Clearing the Fog: Applying the COVID-19 Toolbox to Future Pandemics

100 years had passed since the 1918 flu pandemic, and researchers knew it was only a matter of time before another deadly disease emerged. Even before 2020, Dr. Helen Chu worried.

“Another pandemic was inevitable,” says Chu, pointing to Ebola and bird flu as examples. “We had seen an acceleration of various pathogens accelerating due to global travel.” Chu is an associate professor in the University of Washington’s Schools of Medicine and Public Health and part of a research team pondering possible pandemics.

“The recipe is there, with a human-animal interface, the fact that humans travel from place to place very quickly, and based on events in recent history,” she says.

It was then that the team recognized the need for better disease surveillance at the laboratory and community levels. Better genome sequencing could show in real time how the virus mutated as it spread through the community.

The COVID-19 pandemic has taken a brutal toll, but also created opportunities to use this genome sequencing alongside community testing and surveillance, vaccines, and other approaches. The experience has helped advance some techniques in preparation for the next big storm – and revealed areas for improvement as well as mysterious facets we don’t yet understand.

The pace of discovery of novel viruses has only accelerated over the past 20 to 40 years, Chu notes. The 2022 monkeypox outbreak is a recent example of a human-animal disease that can quickly infect continents, aided by international travel. “It’s coming, but we’re better prepared than in the past,” says Chu. “Much better prepared.”

learning and teaching

Newer mRNA vaccines used during COVID-19 are proving effective in preventing serious diseases in the general population, Chu says. Engineering feats addressed the timeline for disease arrival, genome sequencing, and vaccine development. Widespread use of vaccines and treatments reduced the number of deaths. These processes and applications can potentially be used in future outbreaks.

Additionally, advances in home testing offer quick results without waiting in long lines. It’s a “game changer,” says Chu. Knowing your infection status changes behavior, she says. If you get a positive test before going to a party, staying home can help stop the spread. “Their technology can be applied to other pathogens in the future.”

The development of monoclonal antibody therapy is another “amazing” development that shows promise for the future, Chu says. Monoclonal treatment relies on “the ability to take a blood sample from the individual and convert it into a therapeutic within months.”

Simple behavioral approaches also show promise, Chu says. We have learned from the current pandemic that masking works and what measures can slow down the spread of a pandemic. Business and school preparedness plans have reduced the risk of transmission through clear and timely communication, social distancing and masking, which could be expanded for the next pandemic, says Dr. Molly McNairy, associate professor at the Weill Cornell Center Global Health and attending physician at New York-Presbyterian Hospital in New York City.

“Anything companies can do to build this now can be used over and over again,” says McNairy. “Without them, you just go back to shutting down everything nobody wants to do.” McNairy believes the workplace safety and wellness industry will grow over the next 2 to 5 years.

Some changes may remain in the long term. For example, masking in hospitals has been shown to reduce flu transmission and deaths, Chu notes, especially among high-risk individuals.

secrets and injustices

Researchers are still working to solve some challenges. For example, what’s been called “long COVID” can cause a debilitating, long-term illness with symptoms lasting more than 30 to 60 days, Chu says. Experts know little about the number of people affected and why some get sick and others don’t.

Chu says untangling the triggers of Long Covid is a key concern right now. Vaccines can reduce long-term COVID-19 risk, but breakthrough infections still occur and vaccines do not fully protect against long-term COVID-19.

Although they have been effective in the past, it is unclear how effective vaccines against newer variants will be, and booster shots may be needed. Parents of children under the age of 5 have also been waiting for a long time to protect their children with the vaccine. “We know it’s quite effective,” Chu says of the vaccine, which results in high protective antibody titers.

Policy makers and healthcare providers can also play a role. The pandemic has revealed huge gaps in access to health care, particularly among people of color, McNairy says. McNairy has provided international pandemic care, working with patients coping with HIV, Cholera and Covid. She is also an advisor on pandemic workplace safety, risk mitigation and outbreak preparedness.

“Many Americans, particularly vulnerable communities and people of color, lack access to affordable health care,” says McNairy. The way forward also requires more community partnerships around messaging and developing trust with individual patients, says McNairy. “It points to a larger crisis in America from social and racial health disparities that aren’t necessarily getting better,” she says.

Unfortunately, public health messaging has been influenced by politics, and as a result, some populations do not trust the data. Some high-level messages from institutions like the CDC were unclear, such as on masking guidelines, Chu says.

New approaches

Because of the severity and rapidity of emerging infectious diseases, McNairy says a timely, transparent alert system — similar to a hurricane or severe weather monitoring system — could help anyone respond to outbreaks more quickly.

For hurricanes, “we give you a warning and alert to take individual risk mitigation,” she explains. “Climb your house and your windows, move inland, and then there are population-level interventions when the risk increases, such as. B. evacuating communities to safer ground. We haven’t set that up nationally for COVID and pandemics that are coming. Everyone is working on how we can improve surveillance.”

The first step is to collect risk and community transmission data accurately and quickly, similar to the UK and Israel — both of which have national data systems to collect this data, Chu points out. The system could then broadcast how long it takes for the virus to arrive, how many transmissions might occur, and take preventive action at a personal and community level based on severity, Chu says. The community could then switch to masking and other protective measures.

It may be necessary sooner or later. “These are lessons we’ve learned in this pandemic that prepare us much, much better for next time, so we can use our tools,” says Chu. “It’s not over yet, but we’re better prepared for what’s to come and things are only getting better, not worse. Fingers crossed.”

Since 1975 The MJ Murdock Charity Foundation has sought to strengthen the educational, social, spiritual and cultural base of the Pacific Northwest by investing in innovative and sustainable work.

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