#17,741
Although its timing, origins, and impact are unknowable, the next pandemic threat is out there - evolving and adapting - just waiting for conditions to be right to begin its world tour. While respiratory viruses like novel influenza and coronaviruses are the most obvious threat, the next pandemic could easily come from a far different source (e.g. Mpox, Zika, Ebola, Dengue, etc.).
After the 2009 H1N1 pandemic proved to be relatively mild (except, of course, for those who had severe illness), the idea that we could see another 1918-like pandemic was pretty much abandoned. Pandemic planning became passé, and repeated warnings of global unpreparedness (see here, here, here, and here) were largely ignored.Unfortunately, we always appear to be preparing to fight the last pandemic.
Nearly a decade later, in August of 2019 - just a few months before the emergence of COVID - in WHO: Survey Of Pandemic Preparedness In Member States, we saw the dismal results of a two-year survey of global pandemic preparedness.
- Sadly, only just over half (n=104, or 54%) of member states responded. And of those, just 92 stated they had a national pandemic plan. Nearly half (48%) of those plans were created prior to the 2009 pandemic, and have not been updated since.
- It gets worse, as only 40% of the responding countries have tested their pandemic preparedness plans - through simulated exercises - in the past 5 years.
Six months later, when a severe coronavirus pandemic finally did emerge, we learned just how unprepared the world really was to deal with it (see The Most Predicted Global Crisis of the 21st Century).
Fast forward another 4 years, and not only have most nations dismantled their COVID surveillance and reporting systems, the sharing of other infectious disease data has decreased as well (see Flying Blind In The Viral Storm).
Last April, in Lancet Preprint: National Surveillance for Novel Diseases - A Systematic Analysis of 195 Countries, we looked at an independent analysis which suggests that many nations have substantially overstated their compliance with the 2005 IHR regulations, and that surveillance and reporting are far less robust than advertised.
All of which brings us to a lengthy, and highly detailed review article in the journal Microorganisms, which looks at an array of potential pandemic threats (see chart below), and discusses our readiness to deal with them.
The full article is well worth reading, and the underlying message - that `International collaboration, data sharing, and interdisciplinary research are key to staying ahead of viral threats' - is well taken.
But in far too many countries, `Don't test, don't tell' has - for political, economic, and societal reasons - become unofficial policy. Even when disease reports are provided, they sometimes come weeks or months after the fact, and are often lacking in detail.
While we have the advantages of modern technology, unless and until all nations take surveillance, testing, and timely sharing of information seriously, we will remain unnecessarily vulnerable to being blindsided by the next pandemic.
Follow the link below to read the full report.
Emerging Infectious Diseases Are Virulent Viruses—Are We Prepared? An Overview
Jasmine J. Han 1,*, Hannah A. Song 2, Sarah L. Pierson 3, Jane Shen-Gunther 4 and Qingqing Xia 3,*
Abstract
The recent pandemic caused by SARS-CoV-2 affected the global population, resulting in a significant loss of lives and global economic deterioration. COVID-19 highlighted the importance of public awareness and science-based decision making, and exposed global vulnerabilities in preparedness and response systems.
Emerging and re-emerging viral outbreaks are becoming more frequent due to increased international travel and global warming. These viral outbreaks impose serious public health threats and have transformed national strategies for pandemic preparedness with global economic consequences. At the molecular level, viral mutations and variations are constantly thwarting vaccine efficacy, as well as diagnostic, therapeutic, and prevention strategies. Here, we discuss viral infectious diseases that were epidemic and pandemic, currently available treatments, and surveillance measures, along with their limitations.
(SNIP)
6. Discussion
Historically, virus outbreaks have initiated the public response to vaccine development and clinical trials for treatment. The recent COVID-19 pandemic and the recent mpox outbreak showcased the possible effects of constantly changing viruses on society. A genomic mutation develops a new deadly variant by changing its route of transmission and becoming highly infectious with a low viral load. However, our ability to anticipate, respond to, and mitigate the impacts of emerging and re-emerging viruses is more promising than ever due to scientific and medical advancements in this modern era. In addition, with technological advancements in bioinformatics, a rapid, streamlined means of sequencing newly emerging viruses is possible through an automated workflow pipeline [129]. This will facilitate the expedited identification of emerging viruses, resulting in earlier public and medical responses to confine their outbreak. The continuously evolving mutation of viruses may challenge the effectiveness of available vaccines.
In addition, non-invasive environmental surveillance tools for early detection have been developed that are currently used by either research groups or the government, such as wastewater monitoring [130,131] and vector sampling [132]. This method was supported by the provided evidence that non-water-borne viruses can be detected during wastewater monitoring. For example, airborne viruses (coronavirus [121] and influenza [133]) and vector-borne viruses (Zika virus [134] and West Nile virus [135]) were detected via wastewater-based epidemiological studies.
However, whether non-airborne viruses can be detected via bioaerosol monitoring is unclear. Since virus-containing aerosols can be generated through various mechanisms, such as respiratory activities (talking, coughing, and sneezing), medical procedures (intubation, dental procedures, and bronchoscopy), environmental disturbance (vacuuming, cleaning, and sweeping), animal activities, and industrial processes, bioaerosol surveillance can be considered a powerful tool to screen viruses that linger in the air, especially indoor air. Admittedly, this method has some limitations; for example, the potential for a virus to become aerosolized depends on various factors, the virus detection rate can be very low, and some viruses are more capable of remaining infectious in aerosols and surviving airborne conditions than others. In the era characterized by the swift advancement of science and technology, technological limitations are expected to be addressed soon.
Under these circumstances, the means that can prepare us for the next infectious disease challenge become critical. International collaboration, data sharing, and interdisciplinary research are key to staying ahead of viral threats. To prepare for the next outbreak in global public health, research and public effort ought to focus on the availability of reliable surveillance systems for emerging threats, expedited vaccine development as the viral infection emerges and becomes epidemic, public awareness and receptivity towards the benefits of mass vaccination, and practicing good citizenship surrounding the public health measures of testing and quarantines. The information summarized in this review will aid authorities in designing and adopting effective prevention and control strategies to counter the next emerging or re-emerging virus.
The topic that we summarized is an overview of a quickly changing field that expands exponentially with new research findings. Here, we attempted to provide the current research topics and past knowledge of emerging and re-emerging viruses for readers to further explore their interested field of study. Thus, the limitation of this approach lies in the lack of an in-depth description of each topic and virus discussed.
7. Conclusions
COVID-19 disease highlighted the importance of science-based decision making and exposed global vulnerabilities in the prevention and preparedness of pandemic infection and response systems. During the pandemic, medical advancements in developing a new vaccine in a timely manner and improved treatment methods becoming available for viral infections were successes. The development and usage of a vaccine have been proven effective at providing valid protection to individuals, but public awareness and receptivity towards mass vaccination are a challenge. Furthermore, the threat of new variants is constantly challenging the vaccine’s effectiveness.
One of the major challenges faced during the last pandemic was the lack of an effective surveillance system that can provide early warnings about outbreaks. From past experiences, we learned that proactive surveillance, rapid diagnostics, and effective communication networks are pivotal in containing and managing emerging threats. In a world bound by shared vulnerabilities, our collective action and unwavering determination hold the key to safeguarding future generations against the threats that emerge from the virus realm. As we peer into the future, preparedness is not an option but a mandate.
