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Two years before the coronavirus, the CDC warned of an upcoming pandemic



WASHINGTON ̵

1; Two years ago, some of the country’s top public health officials gathered in an auditorium at Emory University in Atlanta to commemorate the flu pandemic in 1918 – also known as “the Spanish flu” – which had killed as many as 40 million people as it swept the world .

The daily conference on May 7, 2018, hosted by the Centers for Disease Control and Prevention, was supposed to break an accident from the past for lessons about the present and warnings for the future. There were sessions titled “Nature against Man” and “Innovations for Pandemic Measures.” Implicit was the understanding that while the 1918 pandemic was an individual disaster, conditions during the 2000s were ideal for another outbreak.

And since there are six billion more people on the planet today than it was in 1918, when the global population was only 1.8 billion, a pathogen that is a less effective killer than the Spanish flu can still prove more deadly in absolute terms.

Long before the coronavirus occurred in Wuhan, China, and then soon spread to almost every country on earth, the 2018 conference offered evidence that epidemiologists at the CDC and other institutions were aware that a new pandemic was ready to strike. They discussed worrying developments. They pointed to obvious gaps in the country’s defense. They supported what they feared.

“Are we ready to respond to a pandemic?” asked Dr. Luciana Borio, who was the head of the then-dissolved section of Global Health in the National Security Council.

Dr. Borio answered his own question: “I’m afraid the answer is no.” She discussed the flu but could just as easily have referred to coronavirus, given the similarities between the two infections.

Among the organizers of the conference were Dr. Daniel Jernigan, head of CDC’s influenza division. He later hosted a webinar entitled “100 years since 1918: are we ready for the next pandemic?” Shown today, that presentation comes as a worrying preview of what the world is facing 2020, with close to a million people infected with coronavirus and more than 44,000 dead.

Dr. Daniel Jernigan. (Courtesy of CDC)
Dr. Daniel Jernigan. (Courtesy of CDC)

Apart from Jernigan’s cooling prophetic presentation, there were plenty of warnings during the symposium on May 7 that federal and state authorities did not respond adequately to pandemic responses.

Top officials only gave these warnings steps from the country’s public health office and raised questions about why this warning was not followed, given how unambiguous it was. “Our anxiety is getting higher,” Jernigan said as the conference closed, adding that “our leadership is becoming very worrying.” (Neither CDC nor Jernigan responded to the request for comment.)

Other public health officials at the event worried that even after an outbreak of SARS (2003), swine flu (2009) and Ebola (2014), a cavalier attitude to infectious disease was permeated. “There is often a feeling among the decision makers we talk to in Washington – but also in other states – that something magical will happen when an emergency happens, that we can just flip a switch and we” I will be able to respond so well we can, says former CDC associate director John Auerbach, who now heads the Trust for America’s Health, a non-profit organization focused on medical readiness.

Auerbach said that based on the organization’s latest report, it was clear that “we have some vulnerability” to a state-level pandemic. Among the concerns that the trust was that only eight states and the District of Columbia had a sick leave law, which means that millions of Americans would continue to work even after they got sick.

The continued lack of a coherent federal paid sickness policy has been underlined by the coronavirus outbreak.

Patients are waiting in line for a COVID-19 test at Elmhurst Hospital Center in New York City, March 25, 2020. (John Minchillo / AP)
Patients are waiting in line for a COVID-19 test at Elmhurst Hospital Center in New York City, March 25, 2020. (John Minchillo / AP)

Auerbach described conversations he had on Capitol Hill about pandemic preparedness and the declining funds earmarked for this purpose. “You know, don’t worry about it,” the legislator apparently told us. “If we do not fund it at the federal level, the governors and local officials will increase funding and compensate” for federal cuts, he was apparently confident.

Apart from being true, Auerbach said, pointing to statistics showing that both states and local governments lowered public health funding and potentially left the nation without necessary defense at any government level.

Two years later, cities and states asked Washington for help, and Americans are wondering how a nation that is thrilled to have their health system as one without equal could have found themselves so poorly prepared for a deadly plague.

President Trump has called the current coronavirus outbreak an “unforeseen enemy” that “came out of nowhere.” He is right in the narrow sense that SARS-CoV-2, as the pathogen is formally known, is a new coronavirus, which means that its exact genomic sequence – the plan for its proteins that trouble the human body – has not been obscured before. Existing armor in the form of vaccines could therefore not protect against the assault.

But the corona virus was hardly unforeseen. In fact, experts like Jernigan have warned of a new pandemic for several years.

