By Andrew Nusca
March 21, 2018

LAGUNA NIGUEL, Calif.—This year marks the 100th anniversary of the 1918 Spanish Flu, which infected 500 million people and killed more than 50 million. The annual flu “season” to which we’ve acclimated seems benign compared to that incident—and yet it infects millions of people each year and kills thousands. (This year has been particularly brutal.)

“What was most concerning” about the 1918 outbreak, said Bruce Gellin, president of global immunization at the Sabin Vaccine Institute, “was that it was taking out the young and healthy.” Life expectancy plummeted from 46 years to just 34. The only medical treatment for the disease? Masks, which of course didn’t work. Researchers wouldn’t identify the virus at the center of the outbreak for another decade.

An estimated 50 to 100 million people died, Gellin said: “Big numbers, but not big data.” There were three waves of the disease. “It started with a small outbreak in rural Kansas” before moving to Europe, Gellin said. It was called the Spanish flu in Europe because only Spain at the time had a free press, which in turn covered the devastation. But the affliction spread unevenly around world. “Where you lived didn’t seem to determine if you lived,” he said.

This year to date, 128 children have died from influenza, Gellin said. “And we’re complacent about it.” The flu is a seasonal condition to be endured, not a population-obliterating disease to be feared.

It should be. Even with the best analytics, Gellin said, the process for identifying the flu to create a vaccine isn’t much better than in 1918. “It’s a guess,” he said. “An informed guess, but a guess.”

The virus’s continual evolution is why we keep crafting new cocktails for it. If it evolves aggressively enough, we’re almost certain to have another pandemic. “The pandemic clock is ticking,” Gellin said. “We don’t know what time it is.” Researchers are tracking one strain in China right now. It has a 40% fatality rate.

“Seventy years from now, we better be doing something differently,” Gellin warned.

The World Bank estimates that a pandemic would cost 4.8% of GDP today, or about $3 trillion. Medicine shortages and travel interruptions for medical professionals would lead to a slow recovery period.

“We know a lot, but we clearly need to know a lot more,” Gellin said. “This is an all-hands-on-deck time.” Not just for flu experts but for people in disciplines far beyond that, he said. Because we need to find a universal flu vaccine, and fast.

Said Gellin: “If we get there, we can make influenza history.”

For more coverage of Fortune’s Brainstorm Health conference, click here.

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