Pandemic prevention is the organization and management of preventive measures against
pandemic
A pandemic () is an epidemic of an infectious disease that has spread across a large region, for instance multiple continents or worldwide, affecting a substantial number of individuals. A widespread endemic (epidemiology), endemic disease wi ...
s. Those include measures to reduce causes of new infectious diseases and measures to prevent outbreaks and epidemics from becoming pandemics.
It is not to be mistaken for pandemic preparedness or mitigation (e.g. against COVID-19) which largely seek to mitigate the magnitude of negative effects of pandemics, although the topics may overlap with pandemic prevention in some respects.
Some efforts of pandemic prevention reportedly risk triggering pandemics while not engaging in any form of pandemic prevention is risky as well.
History
2002–2004 SARS outbreak
During the
2002–2004 SARS outbreak
The 2002–2004 outbreak of SARS, caused by severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1), infected over 8,000 people from 29 countries and territories, and resulted in at least 774 deaths worldwide.
The outbreak wa ...
, the
SARS-CoV-1
Severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1; or Severe acute respiratory syndrome coronavirus, SARS-CoV) is a strain of coronavirus that causes severe acute respiratory syndrome (SARS), the respiratory illness responsible for th ...
virus was prevented from causing a pandemic of
Severe acute respiratory syndrome
Severe acute respiratory syndrome (SARS) is a viral respiratory disease of zoonotic origin caused by the severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1), the first identified strain of the SARS coronavirus species, ''seve ...
(SARS). Rapid action by national and international health authorities such as the
World Health Organization
The World Health Organization (WHO) is a specialized agency of the United Nations responsible for international public health. The WHO Constitution states its main objective as "the attainment by all peoples of the highest possible level of h ...
helped to slow transmission and eventually broke the chain of transmission, which ended the localized epidemics before they could become a pandemic. Human-to-human transmission of SARS may be considered eradicated, however, it could re-emerge as SARS-CoV-1 probably persists as a potential zoonotic threat in its original animal reservoir. This warrants monitoring and reporting of suspicious cases of atypical pneumonia. Effective isolation of patients was enough to control spread because infected individuals usually do not transmit the virus until several days after symptoms begin and are most infectious only after developing severe symptoms.
MERS-CoV/NeoCoV alert
In January 2022, Chinese scientists at the
Wuhan University
Wuhan University (WHU; ) is a public research university in Wuhan, Hubei. The university is sponsored by the Ministry of Education. Wuhan university was founded as one of the four elite universities in the early republican period of China and i ...
and other institutions reported in a
preprint
In academic publishing, a preprint is a version of a scholarly or scientific paper that precedes formal peer review and publication in a peer-reviewed scholarly or scientific journal. The preprint may be available, often as a non-typeset versio ...
the detection of the closest
MERS-CoV
''Middle East respiratory syndrome–related coronavirus'' (''MERS-CoV''), or EMC/2012 ( HCoV-EMC/2012), is the virus that causes Middle East respiratory syndrome (MERS). It is a species of coronavirus which infects humans, bats, and camels. The ...
relative in bats to date, NeoCoV, and PDF-2180-CoV that can efficiently use bats'
ACE2
Angiotensin-converting enzyme 2 (ACE2) is an enzyme that can be found either attached to the membrane of cells (mACE2) in the intestines, kidney, testis, gallbladder, and heart or in a soluble form (sACE2). Both membrane bound and soluble ACE2 a ...
for cell-entry. The to-date unreviewed preprint finds that one mutation could result in a 'MERS-CoV-2' that, like
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19 (coronavirus disease 2019), the respiratory illness responsible for the ongoing COVID-19 pandemic. The virus previously had a ...
, can use humans' ACE2 receptor and at least initially has both a high fatality (MERS-CoV had a mortality of around 35%) and high transmission rate, and hence represents a risk to
biosafety
Biosafety is the prevention of large-scale loss of biological integrity, focusing both on ecology and human health.
These prevention mechanisms include conduction of regular reviews of the biosafety in laboratory settings, as well as strict guidel ...
and of potential
zoonotic
A zoonosis (; plural zoonoses) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a bacterium, virus, parasite or prion) that has jumped from a non-human (usually a vertebrate) to a human. ...
spillover. According to one report, the
WHO
Who or WHO may refer to:
* Who (pronoun), an interrogative or relative pronoun
* Who?, one of the Five Ws in journalism
* World Health Organization
Arts and entertainment Fictional characters
* Who, a creature in the Dr. Seuss book ''Horton Hear ...
stated that further study would be required to find out "whether the virus detected in the study will pose a risk for humans". The study also emphasizes the need for pathogen/spillover surveillance.
Other
* Monkeypox: On 21 May 2022, the
WHO
Who or WHO may refer to:
* Who (pronoun), an interrogative or relative pronoun
* Who?, one of the Five Ws in journalism
* World Health Organization
Arts and entertainment Fictional characters
* Who, a creature in the Dr. Seuss book ''Horton Hear ...
informed about the international
2022 monkeypox outbreak
An ongoing outbreak of monkeypox, a viral disease, was confirmed in May 2022. The initial cluster of cases was found in the United Kingdom, where the first case was detected in London on 6 May 2022 in a patient with a recent travel his ...
in non-endemic countries – an unprecedented number of cases detected outside of Africa after the first of these cases was detected on 6 May. On 24 May, the WHO stated that the outbreak can be contained. The main method used for the early containment is '
ring vaccination
Ring vaccination is a strategy to inhibit the spread of a disease by vaccinating those who are most likely to be infected.
This strategy vaccinates the contacts of confirmed patients, and people who are in close contact with those contacts. Thi ...
' – vaccinating close contacts of positive cases via already-existing vaccines alongside pre-exposure vaccination of people at higher risk.
Measures
Infrastructure and international development
Robust, collaborating public health systems that have the capacity for active surveillance for early detection of cases and to mobilize their health care coordination capacity may be required to be able stop contagion promptly. After an outbreak there is a certain window of time during which a pandemic can still be stopped by the competent authorities isolating the first infected and/or fighting the pathogen. A good global infrastructure, consequent information exchange, minimal delays due to
bureaucracy
The term bureaucracy () refers to a body of non-elected governing officials as well as to an administrative policy-making group. Historically, a bureaucracy was a government administration managed by departments staffed with non-elected offi ...
and effective, targeted treatment measures can be prepared. In 2012 it has been proposed to consider pandemic prevention as an aspect of
international development
International development or global development is a broad concept denoting the idea that societies and countries have differing levels of economic or human development on an international scale. It is the basis for international classifications ...
in terms of health-care infrastructure and changes to the pathogen-related dynamics between humans and their environment including animals. Often local authority carers or doctors in Africa, Asia or Latin America register uncommon accumulations (or clusterings) of symptoms but lack options for more detailed investigations. Scientists state that "research relevant to countries with weaker surveillance, lab facilities and health systems should be prioritized" and that "in those regions, vaccine supply routes should not rely on refrigeration, and diagnostics should be available at the point of care". Two researchers have suggested that public health systems "in each country" need to be capable of detecting contagion early, diagnosing it accurately, implementing effective disease control measures, and fully collaborating with the relevant international authorities at each stage . U.S. officials have proposed a range of reforms to international health regulations and global institutions for global health security.
Technology-centric measures
Biosafety technologies and biotechnology regulation
Potential policies that support global
biosafety
Biosafety is the prevention of large-scale loss of biological integrity, focusing both on ecology and human health.
These prevention mechanisms include conduction of regular reviews of the biosafety in laboratory settings, as well as strict guidel ...
could make use of various technologies, including but not limited to laboratory containment technologies. Proposals to increase biosafety in terms of laboratories, scientific field work and research and development-related activities include:
* limiting research on highly contagious biological agents to only trained researchers in well-protected environments and advanced biological safety systems and disposal of biohazards.
* improving physical security and educating scientists about the misuse potentials
* review processes that ensure risks are justified and minimized, such as preventing certain
gain-of-function
Gain-of-function research (GoF research or GoFR) is medical research that genetically alters an organism in a way that may enhance the biological functions of gene products. This may include an altered pathogenesis, transmissibility, or host ran ...
studies (the exact definition of "gain-of-function" is contested and there also the term "enhanced potential pandemic pathogens"). Arguments for gain-of-function-type research may include "that vaccines and therapeutics can be pre-emptively researched and developed" this way.
