The next pandemic

We were lucky. The COVID-19 pandemic killed more than 500,000 Americans in 2020 and shut down economies all across the globe. But the next pandemic could be infinitely worse. And we aren’t even remotely ready for it.

So, now, even as nearly every American is finally able to receive a COVID-19 vaccine and the United States opens up slowly, President Joe Biden’s chief scientific officer for COVID-19 response, David Kessler, is already preparing for what might be next. But that “next pandemic” that he and others are preparing for isn’t what you might think.

Yes, the coronavirus at the heart of COVID-19 is mutating. We’ll need new strategies for it within months. We’ll almost certainly need booster vaccine shots every year for the foreseeable future to deal with new, more deadly variants.

But that isn’t the “next pandemic” that we all should be worried about. The coronavirus at the heart of COVID-19 is quite tame to what very well might come next — like, for instance, an especially virulent arterivirus species jump that has been the intense focus of biodefense and scientific experts for nearly a decade now. There’s been very little media coverage of this awful threat, but that will change if — or when — it emerges to the human species.

Dr. Kessler and other pandemic experts are preparing right now for the inevitable next pandemic — which includes federal funding for new GMP facilities, mRNA research efforts and rapid-scale science review processes. The COVID-19 response now is as much about manufacturing, distribution and quality assurance as it is the mRNA science. Every available GMP facility in America is now in service to the COVID-19 fight.

Which is critical. We need to get the COVID-19 rapid response right — so that we don’t get it disastrously wrong the next time.

Bill Gates agrees. “We can’t afford to be caught flat-footed again,” Gates wrote in his annual letter. “To prevent the hardship of this last year from happening again, pandemic preparedness must be taken as seriously as we take the threat of war.”

The financial stakes are enormous. While it’s difficult to quantify exactly, the COVID-19 alone probably exacted a $10 trillion toll in 2020. But the human health implications of a pandemic based on something like an arterivirus species jump is an order of magnitude worse — on both the economic and health fronts.

I can’t emphasize enough how deadly an arterivirus species jump pandemic might be for us, the human species. When one type of artervirus — simian hemorrhagic fever virus — jumped from one monkey species to another (Asian macaque colonies), it was brutally lethal.

In one instance, nearly every macaque died after being infected with that particular form of arterivirus. As a comparison point, the coronavirus pandemic has a fatality rate in the low single digits — and has still killed more than 3 million people globally.

Would an arterivirus be as lethal in human populations as it was to the macaque colonies? Would the first wave of arterivirus pandemic cases approach a 100% fatality rate like they did in that non-human primate colony? Let’s hope, and pray, we never find out.

But the horrifying truth is this: we don’t know. Very recent studies show that other types of the arterivirus have been just as lethal in other species. A group of hedgehogs was decimated when one strain of the arterivirus hit them.

Scientists have only just identified the especially deadly strain of arterivirus in the wild in just the past decade, when it jumped from one monkey species to macaques and nearly killed them all in at least one of the non-human primate colonies.

One of the deadliest forms of arterivirus — simian hemorrhagic fever — has been known to jump from one non-human primate species to another since at least the 1960s. The species jumps occurred largely in quarantined settings — not in the wild. The clinical symptoms included all of the usual suspects in deadly hemorrhagic fevers — including internal hemorrhaging in the lungs, liver and kidney. But it wasn’t until 2011 that scientists discovered a species jump in the wild.

Again, we’ve been lucky. There have been no reported cases of this especially virulent arterivirus species jump to humans — so far. But as practices like xenotransplantation and bushmeat hunting continue to advance, it may only be a matter of time before we see a species jump to humans that is 10X (or 30X) as virulent as the coronavirus pandemic.

If so, then we’d better be ready — with GMP facilities; with mRNA vaccine processes that can scale up everywhere, quickly; with the ability to provide low-cost (or no-cost) vaccines to 8 billion people rather than just to a billion or so in the more developed parts of the world.

This is what is keeping David Kessler up until all hours of the night. He knows we have to be ready for the next pandemic, even if our political leaders don’t quite grasp the urgency just yet.

Right now, we are nowhere close to that goal.