Lessons for the next pandemic from two years of Covid
The pandemic declared by the World Health Organization exactly two years ago is not yet over. Covid-19 is on the wane in most countries and many are learning to live with it. But after killing 6mn people globally, according to official statistics, and more than 18mn, according to a new scientific estimate, some places are experiencing a resurgence in cases and deaths. The battle against the Sars-Cov-2 virus therefore should remain a top public health priority as virologists warn of the inevitable emergence sooner or later of new variants that might be more lethal than the Omicron dominant today.
The world must also learn from its Covid experience to prepare for the next pandemic caused by a different pathogen. This is inevitable but even less predictable than the future of the current one. Many scientists think the culprit is most likely to be influenza or another coronavirus, though there is a frightening list of other possibilities from Nipah to Lassa fever.
There are three interrelated lessons from Covid: reduce the risk of a new pathogen with pandemic potential appearing in the first place; if it does emerge, stop it spreading worldwide; and if it goes global, develop an effective armamentarium of vaccines and treatments as quickly as possible.
Pandemic viruses usually originate in animals. China’s ban on trading terrestrial wildlife for food, soon after Covid emerged, was an important first step and must be enforced. Stronger restraints on the rampant African bushmeat trade would be a helpful contribution both to pandemic prevention and nature conservation.
The second stage of pandemic prevention — stopping a dangerous pathogen spreading far beyond its place of origin — depends on having an excellent worldwide viral surveillance system, followed by an effective isolation policy if an outbreak is detected.
Whether China could have stopped Covid at source in 2019 is debatable. But if the best genomic analysis available today had been applied to samples from the first patients suffering from the unknown respiratory infection as it started to spread in Wuhan, it would have shown that a highly transmissible new coronavirus was responsible. An immediate quarantine might just have saved the world from the pandemic.
The global capacity to read the genetic code of viruses, which has grown enormously over the past two years, must be kept in place as Covid wanes, to serve as an early warning system. Extending its reach to poorer countries will be an important part of any initiative to improve the world’s post-pandemic medical infrastructure.
The third element of planning will ensure that vaccines and medicines are developed even faster for the next pandemic than for Covid. A meeting in London this week was a significant step forward. The Coalition for Epidemic Preparedness Innovations (Cepi) raised $1.5bn in contributions to its 100 Days Mission, which will eventually need $3.5bn.
The aim is to have vaccines designed and put through clinical trials, ready for mass inoculation, within 100 days of identifying a dangerous new virus; for comparison, the valiant effort to develop a Covid vaccine took 326 days. The huge research and development programme envisaged by Cepi will have to be supplemented by even larger sums for advance purchase commitments, put up by governments when it may not be clear how great a risk the virus really poses to the world.
But medical science and technology can only do so much for preparedness. Political collaboration across the globe will be required too. If heightened tensions follow the war in Ukraine, the next pandemic will find a more fertile breeding ground.