"We Need to Face Reality Here": Hospitals Must Prepare for the Next Pandemic
Back in 2018, a year before SARS-CoV-2 began stalking the globe, American scholars issued a report on the likely traits of the next pandemic pathogen.
The scholars, from the Johns Hopkins Center for Health Security, were on the hunt for microorganisms that could cause worldwide catastrophe — “a sudden, extraordinary, widespread disaster” that would trigger great suffering, death, and economic damage.
What they concluded: The culprit would be airborne, and the resulting respiratory disease, with a low but significant fatality rate, would be contagious before symptoms surface.
"We need to get serious about respiratory viruses," Amesh Adalja, M.D., the report’s lead author, warned at the time. "There's a lot of focus on diseases that aren't going to be able to change civilization in a way that something that's spread through the respiratory route would be."
Of course, Adalja’s report, which listed coronaviruses among the most likely suspects, was spot on.
Now that the predicted catastrophe has materialized and much of the world was caught flat-footed, experts have issued a new warning they hope will be better heeded: We must prepare, in a more serious way, for the next pandemic.
“The risk of pandemics is increasing rapidly, with more than five new diseases emerging in people every year, any one of which has the potential to spread and become pandemic,” warns a United Nations report, issued during the Covid crisis.
Whether the pandemic is set off by a coronavirus, an influenza strain, or another pathogen altogether, Adajla says today, preparations should focus on “any kind of efficiently spreading respiratory virus” — in other words, disease with the capacity to spread through the air.
"We need to face reality here," says Edward Holmes, Ph.D., a virologist at the University of Sydney, who monitors bat viruses and suspects another coronavirus pandemic is imminent. "The next one could come at any time. It could come in 50 years or in 10 years. Or it could be next year."
When it does come, will hospitals be ready?
As they continue to battle Covid-19, healthcare facilities are simultaneously planning ahead, exploring, if not already implementing, protocols and technologies that will better protect patients and staff from airborne microorganisms.
Given the toll of the current pandemic, no hospital can delay preparing for the next one, says Richard Waldhorn, M.D., an expert on hospital emergency preparedness with the Johns Hopkins Center for Health Security.
“It’s very important to prevent the hospital from becoming a disease amplifier.”
“The Virusphere is Just Immense”
Pathogens harboured by animals have jumped to humans for decades, but in the distant past, when individuals acquired deadly infections this way, they likely fell ill and died in the vicinity.
“Now an infected person can be on a plane to Paris or New York before they know they have it,” says Dennis Carroll, PhD, an emerging infectious disease expert with the U.S. Agency for International Development.
Global travel and trade, urbanisation, deforestation, agricultural expansion, climate change — all are bringing humans into closer contact with bats, livestock, and other animals that harbour dangerous viruses.
“We are rolling the dice faster and faster and more and more often,” says Raina Plowright, Ph.D., a virus researcher at the Bozeman Disease Ecology Lab in Montana.
According to the U.N. report, mammals and birds may host more than 800,000 undiscovered viruses that could be transferred to humans.
Edward Holmes, the Australian virologist, found 24 new coronaviruses in several hundred bats in a small region of southern China; a number of the pathogens were related to SARS-CoV-2 and SARS-CoV, the virus that caused the 2003 SARS outbreak in China and four other countries.
"We're only just starting to scratch the surface," says Holmes. "The virusphere of coronaviruses is just immense."
Then again, the next pandemic pathogen may not be a coronavirus. The deadly Nipah virus, another airborne virus carried by bats, ranks among the World Health Organization’s top 10 priority diseases. So does MERS, a respiratory coronavirus harboured by camels that emerged in 2012 in the Arabian peninsula and remains a threat.
Then there’s influenza: 30 influenza pandemics have occurred in the past 400 years, including four in the last century.
“Based on [influenza’s] genetic structure, it’s really only a matter of time before new strains emerge that have the capacity for efficient human-to-human transmission,” says Amesh Adalja.
Read part 2 here.