Pandemic Prevention
   HOME

TheInfoList



OR:

Pandemic prevention is the organization and management of preventive measures against
pandemic A pandemic ( ) is an epidemic of an infectious disease that has a sudden increase in cases and spreads across a large region, for instance multiple continents or worldwide, affecting a substantial number of individuals. Widespread endemic (epi ...
s. Those include measures to reduce causes of new infectious diseases and measures to prevent outbreaks and epidemics from becoming pandemics. It is not to be mistaken for pandemic preparedness or mitigation (e.g. against COVID-19) which largely seek to mitigate the magnitude of negative effects of pandemics, although the topics may overlap with pandemic prevention in some respects. Pandemics typically arise naturally from interactions between humans and animals, but emerging technologies are also expected to facilitate the synthesis and enhancement of dangerous pathogens, making
bioterrorism Bioterrorism is terrorism involving the intentional release or dissemination of biological agents. These agents include bacteria, viruses, insects, fungi, and/or their toxins, and may be in a naturally occurring or a human-modified form, in mu ...
and laboratory accidents emerging threats. Pandemic prevention measures include early detection systems, international coordination with information sharing, laboratory
biosafety Biosafety is the prevention of large-scale loss of biological integrity, focusing both on ecology and human health. These prevention mechanisms include the conduction of regular reviews of biosafety in laboratory settings, as well as strict guidel ...
protocols, oversight of
gain-of-function research Gain-of-function research (GoF research or GoFR) is medical research that genetically alters an organism in a way that may enhance the biological functions of gene products. This may include an altered pathogenesis, transmissibility, or host ran ...
, restricting access to dual-use biotechnology, monitoring spillover risks in wild animal populations, regulating
wildlife trade Wildlife trade refers to the exchange of products derived from non-domesticated animals or plants usually extracted from their natural environment or raised under controlled conditions. It can involve the trade of living or dead individuals, tis ...
and wet markets, reducing
intensive animal farming Intensive animal farming, industrial livestock production, and macro-farms, also known as factory farming, is a type of intensive agriculture, specifically an approach to mass animal husbandry designed to maximize production while minimizing cos ...
, protecting ecosystems, and strengthening public health care systems. In May 2025, all Member States of the World Health Organization (WHO) formally adopted by the world's first Pandemic Agreement.


History


2002–2004 SARS outbreak

During the
2002–2004 SARS outbreak The 2002–2004 outbreak of SARS, caused by severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1), infected over 8,000 people from 30 countries and territories, and resulted in at least 774 deaths worldwide. The outbreak w ...
, the
SARS-CoV-1 Severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1), previously known as severe acute respiratory syndrome coronavirus (SARS-CoV), is a strain (biology), strain of coronavirus that causes severe acute respiratory syndrome (SARS), the ...
virus was prevented from causing a pandemic of
Severe acute respiratory syndrome Severe acute respiratory syndrome (SARS) is a viral respiratory disease of zoonotic origin caused by the virus SARS-CoV-1, the first identified strain of the SARS-related coronavirus. The first known cases occurred in November 2002, and the sy ...
(SARS). Rapid action by national and international health authorities such as the
World Health Organization The World Health Organization (WHO) is a list of specialized agencies of the United Nations, specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Gen ...
helped to slow transmission and eventually broke the chain of transmission, which ended the localized epidemics before they could become a pandemic. Human-to-human transmission of SARS may be considered eradicated, however, it could re-emerge as SARS-CoV-1 probably persists as a potential zoonotic threat in its original animal reservoir. This warrants monitoring and reporting of suspicious cases of atypical pneumonia. Effective isolation of patients was enough to control spread because infected individuals usually do not transmit the virus until several days after symptoms begin and are most infectious only after developing severe symptoms. Nevertheless several studies warned about the possible pandemic threat posed by
coronaviruses Coronaviruses are a group of related RNA viruses that cause diseases in mammals and birds. In humans and birds, they cause respiratory tract infections that can range from mild to lethal. Mild illnesses in humans include some cases of the comm ...
.