* monitoring and strengthening laboratory protocols around the world
**Work on coronaviruses at the Wuhan Institute of Virology was carried out at biosafety level 2 (with level 4 being the most secure)
**According to a study "there are no national guidelines or reference standards available in India on certification and validation of biosafety laboratories"
**According to an expert, there "really isn't an agreed to and followed set of standards for how iosafety levelBSL3 and BSL4 labs should secure themselves"
**In a 2018 study it was suggested that there is a need "to update international laboratory biosafety guidance" "to globalize biosafety"
* monitoring and strengthening field work protocols around the world (such as viral sampling)
**The so far closest known relative virus (with a 96.8% similarity) to
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19 (coronavirus disease 2019), the respiratory illness responsible for the ongoing COVID-19 pandemic. The virus previously had a ...
was found in samples from wild
horseshoe bat
Horseshoe bats are bats in the family Rhinolophidae. In addition to the single living genus, ''Rhinolophus'', which has about 106 species, the extinct genus '' Palaeonycteris'' has been recognized. Horseshoe bats are closely related to the Old ...
s in/at caves in northern
Laos
Laos (, ''Lāo'' )), officially the Lao People's Democratic Republic ( Lao: ສາທາລະນະລັດ ປະຊາທິປະໄຕ ປະຊາຊົນລາວ, French: République démocratique populaire lao), is a socialist ...
. No SARS-CoV-2 related viruses could be found in any samples collected in China, including from the only two domestic caves where RaTG13 and
RmYN02
RmYN02 is a bat-derived strain of ''Severe acute respiratory syndrome–related coronavirus''. It was discovered in bat droppings collected between May and October 2019 from sites in Mengla County, Yunnan Province, China. It is the second-closest ...
were detected, indicating such viruses may currently not circulate in bats in the country.
**A small survey reported that many biosafety professionals conducting field collection of potentially infectious specimens have not been formally trained on the topic
**There are multiple known examples of field-associated infections
* making deadly viruses harder to engineer
* global efforts to end research into developing dangerous new diseases
* measures that don't rely on relevant technological equipment and biotechnology products (as well as data and knowledge) only being available to registered scientists and all of these scientists to act responsibly may also be possible
**According to one expert, the "international bioweapons community" should work towards having supply chain choke points identified and help implement robust monitoring of them, such as, for example, key input material
**One international team plans to make DNA synthesis screening available for free to countries worldwide and could establish a level of safety if regulations require that DNA synthesis companies send sequences for screening against a certified database
**Some companies that manufacture DNA started collaboration to limit access to dangerous genes so that only authorized laboratories can obtain DNA of "about 60" lethal germs and toxins
= Risks of pandemic prevention
=
Efforts of pandemic prevention and related endeavors reportedly risk triggering pandemics themselves as of 2021. These risk include, but are not limited to, unwitting laboratory escape and accidents such as spillovers during field interventions/experiments like field collection, and misuse of its results due to e.g. insecure commercial sales of required equipment and/or materials and/or data.
One approach to mitigate risks from pandemic prevention is to "maintain a database with hashes of deadly and dangerous sequences" which don't contain data with a potential for danger (depending on various factors) and also "can't be reverse-engineered to learn the dangerous original sequence if you don't already know it". This would theoretically enable checking sequences against a database of recorded pathogens without maintaining a database of deadly sequences.
Pathogen detection and prediction
In a 2012 study it is claimed that "new mathematical modelling, diagnostic, communications, and informatics technologies can identify and report hitherto unknown microbes in other species, and thus new risk assessment approaches are needed to identify microbes most likely to cause human disease". The study investigates challenges in moving the global pandemic strategy from response to pre-emption. Some scientists are screening blood samples from wildlife for new viruses. The international Global Virome Project (GVP) aims to identify the causes of fatal new diseases before emergence in human hosts by genetically characterizing viruses found in wild animals. The project aims to enlist an international network of scientists to collect hundreds of thousands of viruses, map their genomes, characterize and risk-stratify them to identify which ones to pay attention to. However, some infectious disease experts have criticized the project as too broad and expensive due to limited global scientific and financial resources and because only a small percentage of the world's zoonotic viruses may cross into humans and pose a threat. They argue for prioritizing rapidly detecting diseases when they cross into humans and an improving the understanding of their mechanisms. A successful prevention of a pandemic from specific viruses may also require ensuring that it does not re-emerge – for instance by sustaining itself in domestic animals.
Pathogen detection mechanisms may allow the construction of an early warning system which could make use of artificial intelligence surveillance and outbreak investigation.Edward Rubin notes that after sufficient data has been gathered artificial intelligence could be used to identify common features and develop countermeasures and vaccines against whole categories of viruses. It might be possible to predict
viral evolution
Viral evolution is a subfield of evolutionary biology and virology that is specifically concerned with the evolution of viruses. Viruses have short generation times, and many—in particular RNA viruses—have relatively high mutation rates (on the ...
using
machine learning
Machine learning (ML) is a field of inquiry devoted to understanding and building methods that 'learn', that is, methods that leverage data to improve performance on some set of tasks. It is seen as a part of artificial intelligence.
Machine ...
. In April 2020 it was reported that researchers developed a predictive algorithm which can show in visualizations how combinations of
genetic mutation
In biology, a mutation is an alteration in the nucleic acid sequence of the genome of an organism, virus, or extrachromosomal DNA. Viral genomes contain either DNA or RNA. Mutations result from errors during DNA or viral replication, mitos ...
s can make
protein
Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residues. Proteins perform a vast array of functions within organisms, including catalysing metabolic reactions, DNA replication, respo ...
s highly effective or ineffective in organisms – including for viral evolution for viruses like
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19 (coronavirus disease 2019), the respiratory illness responsible for the ongoing COVID-19 pandemic. The virus previously had a ...
. In 2021, pathogen researchers reported the development of machine learning models for genome-based
early
Early may refer to:
History
* The beginning or oldest part of a defined historical period, as opposed to middle or late periods, e.g.:
** Early Christianity
** Early modern Europe
Places in the United States
* Early, Iowa
* Early, Texas
* Early ...
detection and prioritization of high-risk potential zoonotic viruses in animals prior to spillover to humans which could be used for virus surveillance for (i.a.) measures of "early investigation and outbreak preparedness" and, according to the study, would have been capable of predicting SARS-CoV-2 as a high-risk strain without prior knowledge of zoonotic SARS-related coronaviruses.
An artificial "global immune system"-like technological system that includes pathogen detection may be able to substantially reduce the time required to take on a biothreat agent. A system of that sort would also include a network of well-trained epidemiologists who could be rapidly deployed to investigate and contain an outbreak.
Funding for the United States' PREDICT government research program that sought to identify animal pathogens that might infect humans and to prevent new pandemics was cut in 2019. Funding for United States'
CDC
The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
programs that trained workers in outbreak detection and strengthened laboratory and emergency response systems in countries where disease risks are greatest to stop outbreaks at the source was cut by 80% in 2018.
In 2022, researchers reported the development of an ultra-high-throughput
sequence alignment
In bioinformatics, a sequence alignment is a way of arranging the sequences of DNA, RNA, or protein to identify regions of similarity that may be a consequence of functional, structural, or evolutionary relationships between the sequences. Alig ...
technology that enables searching the planetary collection of
nucleic acid sequence
A nucleic acid sequence is a succession of Nucleobase, bases signified by a series of a set of five different letters that indicate the order of nucleotides forming alleles within a DNA (using GACT) or RNA (GACU) molecule. By convention, sequence ...
s. The open source
supercomputing
A supercomputer is a computer with a high level of performance as compared to a general-purpose computer. The performance of a supercomputer is commonly measured in floating-point operations per second (FLOPS) instead of million instructions ...
-based Serratus Project identified over 130,000 RNA-based viruses, including 9 coronaviruses. While such and related endeavors and data are reportedly risky themselves as of 2021, the project aims to improve pathogen surveillance, the understanding of viral evolutionary origins and enable quickly connecting strange emerging illnesses to recorded viruses.
Despite recent advances in pandemic modeling, experts using mostly experience and intuition are still more accurate in predicting the spread of disease than strictly mathematical models.
CRISPR-based immune subsystems
In March 2020 scientists of
Stanford University
Stanford University, officially Leland Stanford Junior University, is a private research university in Stanford, California. The campus occupies , among the largest in the United States, and enrolls over 17,000 students. Stanford is consider ...
presented a
CRISPR
CRISPR () (an acronym for clustered regularly interspaced short palindromic repeats) is a family of DNA sequences found in the genomes of prokaryotic organisms such as bacteria and archaea. These sequences are derived from DNA fragments of bacte ...
