100 Years Ago, Influenza Killed 50 Million People. Could It Happen Again? (usatoday.com)

Last year 80,000 Americans died of the flu -- and 900,000 more were hospitalized, according to estimates by the U.S. Center for Disease Control and Prevention. NBC News reports: The numbers were shocking. Until now, CDC has said flu kills anywhere between 12,000 and 56,000 people a year, depending on how bad the flu season is, and that it puts between 250,000 and 700,000 into the hospital with serious illness. The numbers for the 2017-2018 flu season go far beyond that... Usually, flu hits first in one region and then another, but this past season saw widespread flu activity all at once, for weeks on end.
Coincidentally, it's the 100-year anniversary of the great flu pandemic of 1918, according to an article shared by schwit1: Up to 500 million people -- about one-third of the world's population -- became infected with the influenza virus, the Centers for Disease Control and Prevention says. As many as 50 million died, or one out of every 30 human beings on the planet, killing more American troops than those that died on World War I battlefields. The intensity and speed with which it struck were almost unimaginable, the worst global pandemic in modern history.
The article asks the ultimate question: Could it happen again? Top health and science groups, such as the World Health Organization, the National Academy of Sciences and the Centers for Disease Control and Prevention, predict influenza pandemics are nearly certain to recur. "Influenza viruses, with the vast silent reservoir in aquatic birds, are impossible to eradicate," the World Health Organization warned. "With the growth of global travel, a pandemic can spread rapidly globally with little time to prepare a public health response." A pandemic could also arise if a strain mutates with or develops directly from animal flu viruses, the CDC said...

In a near worst-case scenario, a new, lethal and highly infectious flu virus would break out in a crowded, unprepared megacity that lacks public health infrastructure, according to Johns Hopkins' Bloomberg School of Public Heath. Such a fast-moving virus could burst from a city and catch a ride with international travelers before public health officials realize what is happening.
The article points out that today there's now safeguards to detect and counteract influenza outbreaks that didn't exist in 1918 (including outbreak-detecting systems, as well as better antiviral drugs and the ability to develop vaccines more rapidly). But it also reminds us that the 1918 flu pandemic killed more people in two years than the plague did in an entire century.

The CDC recommends that every year, anyone six months of age or older should get a flu vaccine. But I'd be curious to hear from Slashdot's readers. Have you gotten your 2018 flu shot?

Comments

Here we go again

[Computer_kid]

Here comes all of the stories on how we are all gonna die from the flu.

Re: Here we go again

[Z00L00K]

It could be another disease, and it can happen again. The question is when.

Yeah, sure it can

[rsilvergun]

if we don't have a strong, coordinated response to a large scale outbreak yeah, it'll happen again. We haven't magically evolved somehow. We're still vulnerable to the same crap we always were.

This is kind of a sticking point for me. I know lots of folks who, because something bad hasn't happened recently or to them or their immediate family, they think it's a non issue. Like those folks who were vehemently opposed to background checks for guns until they were shot at or folks in favor of single payer healthcare because they lost their jobs after a stroke. People's inability or unwillingness to extrapolate never ceases to amaze and infuriate me...

Re:Yeah, sure it can

[alvinrod]

For something like the flu, I don't think there's much that can be done. A huge chunk of the population gets it every single year and you can't really vaccinate against it effectively, so if it's a particularly deadly strain it's going to kill a lot of people. It doesn't matter how good of a healthcare system you have, or what kind of coordinated response you think you have in place, because it will get overwhelmed.

About the only thing that can be done is to devise some way of treating viral infections or shutting them down, Basically something like antibiotics that can take out the virus or destroy enough of it to prevent people from getting ill to the point that it becomes fatal.

Re:Yeah, sure it can

[Anonymous Coward]

You can start your "coordinated response" with _mandating_ employers allow sick employees to either work from home where possible, or take time off. I realize a large portion of Slashdot may not have to endure that but there are a hell of a lot of people who DO. A single sick employee can take out an entire office. That includes basic HVAC maintenance (seriously change your damn filters).

Re:Yeah, sure it can

[Brett Buck]

Supportive health care has gotten MASSIVELY better since 1918, astronomically so. A similarly virulent strain would be bad, but nothing like as bad as it was, because a lot of people back then died due to lack of even basic supportive care.

      Of course, no one said it had to be the same level of virulence, it could be much worse, so ignoring the possibility doesn't make sense.

