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Why another flu pandemic is likely just a matter of when

November 12, 2019

JUDY WOODRUFF: Tonight, we begin a special
series about the threat from influenza. Every year, the seasonal flu emerges and kills
tens of thousands of Americans and hundreds of thousands globally. But there is an even graver concern. Public health officials fear the emergence
of a new, previously unknown flu virus that could be far more lethal and become a pandemic
by spreading across the world. As William Brangham reports, it’s happened
before. WILLIAM BRANGHAM: The heart and the beating? AUTUMN REDDINGER, Survived Influenza: The
heart and my heartbeat, yes, because, of course, I didn’t have a beating heart for a little
bit. WILLIAM BRANGHAM: Six years ago, Autumn Reddinger
started feeling sick. But she was a 33-year-old mom, really healthy. And so she didn’t think much of it. AUTUMN REDDINGER: It was two days after Christmas,
and I just kind of felt a little junky, you know, a little cough here and there, but nothing
horrible. I had texted my fiance, and it was a big jumbled
mess, and that’s when he pretty much… WILLIAM BRANGHAM: The words you texted didn’t
make sense. AUTUMN REDDINGER: Yes, they didn’t make sense. Honestly, I don’t even remember him coming
to pick me up. WILLIAM BRANGHAM: Reddinger was rushed to
her local hospital in Punxsutawney, Pennsylvania, where doctors diagnosed her with the flu. AUTUMN REDDINGER: My lungs started to feel
on fire. WILLIAM BRANGHAM: Meaning, when you would
breathe in, it would burn? AUTUMN REDDINGER: Breathe in, breathe out,
it just — it burned. WILLIAM BRANGHAM: The flu was attacking her
lungs and filling them with fluid. She was then medevaced to University of Pittsburgh
Medical Center, where she was eventually put under the care of Dr. Holt Murray. DR. HOLT MURRAY, University of Pennsylvania Medical
Center: The lungs become very boggy. They fill with water, and you’re not able
to move oxygen from the outside world into your bloodstream. WILLIAM BRANGHAM: You can’t breathe. DR. HOLT MURRAY: You can’t breathe, yes. WILLIAM BRANGHAM: It kept getting worse. Her lungs were failing. She was put on a ventilator, but even that
couldn’t get enough oxygen into her. AUTUMN REDDINGER: It was a nurse who slipped
up and made a comment about me dying. And I was just like, what? “Oh, yes, you died, like, twice. You were on a machine to keep you alive.” And I’m like… WILLIAM BRANGHAM: That machine, called an
ECMO, took out her dark, depleted blood, pumped it full of oxygen, and fed it back into her
body. DR. HOLT MURRAY: It runs through the pump and
the oxygenator and comes out cherry red. WILLIAM BRANGHAM: That is a very intensive
intervention to try to save someone’s life. DR. HOLT MURRAY: It’s as intensive as it gets. We’re taking five liters of blood a minute,
taking it out of the body, and returning it. WILLIAM BRANGHAM: Days like that are what
keep Dr. Anthony Fauci up at night. DR. ANTHONY FAUCI, Director, National Institute
of Allergy and Infectious Diseases: In 2017-’18, we had the worst seasonal flu in recent memory,
about 80,000 deaths and almost a million hospitalizations. You do that every year for 20, 30, 40 years… WILLIAM BRANGHAM: That’s a huge toll. DR. ANTHONY FAUCI: … at the end of that time,
that’s a huge toll in illness and in deaths. WILLIAM BRANGHAM: Fauci is the director of
the National Institute of Allergy and Infectious Diseases at the National Institutes of Health. He says, while many take the so-called seasonal
flu for granted, it still kills tens of thousands in the U.S. every year. DR. ANTHONY FAUCI: So, this is the influenza virus. This is the inner core of the influenza virus. WILLIAM BRANGHAM: But the seasonal flu isn’t
really what Fauci loses sleep over. It’s the concern that a new flu strain emerges,
a virus we have never seen before and have no protections against, like what happened
in 1918. DR. ANTHONY FAUCI: In 1918, we were swimming in
the dark, as it were. WILLIAM BRANGHAM: That year, a new virus emerged,
triggering one of the worst pandemics in human history. Often called the Spanish Flu, this virus killed
at least 50 million people worldwide, and reached almost every nation on Earth. About 675,000 people died in the U.S. alone. DR. JEREMY BROWN, National Institutes of Health:
So, you had this disease that was spread very quickly across the world that was killing
millions of people. And yet people didn’t know what it was that
was killing them. WILLIAM BRANGHAM: Dr. Jeremy Brown directs
the Office of Emergency Care Research at the National Institutes of Health, and he wrote
the book “Influenza: The Hundred-Year Hunt to Cure the Deadliest Disease in History.” Brown says, not only did doctors not understand
this was a virus sickening people, but they had no antibiotics to treat the secondary
deadly pneumonia that often accompanies flu. The treatments they did have often made things
