‘There are viruses just waiting in the wings’: how do we stop the next pandemic?
In late 2019, Kirby Institute virologist Prof Stuart Turville was looking for another job.
“The funding rates were too low to survive,” he says.
But before he could leave, the Covid-19 pandemic hit. He now runs the institute’s high-security containment lab at the University of New South Wales, where the virus that causes Covid-19 is studied and grown. He and his skeleton team work long hours analysing hundreds of Covid samples from around the country, studying variants and working on treatments. When Turville gets home, after briefly seeing his children, he writes funding grants, and now it’s easier to secure them.
When he thinks back to the time before the pandemic when he considered throwing in the towel, Turville quotes the 2005 fantasy film, Nanny McPhee.
“‘When you need me, but do not want me, then I must stay’,” Turville says.
“I will tell that now to every virologist I train from herein. If they are not funded, not wanted, I will remind them to hold fast. One day, they will be sorely needed.”
Climate change and habitat destruction will bring ‘surprises’
When that day may come is difficult to predict, Turville says, but virologists and infectious diseases experts agree that more pandemics are inevitable. What is less certain is where the next ones will come from, and how severe they will be.
The answers to those questions depend on how much responsibility humans take for their impact on the environment, Turville says. History shows that advances in technology, while improving our ability to deal with pandemics, can also be the very things that trigger them and fuel their spread.
“We are clever and unfortunately naive at the same time with respect to the planet,” Turville says. “Economics and big leaps and bounds in technology bring great standards of living across the globe, but can unearth many unwanted nasties.”
He uses HIV as an example. It has been estimated that HIV entered the human population from primates somewhere near Kinshasa, now the capital of the Democratic Republic of the Congo, around the early 1900s. Yet it was not identified in humans until the early 1980s, having spread with the growth of transport links.
“The developing area of Kinshasa led to the infrastructure that moved the virus along that route,” Turville said. “Then, it moved on to the harbours and then on to the cities, as we all know. It was driven by economic activities.”
Other viruses have emerged from humans disturbing the environment, Turville says. The bat-borne nipah virus, which causes severe encephalitis – inflammation of the brain – in humans, stems from intensive agriculture practices, and climate change.
About three-quarters of all novel emerging viral diseases over the past two decades have been zoonotic, transmitted from an animal source, mostly bats, rodents or birds. But often missing from discussions of their origins is the role of humans.
“Unfortunately, things like climate change and habitat destruction will bring with them ‘surprises’ as animal struggle to deal with their changing environments courtesy of us,” Turville says.
Prof Dominic Dwyer, a medical virologist who is part of a team of 14 investigating the Covid-19 pandemic for the World Health Organization, agrees. The same team is now identifying the studies that need to be done to better prepare for the next pandemic and prevent it from being so severe.
Dwyer says a key part of planning for future pandemics will be understanding animal, environment and human interaction.
“All the viruses that have emerged in the last 50 years have come from either animals or the environment, and the connection, the network, between those factors and humans is so important,” he says.
“Preparing and planning includes considering demographics, the crowded environments people live in, the healthcare environments that allow some things to spread but not others, climate change and the influence of the way we use the land and interact with wildlife, the way we do trade, farming and tourism. All of those things have an impact on what lets a pandemic emerge and get going.”
In infectious diseases, this is often referred to as the One Health approach – integrating human, animal and environmental health sectors, as well as social sciences, bioinformatics and technology, and collaborating internationally.
After the 2002–04 Sars outbreak, an epidemic involving severe acute respiratory syndrome caused by a coronavirus, nearly all countries agreed to report any new or concerning viruses to the WHO and to the rest of the world.
“Now we realise through Covid that not only do you have to do that, you have to do it quickly,” Dwyer says. “That’s something new, and that’s what the G7 have been talking about. What’s the contract we need to make between countries to ensure reporting more quickly?”
Can we be confident that countries that sign up will follow through with their commitment full, transparent, and rapid reporting?
“I would be,” Dwyer says.
“This has clearly been the worst thing in 100 years, so you would hope they would be.
“But you’ve got to do this sort of stuff diplomatically. Now I’m not a diplomatic, thank God. But how does the world, for example, persuade China or other perhaps more closed countries, to join in and do it for everybody? That’s a diplomatic discussion, but the more you sling mud or ascribe blame, the less likely you are to get cooperation.”
‘There are viruses just waiting in the wings’
A paper published by Elsevier titled Preparing for Emerging Zoonotic Viruses, says experts had warned of the Covid-19 pandemic for years, often modelling it in the literature under the name Disease X.
“The disease X scenario that many scientists had warned about came true,” the article says.
“However, previous investments in surveillance, diagnostics, novel laboratory techniques, open data sharing and vaccine platforms did pay off. The speed of these key developments in the surveillance and control of the new virus is unprecedented.”
Dwyer says these scientific and technological advances, combined with more rapid data-sharing by governments, would stand us in good stead in managing a future pandemic. Patchy investment in public health, including in Australia, had been somewhat rectified.
“I think next time around we will be in a better situation, develop the tests and genomics more quickly, and therefore control it better and more quickly,” he says.
Prof Cassandra Berry, a researcher in viral immunology from Murdoch University, said to respond more rapidly, Australia needs to “start training and investing in its next generation of virus hunters now”.
The loss of expertise to other countries, the lack of local research funding and a lack of up-and-coming scientists who stay in the field long-term means Australia’s capacity to develop vaccines and produce them onshore is lacking, she says.
“We need to harness more talent in Australia, we are losing talent overseas, we are losing women in Stem who bring diversity to the table, and that means we are not understanding all facets of virology, yet these are the people who we should be developing to become vaccine manufacturers and virologists of the future.
“There are viruses just waiting in the wings. The next pandemic will likely be an airborne virus that’s highly transmissible, already out there, highly mutable and with an animal reservoir. It will be particularly dangerous if it has no visible signs, if it spreads by stealth.
“We are way overdue for another flu pandemic, and there are ones out there a few mutations away from moving from birds to humans. We need the funding invested now in our researchers to prepare.”