     

Re:Yeah, sure it can

[whoever57]

I have read many times that the flu shots will result in reduced symptoms, even if it doesn't prevent it entirely.

Flu shots will reduce the number of people who die from the flu.

Re:Yeah, sure it can

[glitch!]

For something like the flu, I don't think there's much that can be done. A huge chunk of the population gets it every single year and you can't really vaccinate against it effectively, so if it's a particularly deadly strain it's going to kill a lot of people.

I disagree with the first and agree with your second. After my first decade of life, I started getting serious lung infections and they came every two to four years. Usually it was some form of pneumonia and as a secondary infection from a simple cold or flu. It became a recurring fact of life. I would get sick several times a year, and sometimes it would bloom out into a lung infection. I used the stupid simple antibiotics (eg, amoxicillin) and even the "advanced" ones (azithromycin) but not much changed.

Leaving out detail here, I gave up sugar. And then I went low carb. And I do not get the flu or cold ever. EVER! I do take aspirin and/or small doses of prednisone for back pain, but that is all I take. And I never get sick any more. This is just one data point; use it any way you wish.

Re:Yeah, sure it can

[VeryFluffyBunny]

Supportive health care has gotten MASSIVELY better since 1918, astronomically so. A similarly virulent strain would be bad, but nothing like as bad as it was, because a lot of people back then died due to lack of even basic supportive care.

Of course, no one said it had to be the same level of virulence, it could be much worse, so ignoring the possibility doesn't make sense.

Yes, and not to mention the fact that, back 1918, there was extreme wealth inequality and the majority of people were poor and malnourished. It wasn't until after WWII that governments started to take public health and nutrition seriously because they realised that far too many military-age men we too unfit to fight for them in wars.

Public nutrition and health have got much better since 1918 but it is starting to look like it's starting to slip back with obesity, heart disease, child poverty, etc., making a lot of people very unhealthy and vulnerable to disease. Oh, there's a lot more elderly and infirm people around these days who are particularly vulnerable to the flu.

Re:Yeah, sure it can

[quantaman]

if we don't have a strong, coordinated response to a large scale outbreak yeah, it'll happen again. We haven't magically evolved somehow. We're still vulnerable to the same crap we always were.

This is kind of a sticking point for me. I know lots of folks who, because something bad hasn't happened recently or to them or their immediate family, they think it's a non issue. Like those folks who were vehemently opposed to background checks for guns until they were shot at or folks in favor of single payer healthcare because they lost their jobs after a stroke. People's inability or unwillingness to extrapolate never ceases to amaze and infuriate me...

Though I think we're much better able to have a strong, coordinated response now than 100 years ago.

1) Our ability to treat sick people is a lot better.
2) Wide scale distribution of surgical masks is way more feasible now than 100 years ago.
3) Lots of people can work remotely if need be.
4) Hygiene is way better.
5) Schools could even be closed if need be, with remote learning options used as much as possible.

Sure these are progressively more drastic actions, but if we're hitting even a 1% fatality rate I suspect most go into effect.

Re:Yeah, sure it can

[sjames]

It has gotten much better, but at the same time, resources are limited. During last year's flu season, the largest local hospital here had to bring in a mobile ER unit meant for disaster relief to handle overflow. It's not hard to imagine resources being completely overwhelmed if we get much worse one year.

Re:Yeah, sure it can

[Anonymous Coward]

When you gave up sugar...did you also simultaneously (and perhaps coincidentally) become less social? Go out to parties less frequently? Less sexually active, and with a much smaller (like, one or zero) group of people?

Because your story sounds a whole lot like mine. I used to get sick twice or so a year, every single year, sometimes getting lung infections requiring antibiotics. I tried many special diets and supplements, and nothing worked.

But I also became antisocial in my old age. I don't date. I don't go out to parties. I don't make out with people. I go to work, of course, but I don't touch people and I keep my hands clean and so on.

Now I never ever ever get sick. It just doesn't happen. Well, I did get food poisoning a few years ago when I ate at a restaurant.

Diseases are spread via social interaction. Get less of it, and your exposure goes down. Online communities are great for preventing loneliness.

Re:Yeah, sure it can

[allcoolnameswheretak]

I haven't been seriously ill since I started working out, on average three times per week, which I've been doing for about four years now. Haven't reported sick at my job since then.
Sometimes I get a mild irritation in the throat or nose area, but then it heals away before it gets any worse. I've never had a flu vaccine. In contrast, some of my colleagues who did get the vaccine still got a bad cold. But I understand the vaccines always target a few strains that are most likely to proliferate. Sometimes you get unlucky and the dominant strain of the year wasn't covered by the vaccine.

