Interview, Podcast
The 12 best ways to stop the next pandemic | Dr Cassidy Nelson (2020)
- Policy proposals are expected to be released before the virus becomes widespread in the U.S. or Europe, with 12 specific ideas anticipated to remain sensible for several years.
- Applications for the Emerging Leaders in Biosecurity fellowship will open in November, while an updated problem profile is expected within three months.
- The outbreak is predicted to peak in Wuhan in about one month, in China generally within two to three months, and potentially in the rest of the world within several months thereafter, depending on import rates.
- Containment similar to SARS is considered unlikely; while the outbreak might disappear within a year if contained in China, the virus is expected to potentially become endemic like seasonal coronaviruses.
- Global healthcare systems are expected to operate at over 95% capacity, rendering them unable to absorb major surges, and 19th-century public health measures are viewed as ineffective for large-scale outbreaks.
- Travel bans are predicted to merely delay cases rather than prevent them unless local transmission is fully stopped, potentially creating disincentives for countries to report cases.
- Metagenomic sequencing costs are falling and accuracy rising, though the technology remains expensive and requires specialized expertise beyond the capability of typical emergency room doctors.
- Vaccine development traditionally takes 10 to 15 years; however, CEPI has set a target of 16 weeks to a candidate and 30 weeks to manufacturing a million doses, a timeline considered too long by some.
- Machine learning is expected to significantly improve pathogenicity predictions, while environmental biosurveillance, despite massive investment, may only reduce the risk of human disease by approximately 60% and cannot detect every pathogen.
- Current DNA synthesis screening lacks legal mandates in any country, covers only orders over 200 base pairs, and risks shifting orders to India and China if Western countries enforce strict rules.
- Dual-use research oversight is currently described as ineffective, with no assigned task for the UK's 2018 biological security strategy requirements, and tabletop exercises are expected to yield variable policy translation.
- Interest in biosecurity initiatives risks drying up without sustained funding, mirroring post-2001 and post-2009 patterns, as most national pandemic plans focus exclusively on influenza and fail to account for novel pathogens.
- Future scenarios may include deliberate biological events or viruses with transmission rates differing from influenza, though progress on several fronts is anticipated over the next few decades.