MERS-CoV/NeoCoV alert

In January 2022, Chinese scientists at the
Wuhan University Wuhan University (WHU; 武汉大学) is a key comprehensive public university in Wuhan, Hubei, China. It is directly affiliated with and funded by the Ministry of Education of the People's Republic of China, Ministry of Education of China. The un ...
and other institutions reported in a
preprint In academic publishing, a preprint is a version of a scholarly or scientific paper that precedes formal peer review and publication in a peer-reviewed scholarly or scientific journal. The preprint may be available, often as a non-typeset versi ...
the detection of the closest MERS-CoV relative in bats to date, NeoCoV, and another virus, PDF-2180-CoV, that can efficiently use bats' ACE2 for cell entry. The study, now published in ''
Nature Nature is an inherent character or constitution, particularly of the Ecosphere (planetary), ecosphere or the universe as a whole. In this general sense nature refers to the Scientific law, laws, elements and phenomenon, phenomena of the physic ...
'' found that one mutation could result in a theoretical 'MERS-CoV-2' that, like
SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19, the respiratory illness responsible for the COVID-19 pandemic. The virus previously had the Novel coronavirus, provisional nam ...
, can use humans' ACE2 receptor. The theoretical virus could also have a high mortality burden, since MERS-CoV had a
case fatality rate In epidemiology, case fatality rate (CFR) – or sometimes more accurately case-fatality risk – is the proportion of people who have been diagnosed with a certain disease and end up dying of it. Unlike a disease's mortality rate, the CFR does ...
of around 35%. This 'MERS-CoV-2' therefore represents a risk to
biosafety Biosafety is the prevention of large-scale loss of biological integrity, focusing both on ecology and human health. These prevention mechanisms include the conduction of regular reviews of biosafety in laboratory settings, as well as strict guidel ...
and potential
zoonotic A zoonosis (; plural zoonoses) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a virus, bacterium, parasite, fungi, or prion) that can jump from a non-human vertebrate to a human. When h ...
spillover. The study emphasized the need for pathogen/spillover surveillance to further understand any possible threat from related viruses. The
WHO The World Health Organization (WHO) is a specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Geneva, Switzerland, and has 6 regional offices and 15 ...
stated that further study is needed to find out "whether the virus detected in the study will pose a risk for humans".


Monkeypox

On 21 May 2022, the
WHO The World Health Organization (WHO) is a specialized agency of the United Nations which coordinates responses to international public health issues and emergencies. It is headquartered in Geneva, Switzerland, and has 6 regional offices and 15 ...
reported on the international 2022 monkeypox outbreak in non-endemic countries which involved an unprecedented number of cases detected outside of Africa. The first of these cases was detected on 6 May 2022. The main method used for early containment is '
ring vaccination Ring vaccination is a strategy to inhibit the spread of a disease by vaccinating those who are most likely to be infected. This strategy vaccinates the contacts of confirmed patients, and people who are in close contact with those contacts. This ...
' – vaccinating close contacts of positive cases via already-existing vaccines alongside pre-exposure vaccination of members of the public at higher risk.


