As more people get the COVID-19 vaccine, light appears at the end of a long, bleak tunnel. But there’s far more work to do to stave off the next global virus outbreak – a future pandemic that experts say is likely if not assured.
There are plenty of improvements possible, from closer relationships between public health officials and food producers to a more cohesive, global virus response network. Three Duke experts discussed these and other issues Thursday in a virtual briefing for media.
Watch the briefing on YouTube.
Here are excerpts:
ON WAYS TO PREVENT THE NEXT PANDEMIC
Dr. Gregory Gray, infectious disease specialist
“We need to find ways to do health research, surveillance at the human/animal nexus in partnership with big agriculture. We’ve got to find ways to protect their business interests and yet anticipate new viruses that are going to emerge and cause morbidity in both their animals and potentially in humans.”
“There’s a bunch of new tools to do that. We have aerosol samplers, water samplers. Those of us in the human health fields have many more tools and many more resources. But there’s a big push back from industry. They’re very concerned that we might harm their businesses.”
Linfa Wang, professor, emerging infectious diseases
“Not a single nation wants you to discover a virus in their country. So, if we don’t change that, I think we have little hope of having transparency.”
“We have to treat virus like a common enemy, politics aside, like fighting terrorists or fighting crime. Interpol is an international organization to fight crime; can we have something like that to fight future viruses? This is our common enemy.”
“As a basic research scientist, I think that what I can actually do to improve is actually limited. We have to have a new model to prevent every 10 years having a major outbreak.”
Stuart Pimm, professor, conservation ecology
“This is not a unique event. We’ve had previous outbreaks. Some of them, like HIV, have killed far more people than COVID-19 has. This emergence of diseases is routine. Some are small; some of them are catastrophic. We have to start doing things that will change that dynamic. This is not the last one. That’s an awful, terrible, depressing thing to say. But we have to be cognizant of that.”
ON HOW VIRUS DETECTION IS LACKING
Dr. Gregory Gray
“We’ve attempted to predict, if you will, these viral threats, but we’ve missed the specific viruses both in 2009 and 2019, so we haven’t done so well. We’ve done much better in responding, but that’s not the greatest strategy, to wait until something is a problem.”
“We have a whack-a-mole policy right now. We wait for a pathogen to cause a lot of morbidity, and then we respond. We have to figure out a better way to predict these and mitigate them before they cause a lot of harm.”
ON ROLE OF NATURAL ENVIRONMENT MANAGEMENT
“It’s important not to think of this being some exceptional event that happens just once and won’t happen again for 100 years. Two or three major viruses spill into the human population each year. There have been other viruses like this. HIV … killed at least 10 million people around the world.”
“In all cases, it’s a consequence of our human actions imposing upon the natural world. In the case of HIV, it was cutting down forests in west Africa. In this case it’s by contact with bats or some other related species. It’s clear there’s a lot of very cost-effective things we can do to prevent that kind of abuse of the world’s natural ecosystems. Limiting wildlife trade, limiting the number of species we use as bushmeat.”
ON WHY THERE ARE MORE VIRAL OUTBREAKS
Dr. Gregory Gray
“Hominids have been harvesting wildlife for food for an estimated 200 million years. So it’s not simply our contact with wildlife. I think there have been a number of other things that have happened.”
“The very large dense populations of people in mega-cities that are in close proximity to large animal populations … can amplify animal viruses. That has really changed in the last 50 years. We have gone to industrialized farming throughout the world. It’s good that we do because we need industrialized farming to produce enough protein to feed the human population, … but that industrialized farming comes with its costs. One of the costs is a virus that doesn’t kill those animals can get into those dense populations and churn – make many copies of itself and periodically mutate. That’s why we need to do surveillance at the human-animal nexus – particularly at domestic animal farms.”
“We’re seeing the movement of people, the movement of animals and the movement of animal products – food - at a rate we’ve never seen before. If a person or an animal or a food product harbors a novel virus, that can be moved rather quickly halfway around the world and cause a threat to a different population.”
ON CHANGING HUMAN BEHAVIOR OF EATING EXOTIC ANIMALS
“It’s a cultural and social status. Seventeen years ago we knew that SARS was transmitted to humans through an intermediate animal called a civet. In southern China … civets were not popular (to eat) until the economic boom. People who are rich enough, they want exotic food. And civets were very expensive. At the peak of the SARS outbreak, a group identified civets as the intermediate host.”
“They tried to mobilize the citizens to say, ‘It’s a tradition in our province, but the risk is there is a virus coming in and it can kill you.’ They did a public opinion poll, and the question was, ‘Do you want to keep the tradition and run the risk of a pandemic, or change the tradition and close down the live animal market?’ ”
“And you know the answer? During the peak of SARS, 79 percent of people went for keeping the tradition, and take the risk.”
ON TROPICAL FORESTS AS LAUNCH PADS FOR VIRUSES
“It’s a matter of the proximity in most cases. The edges themselves are where particular kinds of mosquitos hang out. It’s that juxtaposition of people and rainforests and their edges. The most obvious example of that is HIV. Almost certainly that came to our species because people went into the west African forests and began butchering chimpanzees for meats. It’s this notion of moving into places where we really don’t need to be. We really don’t need to be eating bats.”
“We are paying a very heavy price for what is really a fringe activity. We are not getting these viruses from our crop fields.”
Meet the experts:
Dr. Gregory Gray
Dr. Gregory Gray is a professor of medicine, global health and environmental health at Duke. He also holds appointments at Duke-NUS Medical School in Singapore and Duke Kunshan University in China. He has studied infectious diseases for 25 years across five continents.
Stuart Pimm is a professor of conservation ecology at Duke’s Nicholas School of the Environment. He is on a team that found reducing deforestation and the wildlife trade could help prevent future pandemics.
Linfa Wang is a professor in the Emerging Infectious Diseases Programme at Duke-NUS Medical School in Singapore and a faculty member with the Duke Global Health Institute. He studies the transmission of viruses from bats to humans and has researched the origins of the SARS-CoV2 coronavirus.
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