Experts Outline Key Ways to Prevent the Next Pandemic

Modernity is both cause and cure of global pandemics, write four physician-scientist experts in pandemic prevention in the latest issue of the journal Foreign Affairs. There is a growing risk of another devastating global pandemic driven by globalization and human encroachment on nature. At the same time, rapid advances in technology can lower the risk of such a catastrophe, but only with speed, cooperation and trust.

The article is authored by W. Ian Lipkin, professor and director of the Center for Infection and Immunity and founding director of the Global Alliance for Preventing Pandemics at Columbia University Mailman School of Public Health, and an adviser at Pandefense Advisory; Larry Brilliant, CEO of Pandefense Advisory and Senior Counselor at the Skoll Foundation; Mark Smolinski president of Ending Pandemics; and Lisa Danzig an advisor at Pandefense Advisory.

The timing of the COVID-19 pandemic, coming almost exactly 100 years after the 1918 Great Influenza, suggest surviving such an event buys 100 years of safety. “Sadly, the real anomaly was not this pandemic; it was the preceding 100 years of relative calm. All the while, the risk of pandemics had been steadily rising,” the authors write. 

Pandemic risk is exacerbated by population growth, urbanization, greater consumption of meat, and increasing proximity to wildlife. Taken together, these factors increase the risk of animal viruses spilling over to humans. With long-distance travel, a pathogen can now transit the globe in hours. Mass gatherings increase the odds of super-spreader events. 

Climate change exacerbates these problems through habitat loss by pushing wild animals to areas where they are more likely to mix with new animals and more people. Water shortages and crop failures have driven humans into dense megacities and migrant camps where pathogens spread easily. And it has lengthened the breeding seasons and expanded the habitats of disease-carrying ticks, mosquitoes, and flies. Separately, another problem is the growing consumption of bushmeat and trade in exotic pets. 

Another pandemic risk comes from laboratories that study monkeys, rats, and bats, all of which can infect workers, or viruses, that can spread via petri dishes or other equipment. While there is no evidence that SARS-CoV-2 was genetically engineered, the authors say it would be “neither unusual nor nefarious” for a lab in China to have gathered specimens of infected animals. In fact, one such lab was situated near the wet market where the COVID-19 outbreak was first detected.  

Wherever its origins, the next pandemic could arise from a novel coronavirus or an influenza virus and the result might spread more quickly and/or be more deadly than SARS-CoV-2. Another threat is Orthopoxviruses, a category of viruses that includes smallpox and monkeypox. One concern is that people with monkeypox might “spill back” the disease to animals, especially the rodent population of large cities, which in time could lead a virus that resembles a lesser form of smallpox. Bacteria are also becoming  potent threats as the effectiveness of antibiotics declines. 

On the plus side, scientific advances are helping prevent pandemics. Through mobile apps and hotlines, people can now report unusual sickness in livestock or poultry and unexpected die-offs among wildlife, giving authorities a chance to identify the disease, cull the infected animals as needed, and quarantine nearby humans. Additionally, digital surveillance can flag everything from a local news report of a market closure to a spike in online searches for pediatric thermometers, although greater investments in situational awareness is needed. 

Pandemic preparedness has also been improved through advances in viral sequencing and vaccine development, although wealthy nations must do more to share these gains with the Global South. Crucially, the global community must come together to combat mistrust among countries and mistrust between populations and their own public health officials.

The authors conclude: “Without trust, even the best public health policies will fail. It is this human element that will, above all, determine whether the world can use modernity’s gift of science to stave off catastrophe.”