In addition to posing a major threat to global health, pandemics impact economic activity, as witnessed during the spread of COVID-19 around the globe. The disease risks, however, are not uniform for major pandemic threats. For example, risk groups for severe disease during seasonal epidemic influenza, the influenza pandemics of 1918 and 2009, and the ongoing COVID-19 pandemic are different. The 1918 and 2009 influenza pandemics largely killed young adults, while the COVID-19 pandemic has primarily killed the elderly. Indeed, age is the strongest risk factor for severe outcomes of COVID-19. Within age groups, however, persons with underlying medical risk factors, people of lower socioeconomic status, immigrants, ethnic minorities, and Indigenous peoples are at higher risk of infection, hospitalization, and death across these pandemics and epidemics, demonstrating a need for intersectional analyses and preparedness responses