Measures


Infrastructure and international development

Robust, collaborating public health systems that have the capacity for active surveillance for early detection of cases and to mobilize their health care coordination capacity may be required to be able stop contagion promptly. After an outbreak there is a certain window of time during which a pandemic can still be stopped by the competent authorities isolating the first infected and/or fighting the pathogen. A good global infrastructure, consequent information exchange, minimal delays due to
bureaucracy Bureaucracy ( ) is a system of organization where laws or regulatory authority are implemented by civil servants or non-elected officials (most of the time). Historically, a bureaucracy was a government administration managed by departments ...
and effective, targeted treatment measures can be prepared. In 2012 it has been proposed to consider pandemic prevention as an aspect of
international development International development or global development is a broad concept denoting the idea that societies and countries have differing levels of economic development, economic or human development (economics), human development on an international sca ...
in terms of health-care infrastructure and changes to the pathogen-related dynamics between humans and their environment including animals. Often local authority carers or doctors in Africa, Asia or Latin America register uncommon accumulations (or clusterings) of symptoms but lack options for more detailed investigations. Scientists state that "research relevant to countries with weaker surveillance, lab facilities and health systems should be prioritized" and that "in those regions, vaccine supply routes should not rely on refrigeration, and diagnostics should be available at the point of care". Two researchers have suggested that public health systems "in each country" need to be capable of detecting contagion early, diagnosing it accurately, implementing effective disease control measures, and fully collaborating with the relevant international authorities at each stage . U.S. officials have proposed a range of reforms to international health regulations and global institutions for global health security. The "entire architecture of the response to epidemics" may need to get adapted, evolving "from crisis response during discrete outbreaks to an integrated cycle of preparation, response and recovery" .


Technology-centric measures


Biosafety technologies and biotechnology regulation

Potential policies that support global
biosafety Biosafety is the prevention of large-scale loss of biological integrity, focusing both on ecology and human health. These prevention mechanisms include the conduction of regular reviews of biosafety in laboratory settings, as well as strict guidel ...
could make use of various technologies, including but not limited to laboratory containment technologies – for example, tools could promote compliance with existing and novel biosecurity norms and standards. Proposals to increase biosafety in terms of laboratories, scientific field work and research and development-related activities include: * limiting research on highly contagious biological agents to only trained researchers in well-protected environments and advanced biological safety systems and disposal of biohazards. * improving physical security and educating scientists about the misuse potentials * review processes for
gain-of-function research Gain-of-function research (GoF research or GoFR) is medical research that genetically alters an organism in a way that may enhance the biological functions of gene products. This may include an altered pathogenesis, transmissibility, or host ran ...
involving enhanced potential pandemic pathogens. While such research can help develop vaccines and therapeutics preemptively, it requires careful risk assessment and safety protocols to minimize potential hazards. * monitoring and strengthening laboratory protocols around the world ** Work on coronaviruses at the Wuhan Institute of Virology was carried out at biosafety level 2 with level 4 being the most secure. Level 3 containment is now recommended for SARS-CoV-2. As of 2020, the
CDC The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency under the Department of Health and Human Services (HHS), and is headquartered in Atlanta, ...
and other health agencies recommended handling non-SARS non-MERS human coronaviruses and SARS-related coronaviruses from wild animals at Biosafety Level 2 ''in vitro'' and Level 3 ''in vivo''. ** According to a study of Indian BSL-2 and BSL-3 facilities, "there are no national guidelines or reference standards available in India on certification and validation of biosafety laboratories" ** In a 2018 study it was suggested that there is a need "to update international laboratory biosafety guidance" "to globalize biosafety" ** In the wake of the COVID-19 pandemic there was a "global surge in labs that handle dangerous pathogens" and as of 2022 some researchers "are concerned about hese. * monitoring and strengthening field work protocols around the world (such as viral sampling) ** A small survey reported that many biosafety professionals conducting field collection of potentially infectious specimens have not been formally trained on the topic. ** There are multiple known examples of field-associated infections. * making deadly viruses harder to engineer * oversight of high-risk pathogen research * measures that don't rely on relevant technological equipment and biotechnology products (as well as data and knowledge) only being available to registered scientists and all of these scientists to act responsibly may also be possible ** According to one expert, the "international bioweapons community" should work towards having supply chain choke points identified and help implement robust monitoring of them, such as, for example, key input material ** One international team plans to make DNA synthesis screening available for free to countries worldwide and could establish a level of safety if regulations require that DNA synthesis companies send sequences for screening against a certified database ** Only "approximately 80 percent of DNA providers are members of the International Gene Synthesis Consortium, which screens customers and DNA order sequences to prevent the building blocks of dangerous pathogens from falling into the hands of malicious actors". Screening is "costly, time-consuming, and requires human expertise", e.g. making non-participation economically beneficial. ** Reducing risks from methods that "may enable the creation of (or expand access to) particularly dangerous engineered pathogens" may involve careful regulation. ** Several technological local production capabilities create additional challenges ** Some companies that manufacture DNA started collaboration to limit access to dangerous genes so that only authorized laboratories can obtain DNA of "about 60" lethal germs and toxins