So I realize it can all come down to luck as well. Or where you live. The four years I didn't get sick also coincides with moving out from the city to a more quiet town. I guess less people means less chances for infections.
However I do get these irritations that my immune system defeats before they get any worse, so I do like to think most of it comes down to a good immune system thanks to a healthy lifestyle.

Re:Yeah, sure it can

[thegarbz]

- The influenza virus does not care about your low sugar diet.
- The a lung infection or full on pneumonia that is caused as a complication from the flu virus cannot at all be treated with antibiotics.
- Having no symptoms of the flu means that you didn't contract the flu, and not that your body is somehow magically better at fighting it. If you were fighting the infection you would be showing symptoms.
- There's NO such thing as a "simple" flu. You had a common cold.

As they say 9 out of 10 people confuse the flu with a common cold. The remaining people will never confuse the two again.

Re: Yeah, sure it can

[Applehu Akbar]

If 3 billion people kick the bucket from flu...

This is otherwise called the radical Greens’ wet dream.

Re:Yeah, sure it can

[dryeo]

The Spanish flu, in particular the second wave, was different in that it killed a lot of healthy young people, quick. https://en.wikipedia.org/wiki/... Also this chart on life expectancy at various ages, in particular around 1918, https://ourworldindata.org/wp-...

Re:Yeah, sure it can

[postbigbang]

The symptoms of the "Spanish" flu in 1918 were rapid onset, and extreme debilitation. Cities were completely overwhelmed by very seriously sick patients, who before, were "perfectly" healthy. Several of my ancestors died of it, small town residents. Children were left without parents.

It took as little as four to five days from onset of symptoms to death-- from the state of being an otherwise "healthy" person. People drowned in their own mucus, or had fevers that put them into in a variety of cardio jeopardy. Dead. Four days. Gone. Four days. Millions in the USA. Hospitals in those days were for the dying, band they were completely overwhelmed. If you thought The Plague was bad, this was just much faster.

A variant of the "swine" flu could move very quickly and plainly overwhelm current medical service capabilities. We're far more mobile than 1918. Would a flu shot stanch the symptoms? It becomes a numbers game. Some will have better immune systems. Some will have a more natural propensity to succumb, randomly. Others will survive and/or be lower infection vectors, randomly. But a large outbreak could be devastating. Stanching infection vectors is the way to administrate an anti-influenza social posture.

But only the "wrong" kind of people

[RogueWarrior65]

Because the herd needs thinning.

Re:But only the "wrong" kind of people

[coastwalker]

You guessed wrong. The 1918 pandemic was more lethal for healthy young fit adults because it was the strong response of their immune systems that killed them. Good luck!

As it's available, yes.

[MiniMike]

> Have you gotten your 2018 flu shot?

They offer flu shots for free at my office. I have kids in school and elderly relatives, darn right I got it. Also I don't believe in crazy conspiracy theories, so no reason not to get one. Not sure why you want to know, but here it is.

Re:As it's available, yes.

[antdude]

Are they really free? Usually, they are from your medical insurance like your employer's.

Bird Flu

[balsy2001]

If the bird flu goes airborne we could be in trouble.

Yes, I Got My Flu Shot. But Will It Work?

[DERoss]

The main problem with flu shots is that they target a particular variety of influenza. Too often, that is the wrong variety for the pending influenza season.

Last season (2017-2018), my wife and I got our flu shots early in the fall. In the week just before New Year 2018, we both thought we were coming down with colds. The day after New Year, we felt sick enough to see our family doctor, who swabbed high in our noses. After dinner, he called us to tell us we tested positive for influenza.

Later that same night (still 2 January), my wife could not stop coughing. Since she had a heart problem (now fixed), I suggested that I should take her to the local hospital's emergency room. She did not want to go, but I insisted. She was hospitalized for a week with pneumonia although we were both current with both kinds of pneumonia shots. (According to our doctor, the two types of shots only protect against about 60% of the types of pneumonia.)

Each year, we still get our flu shots in the hope that, this time, the shots are targeting the variety of influenza that will be going around. My wife got her flu shot in August, and I got mine the beginning of this month (September).

An attempt to develop a universal flu shot is underway. The goal is not to target any one variety of influenza but instead to protect against all varieties.

