The Road Not Traveled

From Just the News:

A lot of opportunities were missed," said Dr. Carlos Del Rio, a professor of medicine in the Division of Infectious Diseases at Emory University and Professor of Global Health and Epidemiology at the Rollins School of Public Health. "A lot of opportunities were squandered. Global pressure was not where it should be." Experts said the decision to prioritize a pandemic flu over the coronavirus was based on risk assessments, some which failed to adjust to the reality that a growing economy and increased airline travel in recent years changed some of the risk assumptions.

"We knew a pandemic was coming at some point," said Dr. Sarah Fortune, Professor of Immunology and Infectious Diseases and chair of the Department of Immunology and Infectious Diseases at Harvard T.H. Chan School of Public Health. "Given our experiences with SARS1, MERS versus the various modern flu epidemics, I do not think it was unreasonable to put our bets on flu. And in many ways, the investments that we made — and those we failed to make — in flu preparedness are bearing fruit now." Hal King, the chief executive officer for the nonprofit Public Health Innovations and an infectious diseases scientist formerly at the Center for Disease Control and at Emory University School of Medicine, agreed.

"I believe the COVID-19 pandemic was more difficult to prepare for because the majority of the global preparation before this was centered on pandemic flu," King told Just the News. "Pandemic Flu was expected to spread much faster and become more lethal because of the natural spread by birds across continents and via significant human travel by air (of which the models predicted it to kill millions quickly). COVID-19 does not spread across continents by natural spread via birds but only via human to human contact, which we would expect to be more easily containable."  

"However," he continued, "because air travel has so significantly increased in the last 10 years, we need to rethink preparedness (including drugs, diagnostics, and vaccines) for all human to human infectious diseases that could be pandemic." 

This tale of inaction and inertia dates to a period after the 2002-03 eruption in China of SARS, a coronavirus sister to today's pathogen. After the SARS virus peaked, the Chinese Ministry of Health invited scientists, researchers, and doctors to participate in reflective discussions about what was learned and what could be done to thwart future pandemics.

Barry Bloom, an infectious disease researcher and Harvard professor, was one of the attendees and remembers a clarion call to close wildlife markets known to spread the coronavirus to humans. “Everyone knows they are extremely dangerous,” Bloom said. And yet the markets, after a brief pause, were allowed to resume operations.

Equally alarming was the lack of followup after early drug studies found some promising treatments that worked anecdotally during the SARS outbreak in 2003, two smaller coronavirus outbreaks in 2004-05, and MERS in 2012. The anti-malarial drug known as chloroquine was one of a handful flagged as a potential treatment. One such study in 2005 found “chloroquine has strong antiviral effects on SARS-Cove infection of primate cells. These inhibitory effects are observed when the cells are treated with the drug either before or after exposure to the virus, suggesting both prophylactic and therapeutic advantage.” (Read more.)

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