All politics aside, if we learned anything from the COVID-19 crisis it is that our traditional approach to a pandemic is outdated and woefully inadequate.
Over the past two decades, scientists have developed a pandemic preparedness playbook that has failed catastrophically. The National Institutes of Health made massive investments that failed to cope with the COVID pandemic and indeed may have caused it.
The pandemic preparedness playbook is breathtaking, even utopian, in its ambition – and it’s time to change it!
First up, let’s look at the existing “playbook.” It entails three basic steps. First, catalog every existing pathogen by sending scientists to every remote place (bat caves in China and the like) and bring biological samples of wildlife to labs, often in city centers like Wuhan, China.
Second, evaluate the risk of each pathogen infecting humans by testing its ability to penetrate human cells — and sometimes even genetically modifying it to make this more likely.
The latter practice is now called dangerous “gain-of-function” (GOF) research. The idea is to estimate the likelihood the infectious pathogen will mutate in a way that could conceivably threaten humans.
Third, develop vaccines and therapeutics for the few pathogens that pose the greatest risk before they leap to humans.
Crucially, this step involves awarding large contracts to pharmaceutical manufacturers to develop and stockpile the countermeasures.
Believe it or not, every step of this agenda is fraught with risk and danger – as we learned during the COVID crisis.
The very act of sending scientists into remote places to collect pathogens risks a spillover of a pathogen that might never have occurred otherwise.
The laboratory work, even if not classified as GOF, is risky. Even with precautions, there is always a risk a lab will inadvertently leak a pathogen.
In fact, leaks are common, and biosafety oversight is not harmonized worldwide, meaning these pathogens are often manipulated in relatively low-security environments.
President Donald Trump’s executive order placing dangerous GOF work under strict regulatory control helps address the problem, but achieving its goals will require the entire scientific community worldwide to embrace its principles.
All scientists must embrace a culture of careful consideration of the benefits and risks of every experiment — regardless of whether it is classified as GOF.
From a historical and evolutionary standpoint, the playbook makes little sense. The measures developed to counter the threat will never have their efficacy tested in humans before an outbreak occurs.
Inevitably, the version of the pathogen that ultimately causes an outbreak will differ significantly from those collected to develop countermeasures.
Indeed, the one thing we can say with confidence is that the pathogens with the capacity to cause pandemic level outbreaks are by their very nature, unpredictable.
It’s Time to Embrace Increased Health and Wellness as a Strategy
What, then, can be done in the face of the reality that another pandemic will eventually arise? We must stop wasting money on the traditional playbook. We do not need to find and create new pathogens that could cause future outbreaks.
Rather, we must improve our understanding of the pathogens that we know cause disease in humans now, without speculating about hypothetical risks.
We should develop better prevention and treatment strategies for these existing pathogens.
We should learn from recent example: A metabolically healthy population, physically active and eating nutritious food, will cope far better in the face of a novel pathogen than a population facing a severe chronic-disease crisis.
Sweden, without lockdown or school closures, was the best in the world at protecting human life during the COVID pandemic: It had the lowest level of age-adjusted, all-cause excess deaths in the world between March 2020 and December 2024.
Sweden succeeded in part because its people are relatively metabolically healthy.
Ultimately, public-health agencies encouraging people to take whatever steps they can to improve their health will have a dramatic effect during the next pandemic.
Whether simply by stopping smoking, controlling hypertension or diabetes, or getting up and walking more, anything that makes the population healthier will prepare us better for the next pandemic