= Risks of pandemic prevention

= Efforts of pandemic prevention and related endeavors carry risks of triggering pandemics themselves. These risk include unwitting laboratory escape and accidents such as spillovers during field interventions like wildlife virus sampling, and misuse of its results due to e.g. insecure commercial sales of required equipment and/or materials and/or data. However, not engaging in any form of sampling also carries risks, as it could leave communities unprepared for future spillover events and unaware of future potential pathogens. One approach to mitigate risks from pandemic prevention is to "maintain a database with hashes of deadly and dangerous sequences" which don't contain data with a potential for danger (depending on various factors) and also "can't be reverse-engineered to learn the dangerous original sequence if you don't already know it". This would theoretically enable checking sequences against a database of recorded pathogens without maintaining a database of deadly sequences. Another approach is not building such databases or not collecting dangerous sequences in the first place. A 2014 study proposed safer "alternatives to experiments with novel potential pandemic pathogens" than some of the current methods.


Pathogen detection and prediction

In a 2012 study it is claimed that "new mathematical modelling, diagnostic, communications, and informatics technologies can identify and report hitherto unknown microbes in other species, and thus new risk assessment approaches are needed to identify microbes most likely to cause human disease". The study investigates challenges in moving the global pandemic strategy from response to pre-emption. Some scientists are screening blood samples from wildlife for new viruses. The international Global Virome Project (GVP) aims to identify the causes of fatal new diseases before emergence in human hosts by genetically characterizing viruses found in wild animals. The project aims to enlist an international network of scientists to collect hundreds of thousands of viruses, map their genomes, characterize and risk-stratify them to identify which ones to pay attention to. However, some infectious disease experts have criticized the project as too broad and expensive due to limited global scientific and financial resources and because only a small percentage of the world's zoonotic viruses may cross into humans and pose a threat. They argue for prioritizing rapidly detecting diseases when they cross into humans and an improving the understanding of their mechanisms. A successful prevention of a pandemic from specific viruses may also require ensuring that it does not re-emerge – for instance by sustaining itself in domestic animals. Pathogen detection mechanisms may allow the construction of an early warning system which could make use of artificial intelligence surveillance and outbreak investigation. Edward Rubin notes that after sufficient data has been gathered artificial intelligence could be used to identify common features and develop countermeasures and vaccines against whole categories of viruses. It might be possible to predict
viral evolution Viral evolution is a subfield of evolutionary biology and virology concerned with the evolution of viruses. Viruses have short generation times, and many—in particular RNA viruses—have relatively high mutation rates (on the order of one poin ...
using
machine learning Machine learning (ML) is a field of study in artificial intelligence concerned with the development and study of Computational statistics, statistical algorithms that can learn from data and generalise to unseen data, and thus perform Task ( ...
. In April 2020 it was reported that researchers developed a predictive algorithm which can show in visualizations how combinations of