-based system, called PAC-MAN (Prophylactic Antiviral Crispr in huMAN cells), that can find and destroy viruses
in vitro
''In vitro'' (meaning in glass, or ''in the glass'') studies are performed with microorganisms, cells, or biological molecules outside their normal biological context. Colloquially called "test-tube experiments", these studies in biology an ...
. However, they weren't able to test PAC-MAN on the actual
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19 (coronavirus disease 2019), the respiratory illness responsible for the ongoing COVID-19 pandemic. The virus previously had a ...
, use a targeting-mechanism that uses only a very limited
RNA
Ribonucleic acid (RNA) is a polymeric molecule essential in various biological roles in coding, decoding, regulation and expression of genes. RNA and deoxyribonucleic acid ( DNA) are nucleic acids. Along with lipids, proteins, and carbohydra ...
-region, haven't developed a system to deliver it into human cells and would need a lot of time until another version of it or a potential successor system might pass
clinical trial
Clinical trials are prospective biomedical or behavioral research studies on human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel vaccines, drugs, dietar ...
s. In the study published as a
preprint
In academic publishing, a preprint is a version of a scholarly or scientific paper that precedes formal peer review and publication in a peer-reviewed scholarly or scientific journal. The preprint may be available, often as a non-typeset versio ...
they write that it could be used prophylactically as well as therapeutically. The CRISPR-Cas13d-based system could be agnostic to which virus it's fighting so novel viruses would only require a small change. In an editorial published in February 2020 another group of scientists claimed that they have implemented a flexible and efficient approach for targeting RNA with CRISPR-Cas13d which they have put under review and propose that the system can be used to also target SARS-CoV-2 in specific. There have also been earlier successful efforts in fighting viruses with CRISPR-based technology in human cells. In March 2020 researchers reported that they have developed a new kind of CRISPR-Cas13d screening platform for effective
guide RNA
A guide RNA (gRNA) is a piece of RNA that functions as a guide for RNA- or DNA-targeting enzymes, with which it forms complexes. Very often these enzymes will delete, insert or otherwise alter the targeted RNA or DNA. They occur naturally, serv ...
design to target
RNA
Ribonucleic acid (RNA) is a polymeric molecule essential in various biological roles in coding, decoding, regulation and expression of genes. RNA and deoxyribonucleic acid ( DNA) are nucleic acids. Along with lipids, proteins, and carbohydra ...
. They used their model to predict optimized Cas13 guide RNAs for all protein-coding RNA-transcripts of the
human genome
The human genome is a complete set of nucleic acid sequences for humans, encoded as DNA within the 23 chromosome pairs in cell nuclei and in a small DNA molecule found within individual mitochondria. These are usually treated separately as the n ...
's DNA. Their technology could be used in molecular biology and in medical applications such as for better targeting of virus RNA or human RNA. Targeting human RNA after it's been transcribed from DNA, rather than DNA, would allow for more temporary effects than permanent changes to human genomes. The technology is made available to researchers through an interactive website and
free and open source software
Free and open-source software (FOSS) is a term used to refer to groups of software consisting of both free software and open-source software where anyone is freely licensed to use, copy, study, and change the software in any way, and the source ...
and is accompanied by a guide on how to create guide RNAs to target the
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19 (coronavirus disease 2019), the respiratory illness responsible for the ongoing COVID-19 pandemic. The virus previously had a ...
RNA genome.
Scientists report to be able to identify the genomic pathogen signature of all 29 different
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19 (coronavirus disease 2019), the respiratory illness responsible for the ongoing COVID-19 pandemic. The virus previously had a ...
RNA sequences available to them using
machine learning
Machine learning (ML) is a field of inquiry devoted to understanding and building methods that 'learn', that is, methods that leverage data to improve performance on some set of tasks. It is seen as a part of artificial intelligence.
Machine ...
and a dataset of 5000 unique viral genomic sequences. They suggest that their approach can be used as a reliable real-time option for taxonomic classification of novel pathogens.
Testing and containment
Timely use and development of quick testing systems for novel virus in combination with other measures might (possibly) make it possible to end transmission lines of outbreaks before they become pandemics. After an outbreak there may be a certain window of time during which a pandemic can still be prevented. A key difficulty with early detection and containment is that in the globalized and urbanized world, pathogens can spread rapidly to several regions worldwide via travel, before it may be possible to notice them and e.g. initiate contact-tracing and containment measures. Rapid communication of data for health systems to implement any public intervention measures may be important. A "'One Health' global network for proactive surveillance, rapid detection, and prevention of MERS-CoV and other epidemic infectious diseases threats" has been proposed in 2016.
Moreover, there are several issues with tests. For example, a high discovery-rate is important. For instance, this is the reason why no
thermal scanner
A thermal column (or thermal) is a rising mass of buoyant air, a convective current in the atmosphere, that transfers heat energy vertically. Thermals are created by the uneven heating of Earth's surface from solar radiation, and are an example ...
s with a low discovery-rate were used in airports for containment during the
2009 swine flu pandemic
The 2009 swine flu pandemic, caused by the H1N1 influenza virus and declared by the World Health Organization (WHO) from June 2009 to August 2010, is the third recent flu pandemic involving the H1N1 virus (the first being the 1918–1920 Span ...
. Coverage may also be important. (See also:
wastewater-based epidemiology
Wastewater-based epidemiology (or wastewater-based surveillance or sewage chemical-information mining) analyzes wastewater to determine the consumption of, or exposure to, chemicals or pathogens in a population. This is achieved by measuring chemic ...
and pooled COVID-19 populations testing, possibly based on CRISPR)
Some argue that the best forms of prevention for natural nonsynthetic viruses would be stopping the viruses from spilling into humans in the first place, rather than trying to contain outbreaks.
The German program InfectControl 2020 seeks to develop strategies for prevention, early recognition and control of infectious diseases. In one of its projects "HyFly" partners of industry and research work on strategies to contain chains of transmission in air traffic, to establish preventive countermeasures and to create concrete recommendations for actions of airport operators and airline companies. One approach of the project is to detect infections without molecular-biological methods during passenger screening. For this researchers of the
Fraunhofer-Institut
The Fraunhofer Society (german: Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V., lit=Fraunhofer Society for the Advancement of Applied Research) is a German research organization with 76institutes spread throughout Germany ...
for cell therapy and immunology are developing a non-invasive procedure based on
ion-mobility spectrometry
Ion mobility spectrometry (IMS) is an analytical technique used to separate and identify ionized molecules in the gas phase based on their mobility in a carrier buffer gas. Though heavily employed for military or security purposes, such as detect ...
(IMS).
Incentives for countries to report new viruses may be important for sufficiently fast detection and for avoiding cover-ups. A global treaty proposed by the E.U. could address this issue. Rapid regional, possibly also national, capacities in terms of e.g. means, mobile laboraties or diagnostics, personnel, technologies, financial insurances and coordination may also be important.
In cases where vaccines already exist a major method for early containment is '
ring vaccination
Ring vaccination is a strategy to inhibit the spread of a disease by vaccinating those who are most likely to be infected.
This strategy vaccinates the contacts of confirmed patients, and people who are in close contact with those contacts. Thi ...
' – vaccinating close contacts of positive cases (and/or geographical areas) via existing vaccines as well as pre-exposure vaccination of people at higher risk. There are also precautionary vaccine stockpiles. Production capacities may also be important. See also: vaccine-to-variant adjustment for SARS-CoV-2 Omicron
Researchers have developed a portable virus capture device, coupled with label-free
Raman spectroscopy
Raman spectroscopy () (named after Indian physicist C. V. Raman) is a spectroscopic technique typically used to determine vibrational modes of molecules, although rotational and other low-frequency modes of systems may also be observed. Raman sp ...
for identification of newly emerging or circulating viruses as a major first step toward managing the public health response to potential outbreaks. It could rapidly obtain the Raman signature of a virus and use machine learning to recognize the virus based on its weighted combination Raman spectrum fingerprint, being able to distinguish between influenza virus type A versus type B.
