On June 18, 2012, the United States announced a $285 million grant to the Texas A&M University System to create one of three U.S. biosecurity centers.
In a speech in Austin that day, system Chancellor John Sharp said the A&M center will be able to quickly make vaccines to respond to a looming threat: "There is going to be, sometime in the future, an event that will kill, according to scientists and with today’s population, somewhere between 80 and 90 million people on this earth."
That’s an ominous death toll, and we wondered how sure scientists are that such a devastating outbreak is approaching.
When we contacted the A&M System and asked for Sharp’s backup information, spokesman Thomas Graham set up a conference call for us with Scott Lillibridge, the deputy principal investigator for A&M’s Center for Innovation in Advanced Development and Manufacturing, who is a professor of epidemiology at the Texas A&M Health Science Center and former director of the Centers for Disease Control and Prevention’s bioterrorism program.
Lillibridge defined pandemic for us: an event in which multiple epidemics break out around the globe at the same time.
"It’s certain that we’ll have another pandemic sometime," he said. "And we just don’t know when or how serious it will be."
Others agree. We reviewed news stories and spoke by phone and email with Kumanan Wilson of the Ottawa Hospital Research Institute, author of a February 2012 article on estimating flu pandemic deaths in the European Journal of Public Health, and University of Texas professor of biology and statistics Lauren Meyers.
Meyers told us, "I would say it’s a certainty we will get new strains of virus flu that emerge in human populations and cause widespread illness." Wilson said, "The consensus is yes, there will be regular pandemics."
In a Sept. 19, 2011, news story on a conference of the European Scientific Working Group on Influenza, Scientific American quoted University of Virginia School of Medicine professor Frederick Hayden: "What is clear is that (the next flu pandemic) is when, not if." The story described his statement as "one of many proclamations of coming plague during the meeting that was tinged with just enough urgency to generate attention (and research funding) but not ignite an all-out panic."
The World Health Organization’s most recent Global Vaccine Action Plan referred to preparing for "the next pandemic," though noting that it’s "impossible to predict the exact timing or nature of a future pandemic."
"In an influenza pandemic, most of the world’s population will be highly susceptible to the virus infection and it is conceivable that the virus will spread rapidly," the 2006 plan said.
"At the present time, if an influenza pandemic were to occur, the potential vaccine supply would fall several billion doses short of the amount needed to provide protection to the global population."
The plan’s executive summary concludes, "Action must start now – this fact cannot be emphasized strongly enough – action must start now if the world is to prepare itself in the shortest possible time for a potential influenza pandemic." WHO is working on an updated plan, according to its web site.
That degree of preparation, experts told us, is one of the largest elements in determining how many people will die. Other factors include how the contagion spreads, how quickly it kills, how early it’s detected and how coordinated the medical response is.
But preparation is essential because once a major outbreak begins, there’s no time to manufacture enough of the right vaccine.
Each flu season, Lillibridge said, the CDC and counterparts around the world track fast-changing viruses to predict which vaccines will be most needed.
CDC spokesman Tom Skinner told us by phone that once the prediction is made, the CDC sends a "seed" virus to vaccine manufacturers. It takes five months to produce and ship the vaccines, he said.
Technology, communication and distribution give today’s medics a huge advantage over those who faced the 1918-19 "Spanish flu" pandemic, the event both Sharp and Lillibridge used to frame the current threat. That global outbreak was "the mother of them all," said a Nov. 26, 2007, Guardian (UK) news story that listed the death tolls for the 20th century’s three flu pandemics: "The 1968-69 Hong Kong flu killed up to a million people globally, the 1957-58 Asian flu killed up to 1.5 million" and the Spanish flu killed "around 40 million" -- more than World War I, the story said.
All were caused, according to a June 22, 2012, Bloomberg news story, by flu viruses that started with animals, mixed with human flu and then mutated into new strains that humans weren’t immune to.
