In 1918 We Faced the Flu Pandemic. Today, We’re Still Fighting the War.

 1918: The War We Lost

In 1918, the United States fought two wars. One it lost, and one it won.

You may have learned about World War I in history class, or even from your relatives. As a member of the Allied Forces, the United States defeated the Central Powers — a victory touted by history books, movies, and novels.

The second war, however, had a more elusive opponent. It descended perniciously, quietly claiming lives while armies concerned themselves with foxholes and mustard gas. In the first six months, this enemy killed 25 million people worldwide.

Ultimately, between 50 and 100 million lives — five percent of the world’s population at the time — would be lost as a result of the conflict.

This second enemy was, of course, the flu virus. By the time Americans realized that the country was under siege, it was too late to stop it. The flu made its way through the U.S., Europe, and Asia with terrifying speed; people who had been well in the morning dropped dead in the street by dinner time. Families that had already lost sons, fathers, and brothers to the war abroad dwindled as the virus attacked them, affecting the remaining young and healthy. In just one year, the average life expectancy for an American dropped by 12 years.

Over the century that followed, Americans would face three more pandemic flus, but none of them like the one in 1918. The 1957 pandemic flu killed roughly 1.1 million people worldwide; another in 1968 wiped out about another million globally. Most recently, the 2009 H1N1 pandemic flu killed between 151,700 and 575,400 people worldwide, according to estimates from the Centers for Disease Control and Prevention (CDC).

Today, a century after the 1918 pandemic, we know much more about the virus — how it spreads, how it kills. We now have influenza vaccines — unheard of in 1918 — that provide us with (albeit limited) protection. And sophisticated tracking mechanisms help us predict which flu viruses we might encounter in a given year.

We have not, however, completely vanquished the flu. In this particularly bad flu season in the U.S., we need little reminder that the virus is hardy and evolves rapidly. The flu that ravaged humanity in 1918 is not the same strain making headlines in 2018. Likewise, if another global pandemic flu is inevitable, we can’t assume the virus will be one we’ve seen before.

Today, our relationship with the flu has shifted from an adversarial, bellicose one, to one of competition; we are running a race, no longer fighting a war. To survive another century, or another season, public health experts will need stay one step ahead, armed with an artillery provided by science and a war plan drafted from the history of the battle we lost.

Image Credit: State Library of Queensland/Illustration by Victor Tangermann

Why (and How) the Flu Still Kills

A high fever, fluid in the lungs, crushing fatigue, and body aches — if you’ve ever come down with influenza, it likely needs no introduction. It’s often easy to distinguish the full-blown flu from the common cold because the flu’s symptoms tend to come on suddenly and with an intensity that makes it hard to deny.

When a person is infected by any pathogen — a virus or bacteria — they usually won’t know it until that pathogen has started damaging cells. That kicks the immune system into gear, making you start to feel sick. The fever, aches, and mucus all too familiar to flu-sufferers aren’t from the virus itself, but rather are the side effects of the body’s attempt to vanquish it.

Even though our immune systems respond rapidly and with such force, they aren’t always successful in stopping the microbes wreaking havoc on the body’s cells. While most of us who get the flu just stay home and rest, the flu makes some people seriously ill — they have to be hospitalized. Some even die as a result of complications from the flu.

(The flu doesn’t directly cause death. Instead, the virus can induce an infection like pneumonia, or exacerbate an underlying condition. But oddly enough, it’s usually the body’s too-aggressive immune response to the flu that ultimately kills people).

A flu virus spreads when a healthy person ingests or inhales virus-infected droplets flung into the air by a sick person’s cough, sneeze, or mere breath. The CDC does not know exactly how many people get the flu each year. The agency doesn’t know how many people die from it either. People who come down with the flu don’t always seek medical attention. Even when they do, doctors don’t always test for it.

Those caveats make the data on this year’s flu season more striking: as of the first week of February, the number of flu cases in the United States was the highest since the 2009 pandemic. The most people have been hospitalized at this stage in the flu season since the CDC started tracking, in 2005. Both numbers are still climbing.