Surveillance and mapping
=Viral hotspots and zoonotic genomics
=
Monitoring people who are exposed to animals in viral hotspots – including via virus monitoring stations – can register viruses at the moment they enter human populations - this might enable prevention of pandemics. The most important transmission pathways often vary per underlying driver of
emerging infectious diseases
''Emerging Infectious Diseases'' (EID) is an open-access, peer-reviewed journal published by the Centers for Disease Control and Prevention (CDC). EID is a public domain journal and covers global instances of new and reemerging infectious diseas ...
such as the vector-borne pathway and direct animal contact for land-use change – the leading driver for emerging
zoonoses
A zoonosis (; plural zoonoses) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a bacterium, virus, parasite or prion) that has jumped from a non-human (usually a vertebrate) to a human. ...
by number of emergence events as defined by Jones et al. (2008). 75% of the reviewed 1415 species of infectious organisms known to be pathogenic to humans account for zoonoses by 2001.
Genomics
Genomics is an interdisciplinary field of biology focusing on the structure, function, evolution, mapping, and editing of genomes. A genome is an organism's complete set of DNA, including all of its genes as well as its hierarchical, three-dim ...
could be used to precisely monitor virus evolution and transmission in real time across large, diverse populations by combining pathogen genomics with data about host genetics and about the unique transcriptional signature of infection. The "Surveillance, Outbreak Response Management and Analysis System" (SORMAS) of the German Helmholtz-Zentrum für Infektionsforschung (HZI) and Deutsches Zentrum für Infektionsforschung (DZIF), who collaborate with Nigerian researchers, gathers and analyzes data during an outbreak, detects potential threats and allows to initiate protective measures early. It's meant specifically for poorer regions and has been used for the fight against a
monkeypox
Monkeypox (also called mpox by the WHO) is an infectious viral disease that can occur in humans and some other animals. Symptoms include fever, swollen lymph nodes, and a rash that forms blisters and then crusts over. The time from exposure to ...
outbreak in Nigeria.
Improving "frontline healthcare provision and testing capacity for deprived communities around the world" could enable detecting, identifying and controlling outbreaks without delays .
=Syndromic surveillance and border control
=
Expert on infectious diseases at the
Johns Hopkins Center for Health Security
The Johns Hopkins Center for Health Security (abbreviated CHS) is an independent, nonprofit organization of the Johns Hopkins Bloomberg School of Public Health. The center works to protect people's health from epidemics and pandemics and ensures ...
,
Amesh Adalja
Amesh Adalja is an American infectious disease physician. He specializes in infectious disease, bioterrorism, and emergency medicine at Johns Hopkins Center for Health Security and a clinical assistant professor at the University of Pittsburgh Sc ...
states that the most immediate way to predict a pandemic is with deeper surveillance of symptoms that fit the virus' profile. The scientific and technological ways of quickly detecting a spillover could be improved so that an outbreak can be isolated before it becomes an epidemic or pandemic.
David Quammen
David Quammen (born February 24, 1948) is an American science, nature, and travel writer and the author of fifteen books. His articles have appeared in ''Outside Magazine'', ''National Geographic'', '' Harper's'', ''Rolling Stone'', ''The New York ...
states that he heard about the idea to develop technology to screen people at airport security points for whether or not they carry an infectious disease ten years ago and thought it was going to be done by now. Thermometers whose measurement data is directly shared via the Internet and medical guidance apps have been used to plot and map unusual fever levels to detect anomalous outbreaks. Various forms of data-sharing could be added to health care institutions such as hospitals so that e.g. anonymized data about symptoms and incidences found to be unusual or characteristic of a pandemic threat could enable high-resolution "syndromic surveillance" as an
early warning system
An early warning system is a warning system that can be implemented as a chain of information communication systems and comprises sensors, event detection and decision subsystems for early identification of hazards. They work together to for ...
. In 1947, the World Health Organization established such a global network of some hospitals. Such sharing and off-site evaluation of symptoms and possibly related medical data may have complementary benefits such as improving livelihoods of workers who work with livestock and improving the accuracy, timeliness and costs of disease prognoses. The
WHO Hub for Pandemic and Epidemic Intelligence
The World Health Organization Hub for Pandemic and Epidemic Intelligence was established by the Director-General of the World Health Organization and the former Chancellor of Germany in 2021 in response to the COVID-19 pandemic. The Pandemic Hub is ...
is an early-warning center that attempts to aggreggate data and quickly analyze it to predict, prevent, detect, prepare for, and respond to outbreaks and was set up Berlin in September 2021. It uses machine learning and may analyze data about animal health, unusual symptoms in humans, migration and other related developments that may contain detectable patterns.
= Mutation surveillance
=
In December 2020 during the COVID-19 pandemic, national and international officials reported mutated variants of SARS-CoV-2, including some with higher transmissibility and worldwide spread. While mutations are common for viruses and the spread of some of the virus' mutations have been tracked earlier, mutations that make it more transmittable or severe can be problematic. Resources for disease surveillance have improved during the pandemic so that medical systems around the world are starting to be equipped to detect such mutations with genomic surveillance in a manner relevant to pandemic mitigation and the prevention of sub-pandemics of specific variants or types of variants. As of December 2020, contemporary measures such as
COVID-19 vaccine
A COVID19 vaccine is a vaccine intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2), the virus that causes coronavirus disease 2019 ( COVID19).
Prior to the COVID19 pandemic, an e ...
s and medications seem to be effective in the treatment of infections with the tracked mutated variants compared to earlier forms that are closer to the original virus/es. Tools used in the pandemized outbreak of COVID-19 included
PANGOLIN
Pangolins, sometimes known as scaly anteaters, are mammals of the order Pholidota (, from Ancient Greek ϕολιδωτός – "clad in scales"). The one extant family, the Manidae, has three genera: '' Manis'', '' Phataginus'', and '' Smut ...
and
Nextstrain
Nextstrain is a collaboration between researchers in Seattle, United States and Basel, Switzerland which provides a collection of open-source tools for visualising the genetics behind the spread of viral outbreaks.
Its aim is to support public h ...
. In July 2021, scientists reported the detection of anomalous unnamed unknown-host SARS-CoV-2 lineages via
wastewater surveillance
Wastewater surveillance is the process of monitoring wastewater for contaminants. Amongst other uses, it can be used for biosurveillance, to detect the presence of pathogens in local populations, and to detect the presence of psychoactive drugs.
...
.Genomic surveillance refers to monitoring pathogens and analyzing their genetic similarities and differences, which may enable (early) alerts and tailoring interventions, countermeasures and recommendations for the public, like vaccines. In terms of pandemic prevention, it may be especially useful for vaccine-preventable diseases. A problem with the surveillance for mutated variants during the COVID-19 pandemic was that entities don't have sufficient incentives (and/or requirements) to report such variants. A global treaty proposed by the E.U. includes such incentives. A further issue was that vaccines did not provide a high enduring protection against the variants. One approach to solve this problem are pan-virus vaccines that protect against many strains (in this case a pan-SARS-CoV-2-like/variant-coronavirus vaccine), possibly including variants that do not yet exist.
Policy and economics
A 2014 analysis asserts that "the
window of opportunity
A window of opportunity (also called a margin of opportunity or critical window) is a period of time during which some action can be taken that will achieve a desired outcome. Once this period is over, or the "window is closed", the specified ...
to deal with pandemics as a
global community
The term world community is used primarily in political and humanitarian contexts to describe an international aggregate of nation states of widely varying types. In most connotations, the term is used to convey meanings attached to consensus or ...
is within the next 27 years. Pandemic prevention therefore should be a critical
health policy
Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society".World Health Organization''Health Policy'' accessed 22 March 2011(Web archive)/ref> According to the ...
issue for the current generation of scientists and
policymakers
Policy is a deliberate system of guidelines to guide decisions and achieve rational outcomes. A policy is a statement of intent and is implemented as a procedure or protocol. Policies are generally adopted by a governance body within an organ ...
to address. A 2007 study warns that "the presence of a large reservoir of SARS-CoV-like viruses in horseshoe bats, together with the culture of eating exotic mammals in southern China, is a time bomb. The possibility of the reemergence of SARS and other novel viruses from animals or laboratories and therefore the need for preparedness should not be ignored". The US' National Security Council Directorate for Global Health Security and Biodefense, which worked on preparing for the next disease outbreak and preventing it from becoming an epidemic or pandemic, was closed in 2018. A study concluded that the three practical actions "better surveillance of pathogen spillover and development of global databases of virus genomics and serology, better management of wildlife trade, and substantial reduction of deforestation" would have a highly favorable cost-benefit ratio. A second study affirms that if policy priorities were refocused from disease control to prevention, implementing such proactive actions would "cost a very small fraction of the reconstruction budgets".
