically kill the host before they can spread too far. A virus that kills between 5 and 10 percent of people causes many deaths because it spreads for a longer period of time.
These viruses can now spread more quickly partially thanks to rising population density and because we travel so quickly. “We have created the most efficient means for spreading highly infectious disease; It’s called the international airport,” Natsios said. He explained that airports help viruses and bacteria spread more easily, and all major airports would likely be shut down during a pandemic.
And it’s not just our physical health that would suffer during an influenza pandemic.
“It would kill millions, and it would collapse the economy,” Natsios predicted. Such a pandemic would cause mass panic and cost billions in damages, possibly causing the economy to go into a tailspin.
We also have to worry about bacterial infections, not just viruses, causing a pandemic. For one thing, we’re using too many antibiotics in the livestock sector, according to U.N. experts, which we in turn consume through our food. Second, we’re using antibiotics too much in our daily lives, according to scientists who are studying on antibiotic resistance. We’re also not producing new antibiotics quickly enough, so there aren’t sufficient options to try when several stop working against a certain bacteria. Antibiotic resistance is becoming an increasingly big issue.
In fact, the Wellcome Trust, a London-based biomedical research charity estimates that by 2050 roughly 10 million people per year will die due to antimicrobial resistance. Currently, around 2 million Americans get antibiotic-resistant infections each year.
Lance Price, a professor of environmental and occupational health at George Washington University and founding director of the Antibiotic Resistance Action Center, echoed Natsios’s warnings when it comes to isolationism, saying this administration is not showing the “leadership” needed to help prevent or prepare for the next pandemic, especially when it comes to cooperating with other countries.
“Antibiotic resistance is going to change our whole world,” Price said. “We have to attack this globally. These drug-resistant bacteria don’t respect political boundaries.”
Without proper antibiotics, something as simple as a urinary tract infection could spread to the kidneys and then the blood, which would make it a deadly. Sepsis caused by an infection reaching the blood kills up to 30 percent of patients, even with antibiotics still available.
“E. coli is one of the fastest of all of the bacterial species. It’s very quickly becoming resistant to all of our antibiotics,” Price said. “We see strains today that are resistant to all but one antibiotic, and E. coli causes 85 percent of all urinary tract infections.”
Christine Blackburn, an assistant research scientist at Texas A&M who works with Natsios, said that we should be anticipating a pandemic and preparing for it. She explained that this is not a hypothetical situation that is unlikely to actually occur.
“The most concerning thing about pandemics is that it will happen. It isn’t a question of if we will have one but when it will occur,” Blackburn said. “We need strong domestic and international leadership to make pandemic preparedness a top priority, provide funding, and prepare as much as possible to diagnose and respond.”