A flu pandemic could be even worse than Covid-19 has been, National Academy of Medicine says

Work must begin now to begin next generation vaccine development and build capacity in low and middle income countries to make their own vaccines without relying on the supply of wealthy nations, the reports recommend . And governments need to figure out how to ensure that companies have the incentives to work on these vaccines without knowing if they will ever be used or needed.

“From an epidemiological point of view, however, COVID-19 is not a worst-case scenario like the 1918-19 influenza that caused at least 50 million deaths worldwide,” the report said.

According to the WHO, between 290,000 and 650,000 people die each year in a normal year. Covid-19 has killed 5.1 million people worldwide. The next pandemic influenza could kill 33 million people, the academy said.

It’s hard to predict when a new pandemic flu might break out – but it’s certain that it will come.

“Pandemic influenza has re-emerged, and experts fear that the risk of a pandemic influenza may be even higher during the COVID-19 era due to changes in global and regional conditions affecting people, animals and their contact patterns.” when it will happen, a major influenza pandemic is more of a ‘when’ than a ‘if’, “he added.

One key recommendation: a global “moon shot” to develop a universal flu vaccine that would protect people from current and future strains of flu. Current flu vaccines require regular reformulations and adjustments each year, and do not protect against emerging new strains that could cause pandemics.

And this must be done within the framework of global coordination.

“We have too many loopholes and too much depends on underfunded, often informal, agreements,” one of the reports said. “In view of the scale of the threat, we are pitifully underprotected. We urgently and sustainably strengthen our collective defense against an influenza pandemic.”

One report recommends having 4 to 8 billion doses of flu vaccine ready just in case.

“Preparation has to be an ongoing commitment – it cannot go from year to year or from crisis to crisis,” said Dr. Victor Dzau, president of the National Academy of Medicine, in a statement. “COVID-19 has enabled the emergence of new skills, technology, collaboration and guidelines that could be used before and during the next pandemic flu. Investing in science, empowering health systems and building trust is critical to protect people “from the health, social and economic consequences of seasonal and pandemic influenza.”

The coming flu season can be severe.  Here's whyOne report specifically recommends that the National Institute of Allergy and Infectious Diseases, Biomedical Advanced Research and Development Authority, Department of Defense, and other agencies invest now in researching new and better flu vaccines. “This will make it possible to select the most suitable candidates for each purpose and allow sufficient production and distribution to optimize the control of influenza in different environments and phases of pandemics and epidemics,” the report said.

“The World Health Organization should engage with multilateral stakeholders (e.g. evaluations of influenza vaccine candidates, including new candidates who use innovative structures, targets and delivery systems to potentially expand or improve protection,” she added.

One of the reports noted that the Covid-19 pandemic showed that face masks and physical distancing contributed to the dramatic reduction in influenza activity around the world. “Face masks would be simple and inexpensive during the next pandemic influenza and public health officials should mandate their use when the severity and incidence of influenza justify it,” said a statement from the academy.