MANILA — The world failed to prevent the novel coronavirus pandemic, but infectious disease experts who starred in Netflix’s “Pandemic: How To Prevent an Outbreak” documentary series argue the world can prevent the next one or stop an outbreak before it becomes a large-scale, global event.
“I firmly believe that pandemics, in fact, are preventable,” Dennis Carroll, chair of the Global Virome Project leadership board and senior adviser for global health security at University Research Co., told Devex in an interview.
“There's no reason why we should ever have a pandemic again. And quite frankly, no outbreak should even lead to an epidemic. We can be smarter, we can be more effective, and it has to do with our commitments,” he said.
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Preventing pandemics would require strong political commitment and leaders seeing the value of and investing in areas such as disease surveillance, forecasting, and global supply chains, added Carroll and Syra Madad, senior director of the systemwide special pathogens program at NYC Health + Hospitals.
The two have dedicated their lives to helping prevent, prepare and respond to emerging viral threats. In the series “Pandemic: How To Prevent an Outbreak,” shot in 2019, they both emphasized the need to prepare for a potential virus that could cause global disruption and overwhelm health systems and said that the emergence of a deadly virus is not a matter of if, but when.
In January of this year, a few months after filming, the world was alerted to an atypical pneumonia making people sick in Wuhan, China. This would later be known as a new coronavirus, which today has caused the deaths of over 1.5 million people worldwide and disrupted the global economy.
“What we’ve seen today are the consequences of a pandemic. We’ve all known the risks. … [But] no one could have fathom the consequences of this magnitude,” Madad said.
An emphasis on global surveillance
Both experts emphasized the importance of adequate surveillance systems and the value of epidemic and pandemic forecasting, which could help not only in pre-positioning needed resources but also in reducing morbidity and mortality.
“Stuff always ... happens. We may have entire disease outbreaks, and we need to make sure that — regardless of our best efforts — that we have a surveillance system that picks up, at the earliest possible moment, the first signature when an outbreak is beginning,” Carroll said, adding that attention can be given to certain geographically localized hot spots. Outbreaks do not happen everywhere, he said.
In the Netflix series, Carroll identified China as one of those hot spots. Virtually all of the deadly influenza viruses that have emerged in the last half-century emerged from China, he said.
He welcomed U.S. President-elect Joe Biden’s commitment to restore PREDICT, a 10-year project to identify emerging viral threats that have the potential to cause a pandemic. The project was part of the U.S. Agency for International Development’s Emerging Pandemic Threats program — which Carroll led — and received considerable attention when it shuttered its doors in 2019, just a few months before the COVID-19 outbreak.
While successful, the pandemic expert said PREDICT was a “proof of concept” and its scope was “way too small.” To really make a global impact, the scale of viral discovery needed to go beyond a USAID project, he said.
Carroll left USAID in 2019 but aims to build on the work of PREDICT with the Global Virome Project.
“The commitment from the Biden campaign is truly welcome. But I hope they appreciate that the next generation of viral discovery isn't simply doing another five-year investment in PREDICT. It's about building on PREDICT and taking it to the next level so that a global threat like the COVID-19 virus can be met by a global partnership, like the Global Virome Project,” he said.
A wake-up call
Madad said she hopes COVID-19 would serve as a wake-up call for world leaders to commit and invest resources in preparedness measures, as well as in fixing the global supply chain, which collapsed amid the pandemic as countries imposed travel restrictions and major manufacturing hubs like China went on lockdown.
She recalled how even cities such as New York suffered from shortages of protective equipment for hospital personnel starting early on in the outbreak, as demand surged across the globe.
“We need to take a hard look [at] why is it that ... we heard nothing from the economic and political alliances ... in a meaningful way that really spoke to galvanizing a coordinated response.”— Dennis Carroll, leadership board chair, Global Virome Project
“If you compare the burn rate in just a health care system like mine, we were burning at 600% capacity of isolation gowns in April, compared to January. ... And at that time … we weren't getting our orders filled,” she said.
Even today, she said, there’s still a national need for more N95 masks and PPE.
“One of the big things that we often say in emergency management is that if a resource is not walkable, it does not exist. And that has never held more true than [in] this pandemic,” she said.
But while Madad is hopeful, Carroll is somewhat worried that investments will focus on the economic impacts of COVID-19 and that there will be less of a priority for investments to prepare the world for future health threats.
“Health care is one of the first line items that are impacted when our budgets need to be contracted. And I would be fearful that as we go forward, the very needs of the population to deal with just the normative health services are going to be challenged — not just to mention the ability to deal with future threats as well,” he said.
Preventing the next pandemic would require sustained investments and political leaders valuing and acting on the intelligence they receive on emerging disease threats.
While public health institutions such as the World Health Organization and the U.S. Centers for Disease Control and Prevention — heavily criticized for their COVID-19 response efforts — can do better, Carroll said it is the political community that failed to listen to information coming from these institutions and their own intelligence networks on COVID-19 and that failed thereafter in mobilizing the needed response to COVID-19.
“We need to take a hard look [at] why is it that we heard nothing from the European Union, we heard nothing from NATO, we heard nothing from the economic and political alliances — the G-8, G-20 [groups of leading economies] — in a meaningful way that really spoke to galvanizing a coordinated response to this virus,” he said, noting they could have played a role in ensuring that critical health supplies got to where the need was “rather than where the purchasing power was.”
Update, Dec 11, 2020: This article has been updated to clarify a comment of Madad’s about the need for more PPE.