When we talk about the flu, we aren’t talking about a single virus. There are four types of influenza viruses — but only two of them cause serious illness in humans, Catherine Beauchemin, an associate professor of virophysics at Ryerson University in Toronto, explained to Futurism. You might remember hearing about H1N1 (the flu type that hit us in 2009) and H3N2 (the type of flu causing problems this year) — those Hs and Ns stand for hemagglutinin and neuraminidase, proteins found on virus’ surfaces that help either enter cells (H) or separate from cells to go infect another cell (N). The numbers identify groups of strains with similar Hs and Ns.

The flu mutates remarkably quickly, changing dramatically to dodge our antibodies in the span of a flu season or two. That means it can infect people who previously contracted it.

That’s why we get flu shots every year. Even though researchers have a sophisticated global tracking system to anticipate which strain might affect a region in a given year, there’s still a surprising amount of guesswork involved.

Flu seasons typically occur during the colder months, when people are more likely to congregate indoors. Because the flu season is opposite in Australia, the CDC’s Epidemiology and Prevention Branch in the Influenza Division can track that country’s flu season about six months before flu season arrives in North America. As travelers move the virus from Australia to Europe, Asia, and the U.S., public health experts can anticipate which strain will likely be the one to make people sick in the northern hemisphere that year.

The system, and the vaccine made from it, is far from perfect though. “The issue is that the recommendations have to be made some six months before the vaccine is actually used,” Richard Webby, Director of the WHO Collaborating Center for Studies on the Ecology of Influenza in Animals and a member of the Department of Infectious Disease at St. Jude Children’s Research Hospital, told Futurism. Researchers need that time to analyze data from Australia’s flu season, then manufacture and distribute the vaccines.

For a virus that evolves so quickly, that lead time can also be problematic. “There have been instances where the viruses have changed between when the recommendations have been made and when the vaccine has been administered, leading to suboptimal performance.” Webby added. For example, the latest data on this year’s flu vaccine shows it’s around 17 percent effective, though that may change before the flu season ends.

This year’s flu virus, H3N2, isn’t like other strains that have circulated in recent years. It binds to cells differently, and seems to be mutating more rapidly, making it difficult to study and create a vaccine against. The strain also doesn’t grow well in eggs, where bacteria are most commonly grown before being put into vaccines.

“We don’t have a flu vaccine problem so much as we have an H3N2 vaccine problem,” Ed Belongia, a vaccine researcher and director of the Center for Clinical Epidemiology and Population Health at Wisconsin’s Marshfield Clinic, recently told STAT News.

Although we can identify and classify them, track them, and create vaccines to defend against them, the viruses continue to evade us, evolving faster than we can keep up — sickening or killing people in the process.

Image Credit: CDC/Illustration by Victor Tangermann

Fighting the Flu of the Future

In 1918, many of the treatments we have today for secondary infections like pneumonia or strep throat either didn’t exist or were not yet widely available. That partially explains why the epidemic killed so many.

Today, the antiviral Tamiflu can quell symptoms within the first 48 hours of their onset, or even prevent them in the first place. But it’s pricey (a five-day course costs $ 100 minimum) and comes with risks, especially for children and teens, who are more likely to experience serious psychological side effects and “seizures, confusion, or abnormal behavior early during their illness,” according to the CDC.

In 1918, many people felt that the flu descended upon their community out of nowhere. Today, we can at the very least see the flu coming so our doctors and emergency rooms can be prepared — even if we don’t have weapons powerful enough to completely stop it yet.

One elegant solution is to gather data from smart devices sick people usually use to track the spread of the flu. Smart thermometer company Kinsa does just that. Over the past six years, the device’s 1 million users gather real-time data to track infectious disease with the help of “smart thermometers” and a smartphone app. Though it may seem counter-intuitive that a relatively small number of users could track how many people have the flu and where, the flu-tracking data over the past two years has lined up with CDC data — and the app is gathering it much more quickly than public health agencies are able. Nationally, the number of people with the flu is 39 percent higher than it was at this time last year, according to Kinsa’s most recent report.