Environmental policy and economics
Some experts link pandemic prevention with
environmental policy
Environmental policy is the commitment of an organization or government to the laws, regulations, and other policy mechanisms concerning environmental issues. These issues generally include air and water pollution, waste management, ecosystem mana ...
=
The WHO projects that climate change will also affect infectious disease occurrence. It is projected that interspecies viral sharing, that can lead to novel viral spillovers, will increase due to ongoing climate change-caused geographic range-shifts of mammals (most importantly bats). Risk hotspots would mainly be located at "high elevations, in biodiversity hotspots, and in areas of high human population density in Asia and Africa". A 2016 study reviews literature on the evidences for the impact of climate change on human infectious disease, suggests a number of proactive measures for controlling
health impacts of climate change
The effects of climate change on human health include direct effects of extreme weather, leading to injury and loss of life, as well as indirect effects, such as undernutrition brought on by crop failures or a lack of access to safe drinking water. ...
and finds that climate change impacts human infectious disease via alterations to pathogen, host and transmission.
Another way climate change may affect pandemic risks, is by pathogens in thawing permafrost (e.g. in the Arctic) that may have infected now-extinct ancestral humans in such regions. However, a scientist concluded that probably permafrost per se shouldn't host more pathogens than any other environment. Nevertheless, the risk from permafrost pathogens is unknown and viruses from the very first humans to populate the Arctic could emerge. Moreover, researchers have suggested more work on microbes soon to be released from
melting glaciers
Meltwater is water released by the melting of snow or ice, including glacial ice, tabular icebergs and ice shelves over oceans. Meltwater is often found in the ablation zone of glaciers, where the rate of snow cover is reducing. Meltwater can be ...
across the world to identify and understand potential threats in advance.
= Ecosystem degradation and consumption
=
Studies have shown that the risk of disease outbreaks can increase substantially after forests are cleared. The likelihood of human-nonhuman primates contact events is increased jointly by forest landscape fragmentation and certain smallholders' behaviors in forest patches. Loss of biodiversity may remove natural regulation of viruses and make fleeing animals meet other species for the first time. According to
Kate Jones
Kate Jennifer Jones (born 10 April 1979) is an Australian former politician from Queensland. She served as a Labor Party Member of Parliament in the Legislative Assembly of Queensland from 2006 to 2012, and again from 2015 to 2020. Jones firs ...
, chair of ecology and biodiversity at
University College London
, mottoeng = Let all come who by merit deserve the most reward
, established =
, type = Public research university
, endowment = £143 million (2020)
, budget = ...
, the disruption of pristine forests driven by logging, mining, road building through remote places, rapid urbanisation and population growth is bringing people into closer contact with animal species they may never have been near before, resulting in transmission of diseases from wildlife to humans. An August 2020 study published in ''
Nature
Nature, in the broadest sense, is the physics, physical world or universe. "Nature" can refer to the phenomenon, phenomena of the physical world, and also to life in general. The study of nature is a large, if not the only, part of science. ...
'' concludes that the anthropogenic destruction of ecosystems for the purpose of expanding agriculture and human settlements reduces biodiversity and allows for smaller animals such as bats and rats, who are more adaptable to human pressures and also carry the most zoonotic diseases, to proliferate. This in turn can result in more pandemics. In October 2020, the
Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services
The Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) is an intergovernmental organization established to improve the interface between science and policy on issues of biodiversity and ecosystem services. It ...
published its report on the 'era of pandemics' by 22 experts in a variety of fields, and concluded that anthropogenic destruction of
biodiversity
Biodiversity or biological diversity is the variety and variability of life on Earth. Biodiversity is a measure of variation at the genetic (''genetic variability''), species (''species diversity''), and ecosystem (''ecosystem diversity'') l ...
is paving the way to the pandemic era, and could result in as many as 850,000 viruses being transmitted from animals – in particular birds and mammals – to humans. The increased pressure on ecosystems is being driven by the "exponential rise" in
consumption
Consumption may refer to:
*Resource consumption
*Tuberculosis, an infectious disease, historically
* Consumption (ecology), receipt of energy by consuming other organisms
* Consumption (economics), the purchasing of newly produced goods for curren ...
and trade of commodities such as meat, palm oil, and metals, largely facilitated by developed nations, and by a growing human population. According to Peter Daszak, the chair of the group who produced the report, "there is no great mystery about the cause of the Covid-19 pandemic, or of any modern pandemic. The same human activities that drive
climate change and biodiversity loss
Climate change has adversely affected both terrestrial and marine ecosystems, and is expected to further affect many ecosystems, including tundra, mangroves, coral reefs, caves etc. Increasing global temperature, more frequent occurrence of ext ...
also drive pandemic risk through their impacts on our environment."
Stanford biological anthropologist James Holland Jones notes that humanity has "engineer da world where emerging infectious diseases are both more likely and more likely to be consequential", referring to the modern world's prevalent highly mobile lifestyles, increasingly dense cities, various kinds of human interactions with wildlife and alterations of the natural world. Furthermore, when multiple species that are not usually next to each other are driven to live closely together new diseases may emerge. Research shows that abundant animals, plants, insects, and microbes living in complex, mature ecosystems can limit the spread of disease from animals to people. The
United Nations
The United Nations (UN) is an intergovernmental organization whose stated purposes are to maintain international peace and international security, security, develop friendly relations among nations, achieve international cooperation, and be ...
is formulating nature-focused action plans that could help to stop the next pandemic before it starts. These strategies include conserving ecosystems and wilderness that are still untouched by human activity, and restoring and protecting significant areas of land and ocean (i.e. through
protected area
Protected areas or conservation areas are locations which receive protection because of their recognized natural, ecological or cultural values. There are several kinds of protected areas, which vary by level of protection depending on the ena ...
s). Protected areas (which may hold wildlife) also limits
human
Humans (''Homo sapiens'') are the most abundant and widespread species of primate, characterized by bipedalism and exceptional cognitive skills due to a large and complex brain. This has enabled the development of advanced tools, culture, ...
presence and/or limits the exploitation of resources (including
non-timber forest product
Non-timber forest products (NTFPs) are useful foods, substances, materials and/or commodities obtained from forests other than timber. Harvest ranges from wild collection to farming. They typically include game animals, fur-bearers, nuts, seed ...
s such as
game animals
Game or quarry is any wild animal hunted for animal products (primarily meat), for recreation (" sporting"), or for trophies. The species of animals hunted as game varies in different parts of the world and by different local jurisdictions, th ...
, fur-bearers, ...). An article by the World Economic Forum states that studies have shown that deforestation and loss of wildlife cause increases in infectious diseases and concludes that the recovery from the COVID-19 pandemic should be linked to nature recovery, which it considers economically beneficial.
Dennis Caroll of the Global Virome Project stated that the "
extractive industry
Extractivism is the process of extracting natural resources from the Earth to sell on the world market. It exists in an economy that depends primarily on the extraction or removal of natural resources that are considered valuable for exportation w ...
— oil and gas and minerals, and the expansion of agriculture, especially cattle" are the biggest predictors of where spillovers can be seen. A study proposes that policy responses "addressing zoonotic threats should include ecosystem
regeneration
Regeneration may refer to:
Science and technology
* Regeneration (biology), the ability to recreate lost or damaged cells, tissues, organs and limbs
* Regeneration (ecology), the ability of ecosystems to regenerate biomass, using photosynthesis
...
".
In the 2000s, a WHO spokesperson summarized the animal-related aspects of pandemics, stating "the whole relationship between the animal kingdom and the human kingdom is coming under stress".
The integrated, unifying approach of
One Health
One Health is an approach calling for "the collaborative efforts of multiple disciplines working locally, nationally, and globally, to attain optimal health for people, animals and our environment", as defined by the One Health Initiative Task For ...
adresses at health of people, animals and the environment at once. It could "boost risk identification, reduction, and surveillance in animals and at the human-animal-environment interface".
Data on current causes of emerging diseases
A study which was published in April 2020 and is part of the PREDICT program found that "virus transmission risk has been highest from animal species that have increased in abundance and even expanded their range by adapting to human-dominated landscapes", identifying domesticated species, primates and bats as having more zoonotic viruses than other species and "provide further evidence that exploitation, as well as anthropogenic activities that have caused losses in wildlife habitat quality, have increased opportunities for animal–human interactions and facilitated zoonotic disease transmission".
