CAN THE WORLD STOP THE NEXT PANDEMIC?
A year has now passed since we first heard the term COVID-19, not long before the sudden start of our “new normal”. But was the devastation it caused really inevitable? Here, our guest speaker, Debora MacKenzie, argues that the pandemic was eminently preventable – and that if we can’t learn from our mistakes, this could merely be the beginning
ON 11 FEBRUARY 2020, THE WORLD HEALTH ORGANISATION (WHO) GAVE A NAME TO AN ILLNESS THAT HAD EMERGED ONLY TWO OR THREE MONTHS EARLIER: CORONAVIRUS DISEASE 2019, MORE COMMONLY REFERRED TO AS COVID-19.
That day, few would have believed that, a year later, the odd-sounding disease would still be the defining issue for men’s – and everyone’s – health. But it hasn’t just been a year of mounting death tolls, baffling symptoms and economic mayhem. The year has also seen an unprecedented outpouring of science, the invention of effective vaccines and a deeper understanding of how pandemics happen.
So, it’s time to ask ourselves a few things. Could we have stopped the pandemic? Can outbreaks such as this happen again? If so, has COVID-19 taught us how to prevent the next one?
Spoiler alert: during the first lockdown last spring, I wrote a book called COVID-19: The Pandemic That Never Should Have Happened and
How to Stop the Next One. Just based on what we knew then, the answer was yes, we could certainly have prevented it, or if not, controlled it better. And, yes, there will be another outbreak like this, of an animal virus that spreads lethally in people. Since last spring, this has become even clearer: if we learn what we did wrong this time and act on it, there is every chance that we can stop the next one. What we don’t have is any assurance that governments facing the economic fallout of this pandemic will do what is needed.
It isn’t as if we weren’t warned this time. The real scandal of COVID-19 is that scientists have been predicting such a crisis for decades. Some of them even warned about this specific family of viruses. I know: I’m a science journalist, and I’ve been reporting the warnings since the 1990s.
They boil down to this: there are many viruses in wildlife that can spread to and between humans – and even kill. This is happening with increasing frequency, as humans live and work in formerly wild areas and encounter more, sicker wildlife. The germs that jump to us spread further and faster as our global connectedness increases, yet we don’t have adequate plans or enough research and development to detect and limit such outbreaks before they spread out of control.
In other words, the conditions that led to COVID-19 have not gone away, and another pandemic could happen at any time. There are worrying viruses just waiting for their chance.
What has changed, however, is that now we all know that this threat is real. BC – that is, before COVID – few people,
especially in rich countries, believed that our modern world could be struck down by pestilence. Such an idea seemed like something from the distant past. That, I think, is what ultimately kept us from being ready. For years, scientists warned of the threat and many countries had plans in place for a pandemic – at least, on paper. But when COVID-19 hit, the responses in many places, including the United States, were chaotic and ineffectual.
THE ORIGIN STORY
In December 2019, doctors in the Chinese city of Wuhan noticed that they were seeing a lot of unusual cases of severe pneumonia. Tests soon revealed a new kind of coronavirus. They found that it was spreading between family members. Viruses that are new to
people can’t always go from person to person easily, so they don’t travel far. This one could.
It was an important observation: the first hurdle is to recognise the problem. But the Chinese authorities decided to play down the outbreak. Doctors were told to stop putting cases in the central reporting system; then, tests were limited, so the official case numbers didn’t climb. In early January, Beijing told the WHO about the outbreak but claimed – to the Chinese public, as well as to the WHO – that it didn’t spread from person to person.
No one apart from those involved knows why. There was a big government meeting planned for Wuhan in January, and officials might have decided to keep things quiet. A similar coronavirus that broke out in China in 2002, SARS, was contained by isolating people with symptoms; perhaps they assumed that the new virus could be stopped just as easily, with sick people confined in hospitals. Comments from the time suggest that, like officials everywhere, they didn’t want to panic people.
As we now know, people without symptoms can transmit COVID-19, so it continued to spread in Wuhan. Eventually, on 20 January, Beijing announced that COVID-19 could spread from person to person, after all, and put Wuhan – now riddled with the virus – in lockdown three days later. By then, however, some five million people had left for their big annual New Year’s holiday, spreading the virus worldwide.
If they had acted later, it would have been far worse for both China and the rest of the world. If they had acted earlier, they might, in theory, have stopped the pandemic completely.
Yet epidemiologists suspect that no authorities would have acted aggressively enough, or early enough, to stamp out the virus before they knew much about it – especially that people without symptoms could spread it.
After all, many authorities, including in the US, were reluctant to take strong actions even after they knew far more.
But if we had known about this earlier, maybe more countries could have deployed tests, isolated infected people and their contacts and limited or quarantined travellers, before the virus got far. Singapore, South Korea, Vietnam, Taiwan and New Zealand acted swiftly once the truth was out, significantly limiting their epidemics. If more countries had done the same, it wouldn’t have stopped the virus completely but it might have meant far less suffering and death until a vaccine was ready.
POOR COMMUNICATION
Wherever the next outbreak occurs, we need to make sure that we rapidly have access to the complete information. The Chinese officials are far from unique in wanting to keep diseases quiet. In the 1990s, most European countries denied that there was mad cow disease on their farms, long after scientists knew that it had to be there. African countries reluctant to report cases slowed the response to the 2014 Ebola epidemic. The former US president Donald Trump downplayed COVID-19 early on to avoid upsetting people – or the stock market.
So, how do we make sure that this doesn’t happen again? Trump blamed the WHO for not warning the world that the virus was contagious. Yet the WHO had no way to find out if Chinese authorities didn’t tell it or even let WHO experts in.
Even though we are all at risk when a disease breaks out, the treaty that governs this – the International Health Regulations (IHR) – puts the country with the outbreak solely in charge.
The WHO can’t demand to investigate, even if it suspects that it hasn’t heard the whole story, because that would violate national sovereignty, which is sacrosanct in international relations.
This is dangerous in a world as closely connected as ours, where a contagious disease anywhere is soon everywhere. How do we reconcile the need for countries to be independent with the need to make sure that they act in all of our interests, and quickly, when needed? Other international treaties use verification. Under the treaty banning chemical weapons, countries