Some are thinking bigger than treating or tracking the flu. The holy grail for flu treatment would be a vaccine that doesn’t change from year to year depending on the annual strain. If everyone could just get the vaccine once to protect us from all strains of flu for our entire lives, hundreds of thousands of lives could be saved every year.

We’re talking, of course, about a universal flu vaccine.

A team of researchers out of UCLA is genetically-engineering flu viruses that could become candidates for a universal vaccine. The researchers engineered flu cells to stimulate a bigger, more targeted immune response than the real-life strains. So far, the team has only developed the potential vaccine in the lab; the researchers hope to test two strains in animal models before moving into human trials.

Pharma company BiondVax Pharmaceuticals recently completed Phase 3 clinical trials for its universal vaccine candidate, which incorporates synthetic compounds. It has already received a patent in India. This type of vaccine targets specific areas on the surface of a flu virus that determine the phase and severity of the immune response. Being able to “ramp up” or “tamp down” different aspects of that process in animal models has convinced researchers that the vaccine could be useful in preventing other infectious disease beyond the flu, such as HIV and malaria.

FluGen, a startup out of the University of Wisconsin-Madison, is also working with a genetically-mutated form of the virus to make a universal vaccine. According to FluGen’s website, the company’s genetically-altered  viruses have had a gene deleted so that they “can infect cells, express the entire spectrum of influenza RNA and proteins, yet cannot produce any infectious virus particles.”

But to get there, the researchers encountered substantial controversy. You have to break a few eggs to make an omelet; to create a vaccine against mutating flu viruses, you’ll have to mutate a few flu viruses. Researchers worked to avoid creating some kind of super-virus. When the researchers mutated the H1N1 virus from the 2009 pandemic, and when they recreated the 1918 pandemic flu, the global scientific community called their methods and safety into question.

Other researchers, like those on a team at Georgia State University, are harnessing nanoparticles to facilitate a universal vaccine. Most vaccines target the outside surface of a virus’s protein, which varies across different viruses. But if nanoparticles could target further down, on a part of the protein called the stalk, a vaccine could have broader efficacy. In experiments detailed in a study published in Nature Communications in January 2018, mice inoculated with nanoparticles containing the protein to elicit an immune system response were completely immune to four different strains of the flu, including this year’s H3N2. They will need to conduct more animal studies — first in ferrets, as their respiratory systems are quite similar to those of humans — before testing the vaccine on humans.

There are other logistical hurdles to a universal vaccine. There’s little financial incentive for pharmaceutical companies to develop vaccines, much less universal ones only administered once in a person’s life. Distribution of vaccines can be challenging and shortages are not uncommon. Plus, people just love to find reasons why they shouldn’t get the jab.

But these challenges are not insurmountable. A universal vaccine could be possible within a generation. How well it works, well, that’s another question.

As 1918 came to a close, the editors of the Journal of the American Medical Association published its final edition for the year. The editors reflected on what could be learned from the two wars humanity fought that year, then turned their attention to the future.

“Medical science for four and one-half years devoted itself to putting men on the firing line and keeping them there,” they wrote. “Now, it must turn with its whole might to combating the greatest enemy of all — infectious disease.” In another century, perhaps the flu of today — the damage it causes, the lives lost to it — will seem equally distant, perhaps even innocuous.

The post In 1918 We Faced the Flu Pandemic. Today, We’re Still Fighting the War. appeared first on Futurism.

Futurism

Trump’s New Tax on Imported Solar Cells Could Start “Trade War”

A Slap to Solar

Imported solar cells will now cost up to 30 percent more in the United States. On January 22, 2018 President Trump ordered new tariffs as part of his plan to boost domestic manufacturing, with particular focus on the fossil fuels industry.