An UN Environment report presents the causes of the emerging diseases with a large share being environmental: Text is available under Creative Commons Attribution 4.0 International License /ref>
The report also lists some of the latest emerging diseases and their environmental causes:
According to a 2001 study and its criteria a total of 1415 species of infectious agents in 472 different genera have been reported to date to cause disease in humans. Out of these reviewed emerging pathogen species 75% are zoonotic. A total of 175 species of infectious agents from 96 different genera are associated with emerging diseases according its criteria. Some of these pathogens can be transmitted by more than one route. Data on 19 categories of the 26 categories which contained more than 10 species includes:
Bioresearch and development regulation
Toby Ord
Toby David Godfrey Ord (born July 1979) is an Australian philosopher. He founded Giving What We Can in 2009, an international society whose members pledge to donate at least 10% of their income to effective charities, and is a key figure in the ...
, author of the book '' The Precipice: Existential Risk and the Future of Humanity'' which addresses this issue, puts into question whether current public health and international conventions, and self-regulation by biotechnology companies and scientists are adequate.
In the context of the 2019–2020 coronavirus pandemic
Neal Baer
Neal Baer (born 1955) is an American pediatrician and television writer and producer. He is best known for his work on the television shows ''Designated Survivor'', '' ER'' and '' Law & Order: Special Victims Unit''.
Biography
Education
Baer w ...
writes that the "public, scientists, lawmakers, and others" "need to have thoughtful conversations about gene editing now". Ensuring the biosafety level of laboratories may also be an important component of pandemic prevention. This issue may have gotten additional attention in 2020 after news outlets reported that U.S. State Department cables indicate that, although there may be no conclusive proof at the moment, the
COVID-19
Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was COVID-19 pandemic in Hubei, identified in Wuhan, China, in December ...
virus
A virus is a submicroscopic infectious agent that replicates only inside the living cells of an organism. Viruses infect all life forms, from animals and plants to microorganisms, including bacteria and archaea.
Since Dmitri Ivanovsky's 1 ...
responsible for the
COVID-19 pandemic
The COVID-19 pandemic, also known as the coronavirus pandemic, is an ongoing global pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The novel virus was first identif ...
bat
Bats are mammals of the order Chiroptera.''cheir'', "hand" and πτερόν''pteron'', "wing". With their forelimbs adapted as wings, they are the only mammals capable of true and sustained flight. Bats are more agile in flight than most bi ...
coronavirus
Coronaviruses are a group of related RNA viruses that cause diseases in mammals and birds. In humans and birds, they cause respiratory tract infections that can range from mild to lethal. Mild illnesses in humans include some cases of the com ...
es that included modifying
virus
A virus is a submicroscopic infectious agent that replicates only inside the living cells of an organism. Viruses infect all life forms, from animals and plants to microorganisms, including bacteria and archaea.
Since Dmitri Ivanovsky's 1 ...
genome
In the fields of molecular biology and genetics, a genome is all the genetic information of an organism. It consists of nucleotide sequences of DNA (or RNA in RNA viruses). The nuclear genome includes protein-coding genes and non-coding ge ...
s to enter human cells, and determined to be unsafe by U.S. scientists in 2018, rather than from a natural source. As of 18 May 2020, an official UN investigation into the origins of the COVID-19 virus, supported by over 120 countries, was being considered. United States' president Donald Trump claimed to have seen evidence that gave him a "high degree of confidence" that the novel coronavirus originated in the Chinese laboratory but did not offer any evidence, data or details, contradicted statements by the United States' intelligence community and garnered a lot of harsh criticism and doubts. As of 5 May, assessments and internal sources from the
Five Eyes
The Five Eyes (FVEY) is an intelligence alliance comprising Australia, Canada, New Zealand, the United Kingdom, and the United States. These countries are parties to the multilateral UKUSA Agreement, a treaty for joint cooperation in sign ...
nations indicated that the coronavirus outbreak being the result of a laboratory accident was "highly unlikely", since the human infection was "highly likely" a result of natural human and animal interaction. Many others have also criticized statements by US government officials and theories of laboratory release. Virologist and immunologist Vincent R. Racaniello said that "accident theories – and the lab-made theories before them – reflect a lack of understanding of the genetic make-up of Sars-CoV-2." Virologist
Peter Daszak
Peter Daszak is a British zoologist, consultant and public expert on disease ecology, in particular on zoonosis. He is the president of EcoHealth Alliance, a nonprofit non-governmental organization that supports various programs on global healt ...
stated that an estimated 1–7 million people in Southeast Asia who live or work in proximity to bats are infected each year with bat coronaviruses. In January 2021, the WHO's investigations into the origin of COVID-19 was launched. In early 2021, the hypothesis of a laboratory cause of the pandemic received renewed interest and expert consideration due to renewed media discussion.
While biotechnology policies can substantially reduce the risk of a serious catastrophe, it may be important that relevant steps are initiated immediately and on a global basis.
= Dual-use knowledge and research
=
Martin Rees
Martin John Rees, Baron Rees of Ludlow One or more of the preceding sentences incorporates text from the royalsociety.org website where: (born 23 June 1942) is a British cosmologist and astrophysicist. He is the fifteenth Astronomer Royal, ...
, author of the book ''
Our Final Hour
''Our Final Hour'' is a 2003 book by the British Astronomer Royal Sir Martin Rees. The full title of the book is ''Our Final Hour: A Scientist's Warning: How Terror, Error, and Environmental Disaster Threaten Humankind's Future In This Century— ...
'' which also addresses this issue, states that while better understanding of viruses may allow for an improved capability to develop vaccines it may also lead to an increase in "the spread of 'dangerous knowledge' that would enable mavericks to make viruses more virulent and transmissible than they naturally are". Different accelerations and priorizations of research may however be critical to pandemic prevention. A multitude of factors shape which knowledge about viruses with different use-cases, including vaccine-development, can be used by whom. Rees also states that "the
global village
Global village describes the phenomenon of the entire world becoming more interconnected as the result of the propagation of media technologies throughout the world. The term was coined by Canadian media theorist Marshall McLuhan in his books '' ...
will have its village idiots, and they will have global range".
Experts have clarified that, for example, the definition of "dual use" is not well known and that the international community should better engage with the DIY bio community or biohacker students and in a way that does not stifle "localised innovation for peaceful purposes or people wanting to learn about biology". As of 2022, only very few sophisticated centers could recreate SARS-CoV-2 However, for example the progress in genetic engineering enabled all the tools needed to create a virus to be "cheap, simple, and readily available".
94% of countries have no national-level oversight measures for dual-use research.
A
biodefense
Biodefense refers to measures to restore biosecurity to a group of organisms who are, or may be, subject to biological threats or infectious diseases. Biodefense is frequently discussed in the context of biowar or bioterrorism, and is generall ...
expert cautions that overly strict rules "could prompt researchers to move their experiments to nations with less stringent oversight", suggesting there to be a need for international policies.
Food markets and wild animal trade
In January 2020 during the SARS-CoV 2 outbreak experts in and outside China warned that wild animal markets, where the virus originated from, should be banned worldwide. Some scientists point out that banning informal
wet market
A wet market (also called a public market or a traditional market) is a marketplace selling fresh foods such as meat, fish, produce and other consumption-oriented perishable goods in a non-supermarket setting, as distinguished from " dry market ...
s worldwide isn't the appropriate solution as fridges aren't available in many places and because much of the food for Africa and Asia is provided through such traditional markets. Some also caution that simple bans may force traders underground, where they may pay less attention to hygiene and some state that it's wild animals rather than farmed animals that are the natural hosts of many viruses. Jonathan Kolby cautions about the risks and vulnerabilities present in the massive legal wildlife trade.
Some
traditional medicines
Traditional medicine (also known as indigenous medicine or folk medicine) comprises medical aspects of traditional knowledge that developed over generations within the folk beliefs of various societies, including indigenous peoples, before the ...
(i.e.
traditional African medicine
Traditional African medicine is a range of traditional medicine disciplines involving Indigenous peoples of Africa, indigenous herbalism and Traditional African religions, African spirituality, typically including divination, diviners, midwives, ...
, TCM) still use animal-based substances. Since these can trigger
zoonosis
A zoonosis (; plural zoonoses) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a bacterium, virus, parasite or prion) that has jumped from a non-human (usually a vertebrate) to a human. ...