genetic mutation In biology, a mutation is an alteration in the nucleic acid sequence of the genome of an organism, virus, or extrachromosomal DNA. Viral genomes contain either DNA or RNA. Mutations result from errors during DNA or viral replication, mitosis ...
s can make
protein Proteins are large biomolecules and macromolecules that comprise one or more long chains of amino acid residue (biochemistry), residues. Proteins perform a vast array of functions within organisms, including Enzyme catalysis, catalysing metab ...
s highly effective or ineffective in organisms – including for viral evolution for viruses like
SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19, the respiratory illness responsible for the COVID-19 pandemic. The virus previously had the Novel coronavirus, provisional nam ...
. In 2021, pathogen researchers reported the development of machine learning models for genome-based early detection and prioritization of high-risk potential zoonotic viruses in animals prior to spillover to humans which could be used for virus surveillance for (i.a.) measures of "early investigation and outbreak preparedness" and, according to the study, would have been capable of predicting SARS-CoV-2 as a high-risk strain without prior knowledge of zoonotic SARS-related coronaviruses. An artificial "global immune system"-like technological system that includes pathogen detection may be able to substantially reduce the time required to take on a biothreat agent. A system of that sort would also include a network of well-trained epidemiologists who could be rapidly deployed to investigate and contain an outbreak. Funding for the United States' PREDICT government research program that sought to identify animal pathogens that might infect humans and to prevent new pandemics was cut in 2019. Funding for United States'
CDC The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency under the Department of Health and Human Services (HHS), and is headquartered in Atlanta, ...
programs that trained workers in outbreak detection and strengthened laboratory and emergency response systems in countries where disease risks are greatest to stop outbreaks at the source was cut by 80% in 2018. In 2022, researchers reported the development of an ultra-high-throughput
sequence alignment In bioinformatics, a sequence alignment is a way of arranging the sequences of DNA, RNA, or protein to identify regions of similarity that may be a consequence of functional, structural biology, structural, or evolutionary relationships between ...
technology that enables searching the planetary collection of
nucleic acid sequence A nucleic acid sequence is a succession of Nucleobase, bases within the nucleotides forming alleles within a DNA (using GACT) or RNA (GACU) molecule. This succession is denoted by a series of a set of five different letters that indicate the orde ...
s. The open source
supercomputing A supercomputer is a type of computer with a high level of performance as compared to a general-purpose computer. The performance of a supercomputer is commonly measured in floating-point operations per second (FLOPS) instead of million instruc ...
-based Serratus Project identified over 130,000 RNA-based viruses, including 9 coronaviruses. While such and related endeavors and data are reportedly risky themselves as of 2021, the project aims to improve pathogen surveillance, the understanding of viral evolutionary origins and enable quickly connecting strange emerging illnesses to recorded viruses. Despite recent advances in pandemic modeling, experts using mostly experience and intuition are still more accurate in predicting the spread of disease than strictly mathematical models.