Re:Yes, I Got My Flu Shot. But Will It Work?

[evenmoreconfused]

Up until this year, Quebec has offered free flu shots to kids of 6-24 months and everyone over sixty.

But they've decided to cancel them this year for all but "at risk" individuals, not as a cost saving measure, but because they've concluded they don't really work. Or at least haven't for some years now.

http://www.iheartradio.ca/cjad...

There's a lot that can be done

[rsilvergun]

when faced with a large outbreak. Aside from flu shots there's quarantine procedures, extra steps to be taken at hospitals and clinics, keeping water clean, etc, etc. I suspect I'm only scratching the surface since I don't work for the CDC and I haven't studied flue outbreaks.

That's another problem the world has (America especially). This idea that we can't do anything about these things. It's mostly from folks who, well, haven't really studied the topic. It's part of a general antipathy towards experts and "elites", a desire to not be told what to do and a desire to think that "common sense" can solve problems.

Thing is, the world is really, really counter-intuitive. There's so much in this world that doesn't work they way you think it would. Like how it's several times cheaper & more effective at stabilizing a nation to send some food aid than troops, but that if you overdo the aid local businesses can't thrive because they can't compete with free.

The world is a really, really complex beast. Even things we think are simple aren't. There's damn near nothing that couldn't do with a bit more study and care.

Re:There's a lot that can be done

[alvinrod]

when faced with a large outbreak. Aside from flu shots there's quarantine procedures, extra steps to be taken at hospitals and clinics, keeping water clean, etc, etc.

If you have a large outbreak and it's the kind of flu that knocks people straight on their asses instead of just giving them some sniffles and aches and pains, there aren't enough medical care facilities to handle ~10% of the population suddenly needing medical care to potentially prevent their deaths. Even if you get a flu that has a 10% mortality rate, with 10% of the population catching it, that's around 3.5 million deaths in the U.S. That's well over the annual number of deaths and having that many in a short window would create large issue in itself.

That's another problem the world has (America especially). This idea that we can't do anything about these things.

There are things that can be done (I would say you're probably going to have the best results by taking personal precautions than anything the government tries to do), but it's not as easy as saying that we've got a really good plan and expecting the universe to go along with it. As the saying goes, no plan survives first contact with the enemy. Outside of having something akin to antibiotics that would be easily distributable and effective at treating the illness, most of what you might try to propose is just not going to be feasible or nearly as effective as you'd like. If you could have these big plans at a national level that actually worked anywhere near as well as we would like, the Soviets would have won the cold war.

The solution

[slashmydots]

There's a very, VERY sensitive tipping point when it comes to infections spreading or not. It's very close math. You know what countries have very few problems with flu outbreaks? The ones where it's illegal to go to work with the flu.

Re:The solution

[Anonymous Coward]

People don't realize that. The difference between 0.95 and 1.05 is all the difference in the world when it's in an exponent.

Re:The solution

[sjames]

That's the crazy part in the U.S. Even though we had a fairly bad outbreak last year, right after the 5 minutes of doom and gloom on the nightly news, they urged everyone to put the fear aside and go to the crowded malls for a few hours of intensive exposure and the all important shopping.

Herd Immunity

[PopeRatzo]

Flu shots will reduce the number of people who die from the flu.

There are a number of people who will contract the flu virus but never show any symptoms. These people will still spread the flu to their loved ones, co-workers, people on the train, etc.

This is why, "But I never get the flu," is not a good excuse for not getting the flu shot. Even though the flu shot does not work 100%, it still saves lives, and the more people who get the shot, the more lives that are saved. If people who "never get the flu" get the flu shot, more lives will be saved.

If you have any kind of insurance, the shot is free. If you don't have any insurance, the shot is free. Look around. I think CVS or Walgreens has a deal where you pay some small amount, say $5 for a flu shot and they give you $10 in coupons or something, but there are free shots for almost everyone.

Re:Herd Immunity

[Anonymous Coward]

Last time I got a flu shot, it gave me autism. Now I am a better software developer because of it. So there is an added bonus.

Re:Herd Immunity

[PopeRatzo]

Flu spreads by droplets that are coughed or sneezed out. If you don't have coughing or sneezing symptoms, you aren't going to be an effective vector.

I believe that's a misconception. Flu can also be spread by touch or even just by breathing.

https://www.medicalnewstoday.c...

Re:Herd Immunity

[willy_me]

Flu spreads by droplets that are coughed or sneezed out. If you don't have coughing or sneezing symptoms, you aren't going to be an effective vector.