, a possible prevention could be changes to handbooks for practitioners of such traditional medicines (i.e. exclusion of animal-based substances). Senior adviser and veterinary epidemiologist at the National Food Institute at the Technical University of Denmark Ellis-Iversen states that in agricultural animal health "outbreaks of exotic disease in well-regulated countries rarely get big because we identify and control them right away". New York City's Bronx Zoo's head veterinarian Paul Calle states that usually emerging infectious diseases from animals are the result from wildlife consumption and distribution on a commercial scale rather than a lone person hunting to feed their family.
UN biodiversity chief, bipartisan lawmakers, experts and scientists have called for a global ban of wetmarkets and wildlife trade. On January 26 China banned the trade of wild animals until the end of the coronavirus epidemic at the time. On February 24 China announced a permanent ban on wildlife trade and consumption with some exceptions. In early 2022 it was reported that the E.U. "is pushing for a global deal aimed at preventing new pandemics that could include a ban gradual shutdownon wildlife markets".
International coordination
The
Global Health Security Agenda
The Global Health Security Agenda (GHSA) is an international effort operating in the field of infection prevention and control. A brainchild of the Centers for Disease Control and Prevention (CDC), it was launched in February 2014 by a group of 4 ...
(GHSA) a network of countries, international organizations, NGOs and companies that aim to improve the world's ability to prevent, detect, and respond to infectious diseases. Sixty-seven countries have signed onto the GHSA framework. Funding for the GHSA has been reduced since the launch in 2014, both in the US and globally. The 194 WHO member states agreed in December 2021 to begin negotiations on the International Treaty on Pandemic Prevention, Preparedness and Response. On the 2021 Global Health Summit, the G20 communicated to commit to promote a set of principles in the Rome Declaration.
In a 2018 lecture in Boston
Bill Gates
William Henry Gates III (born October 28, 1955) is an American business magnate and philanthropist. He is a co-founder of Microsoft, along with his late childhood friend Paul Allen. During his career at Microsoft, Gates held the positions ...
called for a global effort to build a comprehensive pandemic preparedness and response system. During the COVID-19 pandemic he called upon world leaders to "take what has been learned from this tragedy and invest in systems to prevent future outbreaks". In a 2015 TED Talk he warned that "if anything kills over 10 million people in the next few decades, it's most likely to be a highly infectious virus rather than a war". Numerous prominent, authoritative, expert or otherwise influential figures have similarly warned about elevated, underprepared or contemporary risks of pandemics and the need for efforts on an "international scale" long before 2015 and since at least 1988. Later warnings include a 2015 study which concluded that "a potential risk of SARS-CoV re-emergence from viruses currently circulating in bat populations".
Some have provided suggestions for organizational or coordinative preparedness for pandemic prevention including a mechanism by which many major economic powers pay into a global insurance fund which "could compensate a nation for economic losses if it acts quickly to close areas to trade and travel in order to stop a dangerous outbreak at its source" or, similarly, sovereign or regional-level epidemic-insurance policies. International collaboration including cooperative research and information-sharing has also been considered vital.
As an example of domestic coordination, U.S. Senator
Dianne Feinstein
Dianne Goldman Berman Feinstein ( ; born Dianne Emiel Goldman; June 22, 1933) is an American politician who serves as the senior United States senator from California, a seat she has held since 1992. A member of the Democratic Party, she was ...
for the creation of a new interagency government entity, the Center for Combating Infectious Disease which would combine analytical and operational functions "to oversee all aspects of preventing, detecting, monitoring, and responding to major outbreaks such as coronavirus" and get provided with data and expertise by the
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
. The U.S. has also set up a "Global Zoonotic Disease Task Force" who would help "ensure an integrated approach to preventing, detecting, preparing for, and responding to zoonotic spillover". However, "global preparedness is greater than the sum of national preparedness" and lacks concerted, collective and coordinated action.
John Davenport advises to abandon widespread
libertarian
Libertarianism (from french: libertaire, "libertarian"; from la, libertas, "freedom") is a political philosophy that upholds liberty as a core value. Libertarians seek to maximize autonomy and political freedom, and minimize the state's e ...
ideology which, according to him, "denies the importance of public goods or refuses to recognize their scope". According to the CDC, investing in global
health security Health security is a concept that encompasses activities and measures across sovereign boundaries that mitigates public health incidents to ensure the health of populations. It is an evolving paradigm within the fields of international relations and ...
and improving the organization's ability to prevent, detect, and respond to diseases could protect the health of American citizens as well as avert catastrophic costs. Dennis Carroll argues for a "marriage" between scientific discovery and political
decision-making
In psychology, decision-making (also spelled decision making and decisionmaking) is regarded as the Cognition, cognitive process resulting in the selection of a belief or a course of action among several possible alternative options. It could be ...
and policy formulation. Strengthened
global governance
Global governance refers to institutions that coordinate the behavior of transnational actors, facilitate cooperation, resolve disputes, and alleviate collective action problems. Global governance broadly entails making, monitoring, and enfor ...
– using facts, data, and science – with an emphasis on transparency and accountability and independent monitoring are important.
A study found there to be a need "for a renewed framework for global collective action that ensures conformity with international regulations and promotes effective prevention and response to pandemic infectious diseases" and recommended "greater authority for a global governing body, an improved ability to respond to pandemics, an objective evaluation system for national core public health capacities, more effective enforcement mechanisms, independent and sustainable funding, representativeness, and investment from multiple sectors, among others".
Artificial induction of immunity and/or biocides
Outbreaks could be contained or delayed – to enable other containment-measures – or prevented by artificial induction of immunity and/or biocides in combination with other measures that include prediction or
early detection
Early may refer to:
History
* The beginning or oldest part of a defined historical period, as opposed to middle or late periods, e.g.:
** Early Christianity
** Early modern Europe
Places in the United States
* Early, Iowa
* Early, Texas
* Early ...
of infectious human diseases.
Broad-spectrum antimicrobials, rapid antibody or drug development, and quick drug repurposing and medication provisioning may also be potential ways to prevent outbreak from becoming pandemics. In FY2016, DARPA initiated the Pandemic Prevention Platform (P3) program aimed at the "rapid discovery, testing, and manufacture of antibody treatments to fight any emerging disease threat". The
SARS-CoV-2 Omicron variant
Omicron (B.1.1.529) is a variant of SARS-CoV-2 first reported to the World Health Organization (WHO) by the Network for Genomics Surveillance in South Africa on 24 November 2021. It was first detected in Botswana and has spread to become the ...
escaped the majority of existing SARS-CoV-2 neutralizing antibodies, including of sera from vaccinated and convalescent individuals.
In a
preprint
In academic publishing, a preprint is a version of a scholarly or scientific paper that precedes formal peer review and publication in a peer-reviewed scholarly or scientific journal. The preprint may be available, often as a non-typeset versio ...
published on March 24, 2020 researchers suggested that the unique transcriptional signature of
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19 (coronavirus disease 2019), the respiratory illness responsible for the ongoing COVID-19 pandemic. The virus previously had a ...
in the human immune system may be responsible for the development of
COVID-19
Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The first known case was COVID-19 pandemic in Hubei, identified in Wuhan, China, in December ...
: SARS-CoV-2 did not induce the antiviral genes that code for type I and type III
interferon
Interferons (IFNs, ) are a group of signaling proteins made and released by host cells in response to the presence of several viruses. In a typical scenario, a virus-infected cell will release interferons causing nearby cells to heighten the ...
s. This could be relevant for the development or repurposing of treatments.
Vaccination
Development and provision of new vaccines usually takes years. The
Coalition for Epidemic Preparedness Innovations
The Coalition for Epidemic Preparedness Innovations (CEPI) is a foundation that takes donations from public, private, philanthropic, and civil society organisations, to finance independent research projects to develop vaccines against emerging ...
, which was launched in 2017, works on reducing the time of vaccine-development. The
Global Health Innovative Technology Fund (GHIT)
The Global Health Innovative Technology Fund (GHIT Fund), headquartered in Japan, is an international public-private partnership between the Government of Japan (Ministry of Foreign Affairs and Ministry of Health, Labour and Welfare), 16 pharmaceu ...
is a public-private partnership fund which involves a national government, a UN agency, a consortium of pharmaceutical and diagnostics companies, and international philanthropic foundations to accelerate the creation of new vaccines, drugs and diagnostic tools for global health.Investing In Drugs That Won't Make Money , Forbes, April 30, 2015, accessed on 9/28/2015 It is unclear whether vaccines can play a role in pandemic prevention alongside pandemic mitigation.
