"It's not a question of if another pandemic will occur – it's when," says Prof Stephen Barr, a scientist at Western University in London, Ontario. "And we need to be prepared now so that we can protect ourselves and don't fall into the same situation as we are in right now."
Experts across the globe are absolutely clear: there will be another viral pandemic sooner rather than later. The odds are it will be another form of coronavirus like Sars-CoV-2 – we have had two SARS coronavirus pandemics in the space of less than 20 years so there is a high probability that we will get a third strain of a related coronavirus.
So what can we do now to enable us to rapidly respond when it strikes?
Vaccines are one solution; developing active surveillance and having mechanisms for rapid identification and response to new outbreaks is another; and working on a better public response to a pandemic is key.
Also speaking to the Canadian Broadcasting Corporation (CBC), Prof Volker Gerdts, director of VIDO-Intervac (vaccines and infectious diseases organisation) at the University of Saskatchewan said: “There needs to be more research on emerging diseases and establishing quick platforms or quick solutions that allow us to rapidly respond rather than trying to catch up.”
Where vaccine development is concerned, there are two distinct approaches: catalogue animal coronaviruses, trying to predict what characteristics make them likely to infect humans, and create a vaccine for each; or create a more universal coronavirus vaccine, that will protect against multiple different strains.
Spike protein
We know that each coronavirus strain has a unique spike protein that it uses to enter and infect cells. Having identified the strains that pose the greatest risk of infecting humans, researchers will use the genetic instructions for making each spike protein to create “pseudoviruses” and see which ones can get into human cells. We can then make and store vaccines against the viruses that have the ability to invade our cells. These seed vaccines could then be used to rapidly manufacture large quantities of a particular vaccine when a threat emerges.
At first glance, being able to develop a single vaccine that could combat a variety of coronaviruses sounds utopian. But it hasn’t stopped researchers trying. One possible route is to try to generate immunity not just to the spike protein, which is unique for each coronavirus, but to other proteins that look similar in many different coronaviruses. However, making more universal vaccines with areas that are similar between many viruses may not be as good at triggering the immune system.
Some public reactions to Covid-19 surprised experts. Rather than vaccine development being a major hurdle, experts say the biggest future challenge will be convincing people to take steps to protect humankind from a threat. Dr Iruka Okeke, a professor of pharmaceutical microbiology at the University of Ibadan in Nigeria, says it has been impossible to make people stay home or masked to avoid transmission in most countries. "When given the choice between skipping a holiday and posing mortal risk to another's life, sufficient numbers of people have chosen the latter and we have to presume that they will do it again," she told Nature Medicine.
Clearly, being ready for the next pandemic goes beyond science and needs to look at societal issues also. Effective pandemic response requires a clear, consistent voice and an actionable message. This message needs to be individualised and must evolve. Risk communication experts have started looking at the best ways people can manage the flood of information during a pandemic. There’s been an infodemic of Covid-19 news – not all of it trustworthy – and we need new strategies for sharing reliable information.
In Ireland we now need to invest heavily in our public and occupational health workforces so we're ready for the next global threat to health.
mhouston@irishtimes.com, muirishouston.com