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Previously: Coronavirus is Literally Just the Flu
As we’ve said a million, trillion times: they just renamed “the flu” as “covid-19.”
If that isn’t obvious to everyone at this point, it never will be.
Last month, a small group of international scientists met to decide an issue critical to the health of millions of people all over the planet. For once, it wasn’t about coronavirus, although these experts know a lot about that, too. The task in hand was to save us from a bug we’ve been fighting since before the days of Hippocrates, the first doctor to describe it in 400BC. It’s an adversary potentially as much of a threat as Covid. These scientists are the flu hunters – heads of a handful of international institutions who track this old foe as it evolves and disperses in its own fight for survival.
This crucial annual meeting was held, for the first time since Covid struck, in the plateglass anonymity of the World Health Organization building in Geneva, with a few participants on Zoom. The scientists came armed with mountains of data and decades of experience to decide which four strains of the flu virus circling the globe should be in the next flu vaccine, to protect us from illness and our healthcare systems from buckling. Each has their own opinion and there can be wrangling and even some political positioning. Experts from China, the US, Australia, Japan and Russia are involved. It’s not always easy. But on 25 February, with what surely ought to have been a white puff of pontifical smoke, they made their recommendation public. Many thousands of lives will be saved – if they have got it right.
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“There are periods in which we’re very busy and periods in which we’re extremely busy,” McCauley says. He patiently explains the complexities of the virus, with just an occasional flash of suppressed irritation at this interruption to his lifesaving work. He strides briskly in his white coat between his small glass office overlooking the institute’s atrium and the dark, closed-off labs behind it. Entry to the labs is restricted whenever there is live flu virus around.
In January, the trickle of flu virus samples becomes a flood. Cardboard boxes containing the evidence of its latest mutations are brought in and transferred to freezers at -80C, where they will last for a couple of weeks while lab staff get to work. For what they have to do, the word “testing” is inadequate, McCauley’s frown makes clear. It’s about “isolating the virus, propagating the virus, doing the genetic analysis, doing the antigenic analysis, doing the drug resistance analysis, on all of these,” he says. McCauley must work out how the virus is changing so that he can inform the February meeting.
This year something unusual has been happening. There has hardly been any flu for the past two winters. There’s even speculation that some strains have vanished completely. But the flu hunters know better than to underestimate their enemy. If you can’t see it just now, it’s probably only hiding. Flu is a killer. It’s not just a bad cold. Man flu is – well, not flu. If you’re at work and think you’ve got flu, you probably haven’t. A proper bout will keep you in bed for days, unable to do much more than moan. Without vaccines, it would regularly scythe through the population, and occasionally cause pandemics, as it did in 1918, when it killed at least 20 million people (Covid has so far killed an estimated 6 million). And it’s a complicated, slippery foe, one that is very good at evolving or mutating to escape vaccines.
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In some respects, we are getting on top of flu. Conall Watson, a UKHSA epidemiologist, talks of “really positive developments in flu vaccinations”. He means the introduction of the adjuvant influenza vaccine, which gives older people’s immune systems a boost to help them respond and produce antibodies to the strains in the jab. “We’ve got evidence that it is preventing hospitalisations, but one of the really big steps the UK took was the introduction of a school-age and toddler vaccination programme,” he says, “with the idea of using vaccines to reduce community transmission.”
And the mRNA technology that has proved so successful in the Covid pandemic, used in the Pfizer/BioNTech and Moderna vaccines, is likely to be the future for flu vaccines as well. The companies are now looking to see how they can adapt it. We know mRNA vaccines can be fairly swiftly altered if a serious new coronavirus variant turns up. We could see a scenario where both the Covid and flu vaccines are redesigned every year, depending on the prevailing strains.
Will we ever get to a point where we don’t have to worry about flu? “No,” Zambon says, without hesitation, “because the natural reservoir for influenza A is wild birds.” They take the virus around the globe and there is nothing we can do about it. “So it will always be a threat to the human population.”
Which means that our best hope will continue to be vaccines. We are in the hands of the flu hunters.
Yeah, so – the flu is gone, but the vaccines for the coronavirus were so very effective, that we need coronavirus vaccines for the flu that is gone.
Pfizer makes a lot of money.
