Report: Develop surveillance, diagnosis, treatments and vaccines to prepare for catastrophic pandemic potential pathogens

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The next disease with the potential to sweep the planet with devastation on a scale of that caused by the influenza pandemic of 1918 is likely also to be caused by a virus. As happened then, the virus will likely be spread by the unavoidable act of breathing, and transmitted by people who don’t feel sick. And like the virus behind the 1918 pandemic, during which 2.5 percent of those stricken died, the next pathogen with the potential to cause a global catastrophic risk likely will spare more people than it kills. At the same time, it is likely to be a virus that even scientists cataloguing every virus known so far, have never heard of.

For all of those reasons a pathogen that remains unknown could extend its reach beyond any current national or international capacities to control it. Preparing for it now is necessary, possible, but presents a challenge, according the authors of a report from the Johns Hopkins Bloomberg School of Public Health Center for Health Security, released last week.

The report, The Characteristics of Pandemic Pathogens, issues that challenge with a set of recommendations based on an analysis of findings gathered from published literature, as well as interviews with experts across academia, government and industry.

While the report acknowledges the spread of bacteria resistant to multiple antibiotic medicines poses a global public health threat that endangers many of the gains of modern medicine, it notes that medicines to treat viruses are already much more limited. In addition, viruses reproduce more rapidly, and as a result, mutate at a much faster rate than bacteria, making them all the more of a moving target.

Among their recommendations, the report urges giving high priority to improving surveillance of illnesses caused by respiratory-borne viruses, building capacities to specifically diagnose diseases through microbiological testing, developing new antiviral treatments, and increasing investments to pursue vaccines against respiratory viruses, including a universal influenza vaccine.

An essential step toward preparedness, Dr. Amesh Adalja, who led the project said, is “not sticking to lists” of known threats. HIV was unrecognized and unheard of before it emerged globally, as were SARS, MERS, and the most damaging effects of Zika, he noted. “We’re always surprised.”

Preparedness also means recognizing the impacts of pathogens that do not cause high rates of fatality, and even those that do not directly cause death. While a virus that kills is the likeliest to emerge on a catastrophic scale, a cancer-causing pathogen, or a pathogen that affects reproduction, as rubella and Zika do, could be, as the report notes “highly detrimental to the future of humanity.”

 

One thought on “Report: Develop surveillance, diagnosis, treatments and vaccines to prepare for catastrophic pandemic potential pathogens

  1. David Fedson

    The report on pandemic pathogens prepared by the Center for Health Security (CHS) is surely correct in concluding that the next severe epidemic or pandemic of an emerging virus disease is likely to be caused by a respiratory pathogen. The steps advocated by the CHS to prepare for this event are sensible, but will they be enough? Bill Gates recently announced that during the first six months of next influenza pandemic, almost 33 million people will die. It is common knowledge that pandemic vaccines won’t be available to anyone during this period. What are we supposed to do? Resign ourselves to bury the dead and wait for a vaccine that will be given to those who have survived?
    There is promising alternative, although it is not covered in the CHS report. More than ten years ago it was suggested that inexpensive generic drugs could be used to treat the host response to influenza virus infection and that this might reduce pandemic mortality. (CHS staff have known about this for most of this period.) Unfortunately, the idea has been ignored, dismissed or actively opposed by elite scientists and health officials in major institutions, including WHO. They have chosen not to undertake the laboratory and clinical research that would be needed to show this approach to treatment would work. The candidate drugs (e.g., generic statins and angiotensin receptor blockers) are known to physicians who use them every day. They are available in any country with a basic health care system and could be used to treat patients on the first pandemic day. In addition, they could probably be used to treat patient infected with other emerging viruses (e.g., SARS, MERS, Ebola). Why are CHS staff and the elites who are driving the global agenda for pandemic preparedness ignoring this sensible and highly practical idea?

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