CRISPR-based immune subsystems

In March 2020 scientists of
Stanford University Leland Stanford Junior University, commonly referred to as Stanford University, is a Private university, private research university in Stanford, California, United States. It was founded in 1885 by railroad magnate Leland Stanford (the eighth ...
presented a
CRISPR CRISPR (; acronym of clustered regularly interspaced short palindromic repeats) is a family of DNA sequences found in the genomes of prokaryotic organisms such as bacteria and archaea. Each sequence within an individual prokaryotic CRISPR is d ...
-based system, called PAC-MAN (Prophylactic Antiviral Crispr in huMAN cells), that can find and destroy viruses
in vitro ''In vitro'' (meaning ''in glass'', or ''in the glass'') Research, studies are performed with Cell (biology), cells or biological molecules outside their normal biological context. Colloquially called "test-tube experiments", these studies in ...
. However, they weren't able to test PAC-MAN on the actual
SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19, the respiratory illness responsible for the COVID-19 pandemic. The virus previously had the Novel coronavirus, provisional nam ...
, use a targeting-mechanism that uses only a very limited
RNA Ribonucleic acid (RNA) is a polymeric molecule that is essential for most biological functions, either by performing the function itself (non-coding RNA) or by forming a template for the production of proteins (messenger RNA). RNA and deoxyrib ...
-region, haven't developed a system to deliver it into human cells and would need a lot of time until another version of it or a potential successor system might pass
clinical trial Clinical trials are prospective biomedical or behavioral research studies on human subject research, human participants designed to answer specific questions about biomedical or behavioral interventions, including new treatments (such as novel v ...
s. In the study published as a
preprint In academic publishing, a preprint is a version of a scholarly or scientific paper that precedes formal peer review and publication in a peer-reviewed scholarly or scientific journal. The preprint may be available, often as a non-typeset versi ...
they write that it could be used prophylactically as well as therapeutically. The CRISPR-Cas13d-based system could be agnostic to which virus it's fighting so novel viruses would only require a small change. In an editorial published in February 2020 another group of scientists claimed that they have implemented a flexible and efficient approach for targeting RNA with CRISPR-Cas13d which they have put under review and propose that the system can be used to also target SARS-CoV-2 in specific. There have also been earlier successful efforts in fighting viruses with CRISPR-based technology in human cells. In March 2020 researchers reported that they have developed a new kind of CRISPR-Cas13d screening platform for effective guide RNA design to target
RNA Ribonucleic acid (RNA) is a polymeric molecule that is essential for most biological functions, either by performing the function itself (non-coding RNA) or by forming a template for the production of proteins (messenger RNA). RNA and deoxyrib ...
. They used their model to predict optimized Cas13 guide RNAs for all protein-coding RNA-transcripts of the
human genome The human genome is a complete set of nucleic acid sequences for humans, encoded as the DNA within each of the 23 distinct chromosomes in the cell nucleus. A small DNA molecule is found within individual Mitochondrial DNA, mitochondria. These ar ...
's
DNA Deoxyribonucleic acid (; DNA) is a polymer composed of two polynucleotide chains that coil around each other to form a double helix. The polymer carries genetic instructions for the development, functioning, growth and reproduction of al ...
. Their technology could be used in molecular biology and in medical applications such as for better targeting of virus RNA or human RNA. Targeting human RNA after it has been transcribed from DNA, rather than DNA, would allow for more temporary effects than permanent changes to human genomes. The technology is made available to researchers through an interactive website and
free and open source software Free and open-source software (FOSS) is software available under a Software license, license that grants users the right to use, modify, and distribute the software modified or not to everyone free of charge. FOSS is an inclusive umbrella term ...
and is accompanied by a guide on how to create guide RNAs to target the
SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19, the respiratory illness responsible for the COVID-19 pandemic. The virus previously had the Novel coronavirus, provisional nam ...
RNA genome. Scientists report to be able to identify the genomic pathogen signature of all 29 different
SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) is a strain of coronavirus that causes COVID-19, the respiratory illness responsible for the COVID-19 pandemic. The virus previously had the Novel coronavirus, provisional nam ...
RNA sequences available to them using
machine learning Machine learning (ML) is a field of study in artificial intelligence concerned with the development and study of Computational statistics, statistical algorithms that can learn from data and generalise to unseen data, and thus perform Task ( ...
and a dataset of 5000 unique viral genomic sequences. They suggest that their approach can be used as a reliable real-time option for taxonomic classification of novel pathogens.