Until you kiss your spouse. Or forget to wash your hands before touching produce at the market. There are still plenty of ways to spread the flu - any only one of them needs to work in order to create a new, effective vector.

Re:Herd Immunity

[PopeRatzo]

Since when did the flu shot prevent people from contracting or spreading the flu? It doesn't, on either count. Especially if you are vaccinated against last year's strain, which presumably is NOT the strain that will cause a global pandemic.

Don't spread lies when people's health is at stake. When you hear talking about a flu vaccine that's for the wrong strain, it's never "useless". IN 2017, the flu shot was 30% effective. That's a huge reduction in hte number of vectors spreading the disease. And a lot of lives saved.

https://www.skepticalraptor.co...

https://www.snopes.com/fact-ch...

Re:Herd Immunity

[thegarbz]

This is why, "But I never get the flu," is not a good excuse for not getting the flu shot.

9 out of 10 people confuse the common cold with the flu. The remaining 1 in 10 never confuse the two again.

I've never met a person who's actually had the flu that hasn't gone and gotten the flu shot yearly afterwards. But then flu shots are pretty much free where I live (free for the at risk, free for low income people, free from most employers, and $10 for rich healthy self employed people).

Re: Herd Immunity

[Wycliffe]

One problem with the flu shot is that it is predictive. There have been many, MANY years where the "type" of flu vaccinated for, is not the type the spread through the population. Often, the shot is useless. The flu is really thousands of flus, sadly.

The flu vaccine is based on the most common strains of the previous year. Yes, it's somewhat predictive but have you ever considered that the reason the strain that is vaccinated against is not the one that is most common is *because* it is vaccinated against. That's what you would expect if a large percentage of the population is immune to a certain strain. You would expect that strain to not spread as much.

cigs and beer

[Anonymous Coward]

I've been smoking a pack a day for 40 years, and drinking at least a 12 pack a week. I don't get sick ever. This is just one data point; use it any way you wish.

That's not what made the 1918 flu so deadly

[Solandri]

The Spanish Flu caused a cytokine storm. Basically caused your immune system to overreact, and kill yourself. Consequently, people with strong immune systems - fit and healthy young adults - were the most likely to die from it. Contrast this to modern examples of the flu which mostly picks off children and the elderly.

If the population today is generally healthier than in 1918, something like the Spanish Flu would be even more deadly today than it was then. (Though to be fair, we don't have a World War going on forcing people into tight quarters and to move around the world, spreading the virus.)

No lies: evidence

[Roger W Moore]

Stop lying when lives are at stake. Medical professionals in the US are required to get the flu shots. It's not true only a small amount of them get it - 100% gets it

Sorry, but I'm not the one spreading lies. The vaccination rate among medical professionals in the US is high but well short of 100% according to this article. Furthermore when not mandated the article states that the rate drops to 45%.

In Canada it seems the rates have increased somewhat in recent years but still around half do not get vaccinated as this, very pro-flu vaccine article states. In BC making it mandatory has increased rates of vaccination to 80% but that's avoiding the point.

If the only way you can get medical professionals to have flu vaccinations is to force them to it raises very serious questions about how medically valuable this vaccination is. Trying to cast doctors as uncaring, as the Alberta article does, has not been my experience, Generally, they seem to just disagree that the shots are worth it due to the rapid-evolving, unpredictable nature of the virus. The recommendation I have always received is that when you get elderly it is worth it but for a normal, healthy adult the benefit is minimal.

Re:No lies: evidence

[mlyle]

This. Actually, at this point multiple studies have found that you save more elderly lives from the flu by giving children and young adult flu shots. The elderly get a benefit from flu shots-- but they make a weaker immune response from it than the young. The herd immunity effects from the flu shot are more significant for the old than the direct response.

Yes!

[manlygeek]

Antivaxers are not very bright. The flu is a deadly virus. It doesn't always kill but since it is constantly mutating it can become a lot more deadly all of the sudden and by the time the world realizes this is that flu, you won't be able to vaccinate the mobs quick enough. So get a flu shot every year (they are free if you have any kind of insurance and fairly low cost otherwise). It is true that even if you've been vaccinated it might not protect you from the one that kills but at least it is what you can do right now. You buy lottery tickets with a 1 in 200,000,000 shot of winning. I'd say most flu vaccines have a better chance than that at providing protection. So, get with the program!