IS THIS TRUE?  Are they using these lessons?

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Lessons From a Pandemic, a Decade Later

Health officials are better prepared to fight flu now, thanks to hard lessons learned when the swine-flu pandemic hit in 2009.
By Steve Sternberg, Assistant Managing Editor, Health Initiatives June 11, 2019, at 3:48 p.m.

Lessons From the 2009 Flu Pandemic

Empty vials of H1N1 vaccine sit on a table in 2009. The outbreak of 2009 marked a number of major changes in the way that flu experts respond to pandemic threats.

A decade ago today, on June 11, 2009, the World Health Organization sounded the alarm that a swine-flu pandemic was spreading around the globe.

The influenza A H1N1 virus bore a frightening resemblance to a 1918 virus that killed around 50 million people worldwide, including an estimated 675,000 in the United States – many of them healthy young adults, 15 to 34 years old. The death toll rose so quickly, and took so many lives, that it reduced the average U.S. life expectancy by more than 12 years.

In 2009, it appeared that the virus, or some version of it, was back – and it seemed to share a grim characteristic of the 1918 virus.

Seasonal flu viruses tend to replicate in the upper respiratory tract. But the 1918 virus, and to a lesser extent the 2009 virus, ravaged the lungs. “That’s why you get such severe disease,” says Dr. Terence Tumpey, chief of the Immunology and Pathogenesis Branch in the Centers for Disease Control and Prevention’s Influenza Division.

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In the first year of the 2009 pandemic, between 151,700 and 575,400 people would die worldwide. At least 375 children died in the U.S., twice as many as in a typical flu season.

Since 2009, about 100 million cases of H1N1 influenza have occurred worldwide, and almost a million people have been hospitalized.

In 1918, with the world still reeling from a catastrophic world war, virus experts could do little to mitigate the pandemic’s impact. In 2009, the World Health Organization and its member nations were much better prepared. Aggressive surveillance, improved medical care, accelerated vaccine production and modern antivirals all muted the impact of the 2009 pandemic, says Dr. Dan Jernigan, director of the CDC’s flu division.

Another tool emerged as well from one of the most compelling sagas of all medical history:

In 2005, Swedish microbiologist Johan Hultan successfully concluded a lifelong quest and retrieved a sample of the 1918 virus from the tissues of pandemic victims preserved in the permafrost in the Alaskan village of Brevig Mission. The frozen samples allowed researchers not only to study the virus’ genetic makeup, but to bring it back to life temporarily before dividing up its DNA and storing it in small circular structures called plasmids in CDC freezers.

“I don’t know of anything that compares with what we’ve done,” says Tumpey, who collaborated with other researchers, including Dr. Jeffrey Taubenberger, formerly of the Armed Forces Institute of Pathology and now at the National Institute of Allergy and Infectious Diseases, to examine the 1918 virus. “People have compared it to the ‘Jurassic Park’ of virology.”

Jernigan says versions of the 1918 virus apparently got into the pig population and stayed there for decades, until it mixed with other flu viruses “in the right combination and had the right opportunity” to leap into humans. Then, he says, “it took off.”

When the morphed virus emerged in 2009, all the signs pointed to “a complete shift” in its makeup, Jernigan says. Such a shift in the nature of a flu virus can strike with the force of an earthquake – not just in the world of flu experts, but in the real world as well.

Viruses are chameleons that change gradually from year to year, and there are many different variants of the flu virus. The flu vaccine must be reformulated every flu season to guard against the virus strains expected to be the most harmful in a coming season.

The gradual changes are called virus “drift.” Dramatic changes are referred to as viral “shift.”

When this occurs, the flu virus can become much more virulent and much more difficult for the immune system to recognize. The immune system may be helpless to guard against it, because previous flu exposures, including those from vaccines, are unlikely to confer much protection against such a profound change.

Shift is a key characteristic of a pandemic virus, Jernigan says. Pandemic viruses are also highly transmissible, so an infected person can go on to infect two or three others. And transmission is sustained, he says, meaning the virus keeps on moving from one person to another.

With the 2009 virus, he says, “those three factors were met.”

Pandemic fighters must be equally nimble in their efforts to track the virus down and take countermeasures, especially in regard to distributing anti-viral drugs and jump-starting production of a vaccine.

By investigating virus samples from two children from Southern California, researchers were able to identify elements of the 2009 virus. One of the children had been to the San Diego County Fair. Investigators rushed to the fairgrounds to see whether pigs at the fair could have been the source of the exposures. They were too late, Jernigan says. The pigs had been slaughtered.

They also visited the San Diego Zoo to test a domesticated pig that children could walk on a leash. “We wanted to swab the animal,” Jernigan says, but first they had to win over the zoo’s lawyers. The pig turned out to be negative for the new virus.

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Eventually, disease detectives traced the origin of the 2009 virus to Mexico. And, by comparing it with other viruses in their freezers, they discovered its similarity to the 1918 virus.

As it happened, this appears to have lessened the 2009 flu’s severity against older people, who are usually especially susceptible to the flu. In this case, enough older Americans had been exposed to variations of the 1918 virus over the years that they had some immunity to it. That wasn’t the case for children, which is why the death toll among children was so high.

The 2009 pandemic marked a number of major changes in the way that flu experts respond to pandemic threats. Rather than growing the virus in cell culture, which takes time, they now sequence the virus’ genes, which can be done quickly. Every state can now submit flu virus samples to three laboratories under contract to the CDC to quickly determine what viruses are making their residents sick.

CDC scientists also stock antibody-rich serum samples taken from individuals infected in past epidemics. By exposing flu viruses to serum containing human antibodies, scientists can determine quickly, in the laboratory, how well the human immune system can fight off novel flu viruses.

Serum tests offered the first clue that older people carried some immunity to the 2009 virus, Jernigan says.

Researchers also can track the evolution of viruses much more effectively. And when a terrifying new virus emerges, such as the influenza A H7 virus found among birds in China, researchers don’t wait for the virus to start circulating among humans. The Chinese vaccinate billions of birds in commercial markets to keep the virus from spreading and infecting humans. And the U.S. has forwarded information about the H7 virus to vaccine manufacturers, so they can have stockpiles on hand in case it begins circulating among humans.

Researchers additionally have developed an influenza risk assessment tool, designed to assess the likelihood that an emerging flu virus will spark a pandemic, and, if it were to take off, how bad it would be.

“We have a very aggressive risk posture,” Jernigan says.

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Well – are they using all of these lessons in our present “manufactured”  coronavirus?

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