The new tariffs will be in place for four years, and gradually decrease to 15 percent. Analysts have identified this move as a clear blow to China — the nation accused of flooding U.S. markets with cheap solar components.

While domestic solar manufacturers are likely to see big gains — U.S. panel maker First Solar Inc. had their shares jump by as much as 9 percent — the move could be detrimental to renewables as a whole. According to the Solar Energy Industries Association, the move will also cost the U.S. solar sector roughly 23,000 jobs. Tom Mazzie, CEO of the electric utility company CleanChoice Energy, told Futurism, “It’s simple math: Tariffs increase solar costs. Higher costs means less solar. Less solar means fewer jobs.”

According to Mazzie, it’s precisely areas of the country that voted for Trump — compelled by his campaign promise to bring back coal jobs — that will be hurt the most. “The Southeast, Texas, and the Southwest are poised for huge growth in utility scale solar, but tariffs will hurt those areas the most because those are among the most cost sensitive markets,” Mazzie said.

As part of the same announcement, the President also declared new tariffs of up to 50 percent on imported washing machines for the next three years.

Risking A Trade War

Beijing was quick to react to Trump’s announcement, “resolutely” defending “its legitimate interests.” As reported by the Financial Times, Wang Hejun, an official at China’s commerce ministry, warned that the new measures “not only hurt the healthy development of the industries in U.S. but also worsen the global trade situation of the relative products.”

Speaking with Futurism, Susanne Droege, climate policy and international trade expert at the German Institute for International and Security Affairs, said that in most cases unilateral tariffs constitute a breach of the fundamental idea of free trade. “If a member  of the World Trade Organization (WTO) imposes unilateral tariffs, this needs justification,” she said, unless they are imposed against unfair competition.

If there is no justification, then the members suffering from this tariff can make a complaint under the WTO dispute settlement mechanism, she explained. “If countries do not want to use the WTO, they could also just implement a tariff themselves — on whatever good they want — and wait what is going to happen,” she said. “The point here is that this risks a trade “war” of a larger scale.”

While Trump’s new tariffs may meet the approval of fossil fuels advocates and rust-belt voters, they also risk launching a trade war between the United States and its trading partners in Asia. The cost of bolstering domestic manufacturing could be more than the U.S. can afford in the current geopolitical climate.

The post Trump’s New Tax on Imported Solar Cells Could Start “Trade War” appeared first on Futurism.

Futurism

‘Uncivil War’ is a Fast-Paced Multiplayer Card Game that’s Looking for Beta Testers

Iron Horse Games has teamed up with Yo to the Yo! [Free] developer Purple Pwny Studios to create a fast-paced card battling game called Uncivil War, and they’re currently looking for beta testers to offer some feedback. Uncivil War is loosely based on the classic high/low card game War that we all played when we were kids and has you recruiting soldiers and building up an army which you’ll take into battle in PvP against other live players or PvE in the single-player campaign. With more than 200 unique cards Uncivil War hopes to add the strategy and competitive play of games like Hearthstone and Magic: The Gathering but condensed into the quick, approachable battles that are the heart of War. Here’s some gifs showing Uncivil War in action.

As someone who loves the idea of card battlers but has always struggled to get into them due to their complexity, the more simplified but still strategic style of Uncivil War is really appealing to me. If you also like the idea of it then you can throw your hat in the ring to take it for an early test drive by visiting the forum thread for Uncivil War and hitting the link for signing up to beta test. It sounds like the developers are really keen on getting feedback from actual players to help steer the direction that Uncivil War ultimately takes both in its development leading up to release and for post-release updates. We’ll be keeping our eye on this one and will let you know when a release window is announced.

TouchArcade

The CDC Is Preparing for Nuclear War. Should You Prepare, Too?

Odd Timing

On January 2, U.S. President Donald Trump sent the now-infamous tweet in which he asserted that his “nuclear button” was both “much bigger” and “more powerful” than that of North Korean leader Kim Jong Un. Two days later, the Centers for Disease Control and Prevention (CDC) announced plans to stage a livestreamed grand rounds (a teaching session for medical professionals) titled “Public Health Response to a Nuclear Detonation” on January 16.

