Bracing for the Looming Pandemic Threat: Experts Kate Bingham and Tim Hames Urge Immediate Preparation

 

Bracing for the Looming Pandemic Threat: Experts Kate Bingham and Tim Hames Urge Immediate Preparation

The looming specter of the next major pandemic is a grim reality we must confront. Experts in global health tell us that it's not a mere possibility but rather a probability. This unsettling truth is compounded by the sobering fact that the world, including Britain, remains ill-prepared to face this impending crisis.

To combat what the World Health Organization ominously dubs "Disease X," we'll once again require rapid vaccine development and distribution. Regrettably, our current preparations offer no guarantees of success. As we reflect on the COVID-19 crisis, we must remember that governments worldwide were dangerously unprepared for a global health emergency. It was a scenario that many regarded as a doomsday scenario rather than a tangible threat.

Let's cast our minds back to May 2020. The outlook was undeniably bleak: infections and fatalities were on an alarming upward trajectory, and healthcare systems were stretched to the brink. The pandemic had inflicted more damage on the global economy than any recent recession.

Mass vaccination was the only plausible solution, yet no human coronavirus vaccine had ever received approval, let alone one for COVID-19. Furthermore, the historical success rate for vaccine development, from laboratory conception to mass production, was a discouragingly low 10 percent. The challenge before us was monumental.

It was in this dire moment that then-Health Secretary Matt Hancock unexpectedly reached out to me, asking me to lead the Vaccine Taskforce. Without hesitation, I took a leave of absence from my nearly three-decade career as a biotech venture capitalist, specializing in drug development, to spearhead the search for a portfolio of vaccines. The hope was that at least one would prove effective.

Simultaneously, scientists worldwide were working feverishly to develop potential vaccines at an unprecedented pace. The taskforce operated tirelessly, identifying promising candidates in their early stages, ensuring their safety and efficacy, securing binding agreements amid international competition, and facilitating large-scale manufacturing.

As history shows, several months later, two of the taskforce's selected vaccines received regulatory approval. In December 2020, the UK initiated the world's first vaccination program.

However, we mustn't forget that none of this was inevitable. Nor can we afford to grow complacent now that COVID-19 is perceived as a common ailment, even though it remains lethal to vulnerable populations. Scientists are well aware that the virus could mutate into more infectious variants, potentially evading existing treatments and vaccines.

Yet the specter of mutated COVID-19 variants pales in comparison to other viral threats. The 1918-1919 flu pandemic claimed over 50 million lives worldwide, a death toll twice that of World War I. Today, we face the possibility of a similar catastrophe from any of the numerous viruses already in existence.

Viruses are driven to replicate as prolifically as possible across various hosts, resulting in continual mutations and cross-species transmissions. Some of the deadliest viruses, such as smallpox, measles, Ebola, and HIV, originated in animals before becoming highly transmissible among humans.

Presently, there exist 25 known virus families, each comprising hundreds or thousands of distinct viruses, any of which could evolve into a pandemic threat. Alarmingly, there may be over one million undiscovered viruses capable of leaping between species, mutating dramatically, and causing mass human casualties.

The question is, why were we caught off guard by COVID-19 in 2020? It wasn't a sudden, unforeseen attack like a giant asteroid or an alien invasion. In reality, warning signs had been flashing for some time. We knew that a pandemic like COVID-19 was a matter of when, not if, given the escalating pace of pandemics in recent decades.

Unlike epidemics, which are confined to specific regions or countries, pandemics span continents. COVID-19 was, in fact, the seventh pandemic outbreak since the turn of the millennium, preceded by SARS in 2002-2004, H5N1 bird flu in 2004, H1N1 swine flu in 2009, MERS in 2012, Ebola in 2014-2016, and Zika in 2015-2016.

What prevented these outbreaks from wreaking global havoc was often a combination of factors: low infectivity (as seen with MERS), relatively low fatality rates (such as swine flu), or swift, coordinated international responses (like SARS). It was a fortuitous blend of good luck and preparedness.

