Thursday, March 26, 2020

We Knew. We've Known for Years. We Just Ignored the Warnings. That Must Stop - Now.

When we think of climate science we think of what are sometimes called "earth sciences." Stuff like physics, chemistry, atmospherics, geology, hydrology, glaciology - the droughts, floods and severe weather events sciences.  Much less known are the related medical sciences, specifically epidemiology. And yet that community of doctors and scientists has been warning us for a long time that pandemics were in our future. Author and journalist Bryan Walsh explains that now is the time to begin preparing for the next pandemic.  A lot of lives will be lost paying for the mistakes we're still making.
The novel coronavirus pandemic, known as Covid-19, could not have been more predictable. From my own reporting, I knew this first-hand. In October 2019, I attended a simulation involving a fictional pandemic, caused by a novel coronavirus, that killed 65 million people, and in the spring of 2017 I wrote a feature story for TIME magazine on the subject. The magazine cover read: “Warning: the world is not ready for another pandemic”. 
There was little special about my insight. Over the past 15 years, there has been no shortage of articles and white papers issuing dire warnings that a global pandemic involving a new respiratory disease was only a matter of time. On BBC Future in 2018, we reported that experts believed a flu pandemic was only a matter of time and that there could be millions of undiscovered viruses in the world, with one expert telling us, “I think the chances that the next pandemic will be caused by a novel virus are quite good.” In 2019, US President Donald Trump’s Department of Health and Human Services carried out a pandemic exercise named “Crimson Contagion”, which imagined a flu pandemic starting in China and spreading around the world. The simulation predicted that 586,000 people would die in the US alone. If the most pessimistic estimates about Covid-19 come true, the far better named “Crimson Contagion” will seem like a day in the park.
Mankind has seen it all before.
Covid-19 marks the return of a very old – and familiar – enemy. Throughout history, nothing has killed more human beings than the viruses, bacteria and parasites that cause disease. Not natural disasters like earthquakes or volcanoes. Not war – not even close.

The plague of Justinian struck in the 6th Century and killed as many as 50 million people, perhaps half the global population at the time. The Black Death of the 14th Century – likely caused by the same pathogen – may have killed up to 200 million people. Smallpox may have killed as many as 300 million people in the 20th Century alone, even though an effective vaccine – the world’s first – had been available since 1796.
How we dropped the ball on Covid-19.
Covid-19 is very much a disease of the moment, emerging in a crowded city in a newly prosperous and connected China before spreading to the rest of the world in a matter of months. But our response to it has been both hyper-modern – and practically medieval. Scientists around the world are using cutting-edge tools to rapidly sequence the genome of the coronavirus, pass along information about its virulence, and collaborate on possible countermeasures and vaccines, all far quicker than could have been done before. 
But when the virus arrived among us, our only effective response was to shut down society and turn off the assembly line of global capitalism. Minus the text alerts, the videoconferencing and the Netflix, what we were doing wasn’t that different from what our ancestors might have tried to halt an outbreak of the plague. The result has been chemotherapy for the global economy
Just as the eventual emergence of something like Covid-19 was easily predictable, so too are the actions we should have taken to shore ourselves against its coming.
Learn from this pandemic and be ready for the next.
We need to strengthen the antennae of global health, to ensure that when the next virus emerges — which it will — we’ll catch it faster, perhaps even snuff it out. The budget of the WHO, the agency ostensibly charged with safeguarding the health of the world’s 7.8 billion citizens, is somehow no more than that of a large urban hospital in the U.S. 
We need to double down on the development of vaccines, which will include assuring large pharma companies that their investments won’t be wasted should an outbreak end before one is ready.
We need to build more slack into our public health systems. Just as the US military is designed — and funded — to fight a war on two fronts, so our health care systems should have the surge capacity to meet the next pandemic. 
One ongoing challenge in pandemic preparation is what experts call shock and forgetting. Too often politicians make funding promises in the immediate aftermath of a crisis like Sars or Ebola, only to let those pledges lapse as the memory of the outbreak fades
Somehow, I expect that won’t be the case with Covid-19. We need to do all we can to not just survive this pandemic, but to ensure it remains a throwback from the past, not a sign of things to come.


Anonymous said...

We need to double down on the development of vaccines, which will include assuring large pharma companies that their investments won’t be wasted should an outbreak end before one is ready.

Better yet, we need to take the development and manufacture of vaccines out of the hands of for-profit pharmaceutical corporations so that society is not held to ransom when an outbreak happens. We've known since the worldwide Kansas Flu epidemic of 1917-18 (using Trump's preferred naming convention) that the private sector cannot be relied on in an emergency.

Just look at the way Gilead Sciences gamed the system to get a 5-year monopoly on its experimental antiviral remdesivir developed with massive public funding and collaboration with USAMRIID and CDC. If the drug works against Covid-19, with trials currently underway in China, Gilead will make out like bandits, having successfully placed development costs on the public while privatizing profits. This is simply wrong and needs to stop. Any drug developed with public assistance should either be very limited in its patent life or should come with strings attached that see the government share in the control of the patent and the profits. The government should be able to void the patent and allow the manufacture of generics if needed. We've had quite enough of disaster profiteering.


The Disaffected Lib said...

I couldn't agree more, Cap. Britain's venerable astronomer royal, Baron Martin Rees, dealt with the peril of private scientific research in his 2003 book, Our Final Hour. He demonstrates everything we lose and the risks we bear when primary research is privatized. He buttresses his argument by discussing the extensive number of breakthroughs that have come from publicly funded research.

Anonymous said...

I see that Ireland today nationalized all private hospitals for the duration of the pandemic. "We're all in this together" is smart politics.