worse. DR. JEREMY BROWN: So, you had bloodletting. And you had enemas. Everybody seemed to get an enema back then. WILLIAM BRANGHAM: Exactly at the moment when
you’re incredibly dehydrated because of the pneumonia. DR. JEREMY BROWN: And then whiskey and champagne. WILLIAM BRANGHAM: All this led to a higher-than-normal
death rate among 20-to-40-year-olds, the people typically much less susceptible to flu. More soldiers were killed by 1918’s flu than
died in battle during World War I. NARRATOR: Asian influenza spreads rapidly. WILLIAM BRANGHAM: Since 1918, the world has
seen three flu pandemics. Thankfully, none has been as deadly as the
first. There was the 1957 Asian Flu, 11 years later,
the Hong Kong Flu, and, most recently, the 2009 Swine Flu. DR. ANTHONY FAUCI: It wasn’t particularly virulent,
so that the number of deaths in 2009 among the general population was even less than
a regular seasonal flu, even though there were many, many more infections. WILLIAM BRANGHAM: The concern, of course,
is that the next pandemic would be both contagious and deadly. That’s what has public health officials worried
today. If or when a new virus emerges, it will be
the researchers here at the Centers for Disease Control in Atlanta who will try to spot it
and identify it as quickly as possible. REAR ADM. DR. ANNE SCHUCHAT, Acting Director, Centers for
Disease Control and Prevention: It’s not an earthquake or a hurricane, with just one geography
affected. The whole world is vulnerable. WILLIAM BRANGHAM: When a new strain emerges,
it’s up to Dr. Anne Schuchat and her colleagues to help identify the virus, monitor its spread
and help coordinate treatment of the sick. She’s the principal deputy director of the
CDC. REAR ADM. DR. ANNE SCHUCHAT: You don’t want to have a plan
that assumes things are going like this, when your early observations point in another direction. So the better the working relationships are,
the more quickly you can adapt, the more nimble the response. WILLIAM BRANGHAM: Schuchat stresses the importance
of early detection. Even two weeks can make an immense difference
in vaccine development and saving lives. REAR ADM. DR. ANNE SCHUCHAT: We know we will have more pandemics
of influenza. It’s not if. It’s when. WILLIAM BRANGHAM: You’re confident of that? REAR ADM. DR. ANNE SCHUCHAT: Absolutely. The probability of a pandemic tomorrow is
the same as it was in 2009. So we can’t be complacent about our state
of preparedness. But we can’t assume that the next pandemic
will be like the last ones. We have to work through the different scenarios. WILLIAM BRANGHAM: And the CDC are not the
only ones gaming out those scenarios. REP. SUSAN BROOKS (R-IN): We have not given it,
I think, all of the attention that it deserves. WILLIAM BRANGHAM: Last may, Johns Hopkins
University put together an exercise to simulate what could happen in the next flu pandemic. Congresswoman Susan Brooks of Indiana, who
has co-sponsored legislation to bolster the nation’s preparedness for public health emergencies,
was part of the exercise. REP. SUSAN BROOKS: Every time you do an exercise,
you realize where the gaps are. If large numbers of people begin to get sick,
actually, your economy is impacted, our national security can be impacted. There are so many things that people just
don’t realize. WILLIAM BRANGHAM: In this scenario, a year-and-a-half
into the pandemic, the hypothetical Clade X flu had killed 150 million people worldwide. A vaccine was still stuck in development. The U.S. president and vice president were
both sickened, as was a third of Congress. The U.S. government nationalized the entire
health care system to coordinate its response. And all of these were considered realistic
projections. REP. SUSAN BROOKS: These are the types of things
that most citizens don’t think about. We don’t want to think about them. We — but yet we expect the systems to be
in place to take care of them. We expect the medical community, pharmaceutical
community, diagnostic community… WILLIAM BRANGHAM: Our leadership. REP. SUSAN BROOKS: … everyone to be ready. And that’s not how it works. WILLIAM BRANGHAM: Years later, much of Autumn
Reddinger’s experience is still a mystery. You have no idea how you got the flu. AUTUMN REDDINGER: No idea, no clue, no idea. WILLIAM BRANGHAM: She carries a few lingering
traces of her brush with influenza, some scars and a few side effects. AUTUMN REDDINGER: I just kept telling myself,
it’s OK. You’re a miracle. You’re alive. Yes, your toes might not bend. Yes, your lungs act a little funny. Yes, your memory is shot, you have a few scars,
but you’re alive. WILLIAM BRANGHAM: Her case remains a striking
reminder of just how serious this virus can be. For the “PBS NewsHour,” I’m William Brangham. JUDY WOODRUFF: And William’s series continues
tomorrow night, focusing on the potential for a pandemic.

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