In a sense, we lucked out with COVID-19, despite it causing over 20 million deaths worldwide. Most infected individuals did recover. However, consider Ebola with a 67 percent fatality rate or bird flu with a 60 percent fatality rate. Even MERS carried a 34 percent fatality rate. We cannot assume that the next pandemic will be as manageable.

Imagine if Disease X combined the infectiousness of measles with the lethality of Ebola. Somewhere in the world, it's lurking, and eventually, someone will fall ill.

So why are pandemics on the rise? It's not mere happenstance; it's a direct consequence of our modern world. First, globalization has interconnected us like never before. Second, urbanization has resulted in densely populated cities, facilitating the rapid spread of diseases. Third, our relentless destruction of natural habitats, including deforestation and wetland degradation, brings different species, including humans, into dangerously close proximity, providing ideal conditions for cross-species transmissions.

So, what's the solution? Crucially, we must begin addressing the next pandemic now by committing resources.

Pandemic viruses share similarities with computer viruses, which we take seriously. We invest in appropriate software and regularly update our devices to guard against cyber threats. Yet, we invest a fraction of that effort and funding in protecting ourselves from real viruses, the ones with the potential to devastate us.

In 2020, the global cybersecurity market was valued at nearly $170 billion, expected to reach $370 billion by 2028. It's an astonishing sum. However, there's minimal evidence of a similar commitment to protecting against deadly viruses.

The price of inaction is monumental. COVID-19 alone cost us a staggering $16 trillion in lost output and public health expenses, and it's a milder virus compared to Disease X.

Therefore, we must proactively develop prototype vaccines for known virus families before the next pandemic strikes. This approach provides a head start, allowing us to engineer vaccines tailored to Disease X's specific features.

This isn't impossible. The rapid global response to COVID-19 was possible because vaccine frameworks were developed a decade earlier during unsuccessful attempts to combat SARS and MERS.

To tackle Disease X effectively, we must adopt a portfolio strategy once more. Different vaccines trigger distinct immune responses and provide varying levels of protection. Manufacturing capabilities vary globally, so some vaccines may be better suited for large-scale production, while others may be more accessible in developing regions. We must also address the limitations of existing vaccines, such as durability, transport, and cost. Encouraging research into innovative vaccine technologies can lead to more effective and efficient solutions.

Vaccines are just one part of the equation. We must urgently invest in advanced international surveillance systems to detect and neutralize potential virus threats before they spread and mutate.

Moreover, we must rethink our response strategy in the critical period between Disease X's arrival and the availability of an effective vaccine. We can't afford to improvise as we did with COVID-19. Preparation and scientific planning are essential. Key questions regarding school closures,

 lockdown durations, travel restrictions, and mask usage must be thoroughly researched. Data from previous pandemics should be consolidated into a central database accessible to scientists worldwide.

Beyond this, we need to promote international cooperation and support a unified global approach. We should establish biological vaccine manufacturing capacities in countries across continents, particularly in low-population areas to reduce the risk of vaccine nationalism.

This isn't the time for complacency. We've experienced a comparatively mild pandemic, and governments understand the potential for much graver threats in the future. The logical next step is to establish a unified global entity responsible for handling Disease X. The Coalition for Epidemic Preparedness Innovations (CEPI), in close partnership with the World Health Organization, seems ideally suited for this role. CEPI, a truly international initiative launched in 2017, focuses on developing vaccines for future epidemics. They are actively working on compressing vaccine development timelines and creating a library of vaccines.

This approach should be funded by a global budget, with contributions based on national wealth. Furthermore, all nations should commit to a Global Pandemic Treaty, fostering open information sharing among scientists and clinicians and ensuring accountability in vaccine development and manufacturing.

Is this an ambitious endeavor? Absolutely, but not insurmountable. The remarkable success in responding to COVID-19 demonstrated what can be achieved when we unite our efforts. Next time, we must be even more prepared and swifter in our response.