Jernigan’s webinar – which was not delivered during the seminar on May 7, but at an unspecified later date – was co-hosted by Dr. Nancy Messonnier, director of the National Center for Immunization and Respiratory Diseases. She is a member of Trump’s Coronavirus working group, but her role was minimized after she made serious warnings about the pandemic.

Nancy Messonnier, director of the National Center for Immunization and Respiratory Disneys. (Samuel Corum / Getty Images)
Nancy Messonnier, director of the National Center for Immunization and Respiratory Disneys. (Samuel Corum / Getty Images)

Although he doubts about the seriousness of the coronavirus threat, Trump now largely agrees with Messonnier’s concern about the coronavirus, causing a disease called COVID-19. That disease has killed about 4,000 Americans.

The corona virus attacks the lungs directly; The flu is an infection of the upper respiratory tract. But while the viruses seem different, they spread from body to body with similar speed, largely through close contact with sick individuals, often by sneezing and coughing.

In recent weeks, the interest in the flu of 1918 has understandably taken on people eager to understand what can be learned from the catastrophic outbreak.

Dr. Jernigan made these warnings two years ago, as evidenced by the 34-image presentation he delivered in 2018 on the 1918 pandemic.

This presentation is readily available online and has been for the past two years. However, it is not clear if anyone from the White House has seen the presentation. If they did, they would glimpse a reality that has become too familiar to many Americans.

One picture listens to the fact that “human adapted viruses” originating in animals “can cause efficient and lasting transmission.” Although he spoke specifically about the flu virus, the same applies to the coronavirus, which was also zoogent, and is believed to have originated in a wet market in the southeastern Chinese city of Wuhan.

Jernigan’s presentation then includes a discussion of how 1918 spreads, summarizing various well-known aspects of the era that exacerbated the pandemic: World War I, narrow cities, and a lack of understanding of how viruses work.

St Louis Red Cross Motor Corps during the flu epidemic 1918. (Universal History Archive / Universal Images Group via Getty Images)
St Louis Red Cross Motor Corps during the flu epidemic 1918. (Universal History Archive / Universal Images Group via Getty Images)

The most relevant parts of Jernigan’s presentation are nearing the end, in a section titled “The Next Pandemic: Are We Ready?”

Jernigan came to a conclusion that has become common wisdom in recent weeks: that the nation was founded but not prepared for a pandemic. He describes factors that make a pandemic more likely, including a “more crowded and more interconnected world.” Two years later, the simple commercial aviation would lead to the spread of coronavirus from East Asia worldwide.

Another concern for Jernigan was that “the worlds of humans and animals are increasingly converging”, especially as the population increase leads to deforestation, making zoo transfer more likely. China’s animal markets have also come under increased scrutiny, with some wanting them close.

The presentation warned of “potential disruption” in the supply chains for food, energy and medical supplies as well as in the health care itself. These predictions appear to have been implemented in the United States, with governors asking for respiratory protection and hospital overload that led to the construction of a coronavirus treatment facility in the middle of Central Park. It has also been run in supermarkets, although no large-scale food shortages have been reported.

Even more specific warnings follow, and seem particularly haunting given the riotous images that have emerged from New York hospitals. “Needs reusable respiratory protection,” writes Jernigan, in an obvious reference to the N95 masks that have become an esteemed commodity for their role as prophylactic against airborne viral drops. Jernigan also recommends “better fan access” and anticipates what would be a major problem for cities like New York and states like Washington.

A body wrapped in plastic is released from a refrigerator and handled by medical workers at Brooklyn Hospital Center in New York City. (John Minchillo / AP)
A body wrapped in plastic is released from a refrigerator and handled by medical workers at Brooklyn Hospital Center in New York City. (John Minchillo / AP)

“The health care system can be overwhelmed by a serious pandemic,” Jernigan writes, once again predicting exactly what has become the expensive reality of the coronavirus pandemic.

And while praising the advent of new vaccine technologies, he notes that “it takes too long to have vaccines available for pandemic response.” Trump initially promised that both vaccines and therapeutics would be readily available, while public health officials pointed out that both are many months away.

Moving to a more global view, Jernigan argued that “most countries do not have robust pandemic plans and very few exercise response efforts.” This became evident when the corona virus attacked countries such as Italy and Iran, where health systems became overwhelmed and thousands died.

A concluding picture summarized Jernigan’s main argument: “Efforts to improve pandemic preparedness and response are ongoing, but many gaps remain.”

The most common discovery at the symposium on May 7 about the 1918 pandemic was that it would be far more expensive to ignore the lessons learned from that disaster than to take the necessary steps to keep a new outbreak at bay.

“We know what to do,” said former CDC director Dr. Julie Gerberding. “We just have to do it.”

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