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Why another flu pandemic is likely just a matter of when

Despite the availability of vaccines, the flu still kills tens of thousands of people in the U.S. each year, and hundreds of thousands more worldwide. But public health officials fear that an even graver threat lies ahead: the emergence of a new, much more deadly flu virus. As William Brangham reports, the scenario has occurred before.

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  • 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:

    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:

    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:

    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:

    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.

  • Dr. Anne Schuchat:

    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.

  • 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.

  • 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?

  • 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-Ind.:

    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, R-Ind.:

    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, R-Ind.:

    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, R-Ind.:

    … 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 tomorrow night, focusing on the potential for a pandemic.

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