Nathan Wolfe
Nathan Daniel Wolfe, Ph.D. (born 24 August 1970) is an American virologist. He was the founder (in 2007) and director of Global Viral and the Lorry I. Lokey Visiting Professor in Human Biology at Stanford University.
Career
Dr. Wolfe spent ov ...
proposes that pathogen detection and prediction may allow establishing viral libraries before novel epidemics emerge – substantially decreasing the time to develop a new vaccine. Public health surveillance expert and professor at Harvard University,
John Brownstein
John Brownstein is a Canadian epidemiologist and Professor of Medicine at the Harvard Medical School as well as the Chief Innovation Officer at Boston Children’s Hospital. His research focuses on development of computational methods in epidem ...
says that "vaccines are still our main weapon". Besides more rapid vaccine development and development that starts at the earliest possible time, it may also be possible to develop more broader vaccines.
Misinformation
Misinformation is incorrect or misleading information. It differs from disinformation, which is ''deliberately'' deceptive. Rumors are information not attributed to any particular source, and so are unreliable and often unverified, but can turn ou ...
and misconceptions about vaccines, including about their side-effects and (relative) risks, may be a problem.
Food system- and livestock-specific measures
A review suggests that feeding the future human population would require increases in crop and animal production, albeit it is unclear which diets (e.g. future levels of meat production) they project. This would increase contact rates between humans and both wild and domestic animals and the use of antibiotics and thereby increase pandemic risks. It also suggests that "since 1940, agricultural drivers were associated with >25% of all — and >50% of zoonotic — infectious diseases that emerged in humans".
Moreover, selection for specific genes has made the animals genetically highly similar which could enable pathogens to spread more intensely among the livestock.
A report by the FAIRR global investor network found that more than 70% of the biggest meat, fish and dairy producers were in danger of fostering future zoonotic pandemics due to lax safety standards, closely confined animals and the overuse of antibiotics. Some have recommended
food system
The term food system describes the interconnected systems and processes that influence nutrition
Nutrition is the biochemical and physiological process by which an organism uses food to support its life. It provides organisms with nutrients ...
lifestyle
Lifestyle often refers to:
* Lifestyle (sociology), the way a person lives
* ''Otium'', ancient Roman concept of a lifestyle
* Style of life (german: Lebensstil, link=no), dealing with the dynamics of personality
Lifestyle may also refer to:
Bus ...
choices and altered
consumer spending
Consumer spending is the total money spent on final goods and services by individuals and households.
There are two components of consumer spending: induced consumption (which is affected by the level of income) and autonomous consumption (which ...
including moving away from factory farming and towards more plant-based diets.
Measures could include reducing meat production (except for potential
cultured meat
Cultured meat (also known by other names) is meat produced by culturing animal cells ''in vitro''. It is a form of cellular agriculture.
Cultured meat is produced using tissue engineering techniques pioneered in regenerative medicine. Jason Ma ...
), de-intensifying livestock farming, reducing the use of antimicrobials, improving health and health-monitoring of livestock, increasing livestock biodiversity, further understanding of the genetic and functional basis of host adaptation, improving
occupational hygiene
Occupational hygiene (United States: industrial hygiene (IH)) is the anticipation, recognition, evaluation, control, and confirmation (ARECC) of protection from hazards at work that may result in injury, illness, or affect the well being of work ...
and safety of farming and
food processing
Food processing is the transformation of agricultural products into food, or of one form of food into other forms. Food processing includes many forms of processing foods, from grinding grain to make raw flour to home cooking to complex industr ...
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food
Food is any substance consumed by an organism for nutritional support. Food is usually of plant, animal, or fungal origin, and contains essential nutrients, such as carbohydrates, fats, proteins, vitamins, or minerals. The substance is inge ...
(see also:
HACCP
Hazard analysis and critical control points, or HACCP (), is a systematic preventive approach to food safety from biological, chemical, and physical hazards in production processes that can cause the finished product to be unsafe and designs mea ...
Experts warned that depleting the numbers of species by
culling
In biology, culling is the process of segregating organisms from a group according to desired or undesired characteristics. In animal breeding, it is the process of removing or segregating animals from a breeding stock based on a specific tr ...
to forestall human infections reduces
genetic diversity
Genetic diversity is the total number of genetic characteristics in the genetic makeup of a species, it ranges widely from the number of species to differences within species and can be attributed to the span of survival for a species. It is dis ...
and thereby puts future generations of the animals as well as people at risk while others contend that it's still the best, practical way to contain a virus of livestock. There are also other problems with culling and there are alternatives to it, such as
animal vaccination
Animal vaccination is the immunisation of a domestic, livestock or wild animal. The practice is connected to veterinary medicine. The first animal vaccine invented was for chicken cholera in 1879 by Louis Pasteur. The production of such vaccines e ...
. There are also problems with the forms of culling-implementation such as livestock producers and subsistence farmers who are unable to access compensation being motivated to conceal diseased animals rather than report them.
Prevention versus mitigation
Pandemic prevention seeks to prevent pandemics while mitigation of pandemics seeks to reduce their severity and negative impacts. Some have called for a shift from a treatment-oriented society to a prevention-oriented one. Authors of a 2010 study write that contemporary "global disease control focuses almost exclusively on responding to pandemics after they have already spread globally" and argue that the "wait-and-respond approach is not sufficient and that the development of systems to prevent novel pandemics before they are established should be considered imperative to human health".
Peter Daszak
Peter Daszak is a British zoologist, consultant and public expert on disease ecology, in particular on zoonosis. He is the president of EcoHealth Alliance, a nonprofit non-governmental organization that supports various programs on global healt ...
comments on the COVID-19 pandemic, saying " e problem isn't that prevention was impossible, was very possible. But we didn't do it. Governments thought it was too expensive. Pharmaceutical companies operate for profit". The WHO reportedly had mostly neither the funding nor the power to enforce the large-scale global collaboration necessary to combat it.
Nathan Wolfe
Nathan Daniel Wolfe, Ph.D. (born 24 August 1970) is an American virologist. He was the founder (in 2007) and director of Global Viral and the Lorry I. Lokey Visiting Professor in Human Biology at Stanford University.
Career
Dr. Wolfe spent ov ...
criticizes that "our current global public health strategies are reminiscent of cardiology in the 1950s when doctors focused solely on responding to heart attacks and ignored the whole idea of prevention".
Border control
Border control refers to measures taken by governments to monitor and regulate the movement of people, animals, and goods across land, air, and maritime borders. While border control is typically associated with international borders, it a ...
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Global health
Global health is the health of the populations in the worldwide context; it has been defined as "the area of study, research and practice that places a priority on improving health and achieving equity in health for all people worldwide". Problem ...
Infection control
Infection prevention and control is the discipline concerned with preventing healthcare-associated infections; a practical rather than academic sub-discipline of epidemiology. In Northern Europe, infection prevention and control is expanded from ...
Pandemic predictions and preparations prior to COVID-19
Planning and preparing for pandemics has happened in countries and international organizations. The World Health Organization writes recommendations and guidelines, though there is no sustained mechanism to review countries' preparedness for epid ...
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Biosecurity
Biosecurity refers to measures aimed at preventing the introduction and/or spread of harmful organisms (e.g. viruses, bacteria, etc.) to animals and plants in order to minimize the risk of transmission of infectious disease. In agriculture, thes ...
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Priority-setting in global health
In global health, priority-setting is a term used for the process and strategy of deciding which health interventions to carry out. Priority-setting can be conducted at the disease level (i.e. deciding which disease to alleviate), the overall strat ...
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Universal coronavirus vaccine
A universal coronavirus vaccine, also known as a pan coronavirus vaccine, is a theoretical coronavirus vaccine that would be effective against all coronavirus strains. A universal vaccine would provide protection against coronavirus strains that ...
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Wastewater-based epidemiology
Wastewater-based epidemiology (or wastewater-based surveillance or sewage chemical-information mining) analyzes wastewater to determine the consumption of, or exposure to, chemicals or pathogens in a population. This is achieved by measuring chemic ...
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Global Health Security Initiative
The Global Health Security Initiative (GHSI) is an informal international partnership among countries in order to exchange information and coordinate practices for confronting new threats and risks to global health. It was formed to respond to th ...
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Johns Hopkins Center for Health Security
The Johns Hopkins Center for Health Security (abbreviated CHS) is an independent, nonprofit organization of the Johns Hopkins Bloomberg School of Public Health. The center works to protect people's health from epidemics and pandemics and ensures ...