Preparing better for the next pandemic

Breaking new ground 7. nov 2021 3 min Professor, Head of Research Group Frank Møller Aarestrup Written by Kristian Sjøgren

COVID-19 disrupted the world. Researchers are now making suggestions on how to optimally ensure that this does not happen again.

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The world has been rocked by a pandemic for almost 2 years.

COVID-19 has spread from Wuhan, China to all corners of the world, with fatal consequences for millions of people, and researchers, drug manufacturers and politicians everywhere are struggling to cope with the fallout.

For some researchers, however, COVID-19 is already in the rear-view mirror. Instead, they are looking towards preparing for the next pandemic, which could potentially be even worse.

COVID-19 could be considered a relatively easy test of pandemic preparedness, and if we do not learn from the mistakes and shortcomings related to this pandemic, the next one may be much more severe.

“In global pandemic terms, coronaviruses are some of the most straightforward pathogens. These atypical respiratory infections may or may not have originated in China and spread across the world relatively predictably and then were transmitted directly between humans with relatively short incubation periods. Next time we may encounter something much worse, such as a retrovirus like HIV, a virus like Ebola, a parasite or a resistant bacterium, and then things may be more severe if we are not prepared,” explains Frank Møller Aarestrup, Professor and Head of Division, National Food Institute, Technical University of Denmark, Kongens Lyngby.

Frank Møller Aarestrup and colleagues published an article in The Lancet Regional Health – Europe on several initiatives that can improve preparedness for the next pandemic.

Helping low- and middle-income countries

The researchers provide specific examples of the required preparedness so that the next pandemic does not catch us unprepared.

One example is how high-income countries can help low- and middle-income countries by monitoring the various viruses, bacteria and parasites that could trigger the next pandemic.

For example, if a new virus with pandemic potential emerges in Uganda in the current situation, a very long time might elapse before it is identified and characterised. By then, preventive action may be too late, since the virus may have spread across all of Africa before anyone realises it.

“We cannot just tell these countries to send us their laboratory samples or send a team of experts to help them. Instead, we need to figure out how we can help the countries so they can help themselves to discover new viruses. One way would be to use online analytical tools or bioinformatics, which will make analysis easier. In addition, we need to establish some simple methods for sharing data, so that when anything emerges somewhere, researchers around the world can start working on a solution immediately,” says Frank Møller Aarestrup.

Monitoring sewage and airport air for pathogens

Another important initiative, according to the researchers, is early surveillance. Again, the problem is that there is no benefit to discovering a new virus after it has already spread globally. Discovery must occur locally.

Another positive aspect of early surveillance is the ability to go back in time and determine exactly where the virus originated and how it has spread. For SARS-CoV-2, this has been investigated for 2 years, still without agreement. Early monitoring may enable determination in days.

Frank Møller Aarestrup proposes routinely screening sewage or monitoring the air at airports for the emergence of new pathogens.

“With SARS-CoV-2, we ended up lagging behind because it spread more rapidly than we could detect it, reaching both the United States and Europe very early and then spreading globally. In Denmark, for example, we tried to keep it out of the country, but it was already here. Had we discovered it earlier, we could have implemented appropriate measures to deal with the actual situation, instead of constantly chasing a situation that had already changed,” explains Frank Møller Aarestrup.

Mashing up mosquitoes and ticks

According to Frank Møller Aarestrup, another possibility is monitoring vectorborne pathogens: viruses, bacteria or parasites that can infect humans through mosquitos or ticks.

This can be done by collecting 1,000 mosquitoes or ticks a couple of times a month, mashing them into one large lump and analysing whether genes from pathogens we need to be aware of are present in the genetic soup.

“Some countries, including the Netherlands and Spain, are already monitoring the infectious pathogens in the populations of mosquitoes and ticks. This approach should be adopted worldwide,” says Frank Møller Aarestrup.

Improving the management of animals as sources of infection

Since most diseases that end up as pandemics among humans originate from animals, Frank Møller Aarestrup thinks we should also monitor abattoirs for the presence of new and dangerous pathogens.

To back this up, Frank Møller Aarestrup says that approximately 247 new diseases have been described in humans in the past century versus at least 750 for animals. These diseases can potentially jump from animals to humans, such as with swine flu, bird flu, salmonella and COVID-19.

The problem with the diseases in animals is that if, for example, a new virus succeeds in infecting millions of pigs, the virus is more likely to spread from the pigs to people.

“Monitoring hotspots therefore makes sense. This can be difficult with an abattoir in Africa, but there may be some opportunities to identify hotspots and then start risk-targeted monitoring there,” explains Frank Møller Aarestrup, adding that all initiatives obviously require political will both within and between countries.

“One thing we have learned from the current pandemic is that we need to work together on international solutions that can improve preparedness for the next one. In addition, merely setting up systems that target the problems of the past is of little use. The next pandemic may act quite differently, and we must be prepared for all scenarios,” concludes Frank Møller Aarestrup.

Pandemics – One Health preparedness for the next” has been published in The Lancet Regional Health – Europe. In 2016, the Novo Nordisk Foundation awarded a Challenge Programme grant of DKK 60 million to Frank Møller Aarestrup for the project Global Surveillance of Antimicrobial Resistance.

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