why was pandemic preparedness been focused on influenza rather than another virus?


ELI5….. pandemic preparedness was previously talked about with influenza in mind… Why influenza and not another type of virus?

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Because it’s the most recent outbreak we’ve had, certainly. H5N1/H1N1 is the most recent airborne respiratory virus we’ve had to deal with.

Because flu kills a lot of people.

OK, COVID is a once-in-a-thousand-years corona virus that’s killing people. Most corona viruses cause “the common cold”.

Most of the time (even the Spanish Flu from 100 years ago) it’s the flu killing people. Since 2000, flu’s killed about 40K people a year. [{ref}](https://www.cdc.gov/flu/about/burden/index.html )

While it’s not always the flu (some times it’s the Bubonic Plague, or Cholera), it’s usually the flu that’s causing a massive death problem.

Practically speaking, flu was the biggest pandemic player of the 20th century into the 21st. There were flu pandemics in the 1910s, 50s, 60s, 70s, and 2000s.

Influenza is good at pandemics. It has an unusual ability to reshuffle large chunks of genes between two existing strains, occasionally resulting in a new strain that humanity has minimal immunity against. Many existing flu season strains started their lives as new pandemics.

But what about the other big pathogens? Social change and public health measures have knocked out a lot. Plague once killed half of Europe, but minimal hygiene and not living with livestock means no fleas to spread it; typhus is the same story. Cholera requires poop to contaminate drinking water, so clean water is the end of the story. Polio spread similarly, and has been further pushed to the brink of extinction by vaccination. Measles spreads like wildfire but still can’t beat MMR. Smallpox is our crown jewel, completely eradicated by vaccination.

Others are still here, but as slow burns rather than fast spikes. Tuberculosis is still the old classic, killing more than any other infection until COVID hit. HIV was a big surprise at one point, but medication means it’s less and less of an issue. Malaria and yellow fever have been hemmed in by mosquito control, though they’re still big in hot wet parts of the world.

We did have two unsettling hints in SARS and MERS that coronavirus could be more than a lesser-known cold virus, but they were nothing next to H1N1 flu in terms of global spread. Flu and coronavirus also have the key advantage of respiratory spread. The industrialized world doesn’t tolerate dirty water or fleas, but breathing is harder to get rid of.