During the grand rounds, speakers from the CDC, the U.S. Food and Drug Administration (FDA), and other government agencies will deliver presentations with such titles as “Roadmap to Radiation Preparedness” and “Public Health: Preparing for the Unthinkable.”

So, is this a coincidence? Or a scary omen that Trump’s tweet was more than just bluster?

The Doomsday Clock Ticks Closer to Midnight
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According to CDC spokesperson Bert Kelly, the staging of a grand rounds is nothing unusual for the CDC. “Public Health Grand Rounds is part of CDC’s longstanding and routine work, with the goal of ensuring the public health community is prepared for all types of health threats,” he told Futurism. “These presentations take place regularly.”

Additionally, while the timing of a grand rounds on this particular topic may make it seem like the CDC believes the possibility of a nuclear detonation is high right now, CDC spokesperson Kathy Harben told Stat that that’s not the case. She said the agency actually began planning for the session back in April 2017 after CDC officials attended a “radiation/nuclear incident exercise” led by the Federal Emergency Management Agency (FEMA).

Prior Preparation

It’s good news that the CDC isn’t expecting a nuclear detonation in the near future, but there’s still an estimated 22,000 nuclear weapons in existence — so the threat of a future bombing remains. As we learned from Hiroshima and Nagasaki, these events have devastating and long-lasting consequences.

“We can’t predict at this point or confirm with any degree of certainty whether or not a nuclear attack is going to happen in the very near future,” Suzet McKinney, Executive Director of the Illinois Medical District (IMD) told Futurism. Still, that doesn’t mean preparation for such an event isn’t worthwhile, according to McKinney. She believes a whole community approach would be the most likely to save lives.

“No small agency or even a small jurisdiction will be able to handle a nuclear attack on its own,” said McKinney. “Government entities, first responders, and public safety personnel must work together with community members, social service and non-profit organizations, as well as private business and healthcare.”

McKinney suggested government officials make it a point to understand how their individual jurisdiction’s critical infrastructure — its hospitals, police stations, fire stations, water systems, and so on — could be affected by a nuclear detonation. She suggested they try to anticipate the potential needs of not only their own jurisdiction but also those nearby and consider how the areas might work together to cope in the aftermath of a detonation.

Early identification of especially vulnerable populations, such as people who are disabled, don’t have access to technology, or have limited English proficiency, is also important, said McKinney. This information can help officials ensure all citizens are protected in the event of a nuclear event.

Nancy Nydam, the Director of Communications for the Georgia Department of Public Health (DPH) — one of the agencies presenting at the CDC’s grand rounds — confirmed the need for collaboration and communication between various members of the community.

She told Futurism that while public health is not a first-responder in a radiation emergency (which would include a nuclear detonation) they do work closely with first responders in coordinating all responses. They are also responsible for preparing to activate the Community Reception Centers that act as a liaison between public health and the community, providing surveillance, monitoring, decontamination (if necessary), risk communication, and long-term follow-up of anyone who was or may have been exposed to radiation.

As for individuals looking to prepare for a nuclear detonation, the best thing they can do is educate themselves, according to McKinney. Knowing simple things like the importance of sheltering in place to limit radiation exposure or what it means to duck and cover can go a long way toward staying safe in the event of an attack.

She also recommends that members of the public make an effort to understand what their local and state governments are doing to address the threat of nuclear detonation. She suggests checking government websites, attending relevant community meetings, and asking questions if there’s something they don’t understand.

In that respect, the CDC’s upcoming grand rounds is an excellent resource not just for public health officials, but the public as well. The CDC is the nation’s top public health agency, and the information shared during the session could save your life if the unthinkable ever did occur.

Editor’s Note: This piece has been updated to reflect the correct name of the CDC’s teaching session.

The post The CDC Is Preparing for Nuclear War. Should You Prepare, Too? appeared first on Futurism.

Futurism

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