After the COVID-19 crisis, a future pandemic is a tangible concern. The scientific community considers it a matter of ‘when,’ not ‘if,’ focusing on preparedness and risk mitigation. Statistical analysis suggests the probability of a pandemic with an impact similar to COVID-19 is about 2% in any given year, centering the conversation on understanding potential origins and developing response strategies.
Potential Sources of a Pandemic
A new pandemic often begins with zoonotic spillover, when a pathogen transfers from an animal to a human. Human activities like deforestation, mining, and urban expansion are breaking down natural barriers, creating zones where wildlife, livestock, and humans come into close contact. This proximity raises the chances for interspecies viral transmission.
These transitional zones become hotspots for viruses to jump between species. The global wildlife trade amplifies this risk by exposing people to animals that may carry unknown viruses, while handling live or recently slaughtered animals increases the likelihood of transmission through bodily fluids.
Another threat is antimicrobial resistance (AMR), which could fuel a pandemic of “superbugs.” AMR occurs when pathogens evolve and no longer respond to medicines, making infections harder to treat. The overuse of antibiotics in agriculture to promote growth and prevent disease in livestock is a major contributor to this risk.
Pathogens Under Surveillance
Scientists monitor specific pathogen families with pandemic potential. The World Health Organization (WHO) maintains a list of priority diseases for research, including:
- Ebola
- Marburg
- Lassa fever
- Zika
Respiratory viruses, like influenza and coronaviruses, receive special attention because they transmit efficiently and are more likely to cause a pandemic.
Surveillance tracks avian influenza strains like H5N1 and coronaviruses related to SARS and MERS. After the COVID-19 pandemic, the entire Sarbecovirus subgenus, which includes SARS-CoV-2, is now a high-priority risk. This broader focus on virus families is a strategic shift that allows for developing countermeasures effective against multiple related viruses.
Recognizing the next outbreak could be from something new, the WHO uses the term ‘Disease X’ for an unknown pathogen. This concept drives research toward flexible platforms, like adaptable vaccine technologies. These can be rapidly modified to target a novel threat, ensuring preparedness is not limited to known dangers.
Global Prevention and Response Strategies
International prevention efforts focus on coordinated strategies, like expanding global surveillance networks to detect threats in real-time. The ‘One Health’ approach integrates data on human, animal, and environmental health to identify spillover events early. The WHO’s Pathogen Access and Benefit-Sharing System ensures countries share pathogen data so research on tests and treatments can begin immediately.
Advancements in vaccine technology are at the forefront of response strategies. Messenger RNA (mRNA) and viral vector platforms, instrumental during the COVID-19 pandemic, allow for rapid vaccine development once a pathogen’s genetic sequence is known. Organizations like the Coalition for Epidemic Preparedness Innovations (CEPI) are working on a ‘100 Days Mission’ to make vaccines available within three months of identifying a new threat.
This mission involves creating ‘prototype’ vaccines for high-risk virus families that can be tested for safety in advance and adapted quickly. International cooperation is formalized through instruments like the WHO’s Pandemic Agreement to improve coordinated prevention and response. The accord also focuses on ensuring equitable access to medical countermeasures to avoid the disparities seen during the COVID-19 pandemic.
Strengthening Public Health Infrastructure
A nation’s resilience depends on its domestic public health infrastructure. A primary focus is enhancing healthcare system capacity to handle a sudden surge in patients. This includes increasing the number of hospital beds, particularly in intensive care units, and investing in a well-trained healthcare workforce.
Another focus is building resilient supply chains for medical necessities, as shortages of PPE, tests, and ventilators during the last pandemic highlighted vulnerabilities. To mitigate these risks, efforts are underway to diversify manufacturing and stockpile essential supplies. This includes supporting domestic production to reduce reliance on international suppliers during an emergency.
Effective public health communication is also part of national preparedness. Building trust between public health agencies and the community is necessary for ensuring compliance with protective measures and combating misinformation. Clear and consistent information helps guide public behavior and fosters the collective action needed to manage an outbreak.