Preparing for the inevitable next pandemic

The world has been stewing in the COVID-19 pandemic for close to three years now. A monkeypox outbreak where diagnosed cases number in the thousands seems poised to veer into a pandemic sooner rather than later. Scientists and science journalists are already declaring the 21^st century the Pandemicine, where the cumulative effects of human activity, habitat destruction, and climate change will cause new viral pandemics or create zoonoses at a previously unheard of rate.

Even in a best-case scenario, it seems unlikely that humans can completely halt the age of pandemics. But as the United States is mired in another viral outbreak with monkeypox, we should take this opportunity to prepare for the next epidemic 

Scientists aren’t in the dark about which viruses could be coming for us next. A 2021 paper in Proceedings  of the National Academy of Sciences  ranked the viral families most likely to cause pandemics or new spillovers into humans using data from viral surveys from 2009-2015. The paper listed familiar viruses, some of which have already caused regional or worldwide pandemics — SARS-CoV-2, Ebola — and others that haven’t quite captured the world yet. But even those are known viruses with familiar biology: They’re Arenaviruses like Lassa virus, Filoviruses like Ebola or Marburg (which recently caused an outbreak in Africa), insect-borne Bunyaviruses, and a handful of other Coronaviruses. 

All of these viruses have known biology, which means that we are already somewhat prepared. While we don’t yet have treatments for many of them, the biggest lesson of the COVID-19 pandemic has been that treatment is wonderful, but detection and prevention are the first lines of defense. 

Academic and industry scientists should start preparing now for these viruses to spillover. The biotech industry can start preparing affordable, accurate, rapid tests for broad viral families. Pharmaceutical companies can start R&D on small molecule inhibitors like Paxlovid. Academic scientists with the help of federal funding can keep efforts up on teasing out the underlying biology and life cycles of viruses that might spillover. Knowing how these viruses behave — what their vectors are, how they spread from animal-to-human or from human-to-human, what their potential incubation times are — is critical to limit spread at the start of an outbreak. 

These aren’t new ideas. The Centers for Disease Control already has hundreds of pages worth of planning for potential influenza outbreaks. This is good! We shouldn’t have to start from zero every time we are faced with a potential new viral infection.

Not every virus that we know can spillover and cause a pandemic will actually do so. But there’s absolutely no reason to sit and wonder what will happen when and if they do. 

References

1. Carlson, C.J., Albery, G.F., Merow, C. et al. Climate change increases cross-species viral transmission risk. Nature  607, 555–562 (2022). https://doi.org/10.1038/s41586-022-04788-w
2. Grange, Z.L., Goldstein T., Johnson, C.K., et al. Ranking the risk of animal-to-human spillover for newly discovered viruses. Proceedings of the National Academy of Sciences  118 (15). (2021). https://doi.org/10.1073/pnas.2002324118
3. National pandemic strategy. Centers for Disease Control and Prevention (2022). Available at: https://www.cdc.gov/flu/pandemic-resources/national-strategy/index.html. (Accessed: 17th August 2022)