So was 2009’s pandemic of H1N1 "swine flu," which according to the World Health Organization proved less deadly than had been feared, killing about 16,000 people worldwide. Through "pure good luck," said an Aug. 10, 2010, WHO report, the mutating virus didn’t develop resistance to the vaccine or change into a more deadly form.
As to the estimated death toll of a future pandemic, Lillibridge told us, "The chancellor is right in the ballpark."
Later, through an A&M center spokeswoman, Lillibridge said that if a virus as deadly as the 1918 strain broke out, "assuming the same mortality rate today, and a world population of 6.9 billion, that is about 193 million deaths."
Meyer agreed that the range Sharp gave, 80 million to 90 million deaths, is plausible, noting that the Spanish flu might have killed that many even with the world’s much smaller population at the time. "But if and when we get one as deadly as 1918, I think there’s quite a bit of uncertainty," she said.
However, Wilson expressed skepticism as to the 80 million to 90 million range: "Officials said the same this time around (the 2009 pandemic) with the most conservative estimates being grossly higher than the actual death toll."
Wilson’s article in the February 2012 issue of the European Journal of Public Health rounded up several of those estimates:
- A Dec. 8, 2004, WHO "best case" scenario of 2 million to 7 million deaths.
- A Dec. 23, 2006, article in The Lancet saying that if a flu strain like the 1918-19 virus had emerged in 2004, it could have killed 51 million to 81 million people.
- A May 5, 2005, article in the New England Journal of Medicine saying that an H5N1 "bird flu" pandemic could be as deadly as the Spanish flu and, based on the change in world population, could kill 180 million to 360 million.
Sharp said scientists predict "sometime in the future, an event that will kill … somewhere between 80 and 90 million people."
Scientists agree another pandemic is coming. However, they say the number of deaths will depend on many variables -- early detection, coordinated response and luck, to name a few -- and there is not uniform agreement among scientists that 80 million to 90 million people would die. We rate Sharp’s statement Half True.
Speech by Texas A&M System Chancellor John Sharp, Austin, June 18, 2012
Speech by U.S. Department of Health and Human Services Secretary Kathleen Sebelius, June 18, 2012
Texas A&M System press release, "Texas A&M System Awarded National Center for Innovation," June 18, 2012
Telephone and email interviews, excerpted, with Thomas Graham, president of Crosswind Communications public relations, June 27-Sept. 21, 2012
Telephone and email interviews, excerpted, with Scott Lillibridge, deputy principal investigator for Center for Innovation in Advanced Development and Manufacturing, June 27, 2012
Telephone and email interview with Dr. Kumanan Wilson of the Ottawa Hospital Research Institute, Sept. 20, 2012
Telephone interview with Lauren Meyers, University of Texas professor of biology and statistics, Sept. 20, 2012
Scientific American news story, "What Will the Next Influenza Pandemic Look Like?," Sept. 19, 2011
World Health Organization, Global Action Plan for Influenza Vaccines, accessed Sept. 25, 2012
Telephone interview with Thomas Skinner, senior press officer in News Media Branch,
Centers for Disease Control and Prevention’s Division of News and Electronic Media, Sept. 19, 2012
U.S. website flu.gov, "Pandemic Flu History," accessed Sept. 25, 2012
Guardian (UK) news story, "How likely is a flu pandemic?," Nov. 26, 2007
Bloomberg news story, "Deadly Bird Flu May Be Five Steps From Pandemic Potential," June 22, 2012
WHO director press statement, "H1N1 in post-pandemic period," Aug. 20, 2012
European Journal of Public Health commentary by Dr. Kumanan Wilson, "Revisiting influenza deaths estimates—Learning from the H1N1 pandemic," February 2012
WHO report, "Estimating the impact of the next influenza pandemic: enhancing preparedness," Dec. 8, 2004
The Lancet article, "Estimation of potential global pandemic influenza mortality on the basis of vital registry data from the 1918-20 pandemic: a quantitative analysis," Dec. 23, 2006
New England Journal of Medicine article, "Preparing for the next pandemic," May 5, 2005
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