An H1N1 virus caused the last major pandemic with genes of avian origin. It was rampant 1918-1920, often referred to as Spanish Flu it was first identified among troops in the USA in military personnel in spring 1918. The Centers for Disease Control and Prevention (CDC) estimates that about 500 million people or one-third of the world’s population became infected with this virus. The number of deaths was estimated to be at least 50 million worldwide. John Hopkins University Coronavirus Resource Centre currently reports 102.9m confirmed cases and 2.4 million deaths. For sheer scale, the 1918-20 pandemic was evidently a bigger disaster.
Subsequent major pandemics occurred in 1957-8, 1968 and 2009 (more here). The ease of rapid travel has facilitated the spread of viruses. Between 2011 and 2018, the World Health Organization identified and tracked 1483 epidemic events in 172 countries. Diseases such as influenza, Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), Ebola, Zika, plague, Yellow Fever, amongst others. Fig. 1 from the 2019 Global Preparedness Monitoring Board Report demonstrates the global emergence of selected pathogens over the past 50 years, including both those that naturally emerge/re-emerge and those deliberately released.
A century after the 1920 flu pandemic those most at risk are being offered an annual flu vaccination designed to reduce the incidence and severity of the virus. Based on the World Health Organization’s advice the EU’s recommendation for the 2020/2021 seasonal flu vaccine should include A/Guangdong-Maonan; A/Hong Kong; and B/Washington. Viruses mutate, and vaccines need to be redesigned each year depending on forecasts of the prevalent strains. All three virus strains in the 2020/21 vaccine are 2019 variants.
One virus strain can cause more deaths than a world war and result in trillions of dollars of economic damage
In a paper in Nature published last week, two academics from the Scripps Research Institute, in California have called for an alternative approach to pandemic preparedness and investment in the development of a vaccine based on broadly neutralizing bodies. Burton and Topol “call for an investment now in basic research leading to the stockpiling of broadly effective vaccines.” They explain why this should be a priority: “As we’ve seen for influenza, one virus strain can cause more deaths than a world war and result in trillions of dollars of economic damage. Surely, global governments that together spend US$2 trillion a year on defence can find a few hundred million dollars to stop the next pandemic?”
For the future of travel and tourism, we need the world to be much better equipped to deal with pandemics as they emerge. Those countries with recent experience of epidemic diseases have generally been more successful than those which have not. We have learnt to live with and manage influenza; hopefully, we will learn to live with and manage Covid-19 too. The development of broad-based vaccines is likely critical to maintaining the open borders essential to our industry. Otherwise, we may face uncertainty with periodic panic, lockdowns and forced quarantine as a regular hazard for travellers and holidaymakers.