Testing and containment

Timely use and development of quick testing systems for novel virus in combination with other measures might (possibly) make it possible to end transmission lines of outbreaks before they become pandemics. After an outbreak there may be a certain window of time during which a pandemic can still be prevented. A key difficulty with early detection and containment is that in the globalized and urbanized world, pathogens can spread rapidly to several regions worldwide via travel, before it may be possible to notice them and e.g. initiate contact-tracing and containment measures. Rapid communication of data for health systems to implement any public intervention measures may be important. A "'One Health' global network for proactive surveillance, rapid detection, and prevention of MERS-CoV and other epidemic infectious diseases threats" has been proposed in 2016. Moreover, there are several issues with tests. For example, a high discovery-rate is important. For instance, this is the reason why no thermal scanners with a low discovery-rate were used in airports for containment during the
2009 swine flu pandemic The 2009 swine flu pandemic, caused by the H1N1/swine flu/influenza virus and declared by the World Health Organization (WHO) from June 2009 to August 2010, was the third recent flu pandemic involving the H1N1 virus (the first being the 1918â ...
. Coverage may also be important. (See also: pooled COVID-19 populations testing, possibly based on CRISPR) Wastewater surveillance likely cannot replace large-scale diagnostic testing, but could "complement clinical surveillance by providing early signs of potential transmission for more active public health responses". Some argue that the best forms of prevention for natural nonsynthetic viruses would be stopping the viruses from spilling into humans in the first place, rather than trying to contain outbreaks. The German program InfectControl 2020 seeks to develop strategies for prevention, early recognition and control of infectious diseases. In one of its projects "HyFly" partners of industry and research work on strategies to contain chains of transmission in air traffic, to establish preventive countermeasures and to create concrete recommendations for actions of airport operators and airline companies. One approach of the project is to detect infections without molecular-biological methods during passenger screening. For this researchers of the Fraunhofer-Institut for cell therapy and immunology are developing a non-invasive procedure based on ion-mobility spectrometry (IMS). Incentives for countries to report new viruses may be important for sufficiently fast detection and for avoiding cover-ups. A global treaty proposed by the E.U. could address this issue. Rapid regional, possibly also national, capacities in terms of e.g. means, mobile laboratories or diagnostics, personnel, technologies, financial insurances and coordination may also be important. In cases where vaccines already exist a major method for early containment is '
ring vaccination Ring vaccination is a strategy to inhibit the spread of a disease by vaccinating those who are most likely to be infected. This strategy vaccinates the contacts of confirmed patients, and people who are in close contact with those contacts. This ...
' – vaccinating close contacts of positive cases (and/or geographical areas) via existing vaccines as well as pre-exposure vaccination of people at higher risk. There are also precautionary vaccine stockpiles. Production capacities may also be important. See also: vaccine-to-variant adjustment for SARS-CoV-2 Omicron Researchers have developed a portable virus capture device, coupled with label-free
Raman spectroscopy Raman spectroscopy () (named after physicist C. V. Raman) is a Spectroscopy, spectroscopic technique typically used to determine vibrational modes of molecules, although rotational and other low-frequency modes of systems may also be observed. Ra ...
for identification of newly emerging or circulating viruses as a major first step toward managing the public health response to potential outbreaks. It could rapidly obtain the Raman signature of a virus and use machine learning to recognize the virus based on its weighted combination Raman spectrum fingerprint, being able to distinguish between influenza virus type A versus type B.


Surveillance and mapping


=Viral hotspots and zoonotic genomics

= Monitoring people who are exposed to animals in viral hotspots – including via virus monitoring stations – can register viruses at the moment they enter human populations - this might enable prevention of pandemics. The most important transmission pathways often vary per underlying driver of emerging infectious diseases such as the vector-borne pathway and direct animal contact for land-use change – the leading driver for emerging
zoonoses A zoonosis (; plural zoonoses) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a virus, bacterium, parasite, fungi, or prion) that can jump from a non-human vertebrate to a human. When h ...
by number of emergence events as defined by Jones et al. (2008). 75% of the reviewed 1415 species of infectious organisms known to be pathogenic to humans account for zoonoses by 2001.
Genomics Genomics is an interdisciplinary field of molecular biology focusing on the structure, function, evolution, mapping, and editing of genomes. A genome is an organism's complete set of DNA, including all of its genes as well as its hierarchical, ...
could be used to precisely monitor virus evolution and transmission in real time across large, diverse populations by combining pathogen genomics with data about host genetics and about the unique transcriptional signature of infection. The "Surveillance, Outbreak Response Management and Analysis System" (SORMAS) of the German Helmholtz-Zentrum für Infektionsforschung (HZI) and Deutsches Zentrum für Infektionsforschung (DZIF), who collaborate with Nigerian researchers, gathers and analyzes data during an outbreak, detects potential threats and allows to initiate protective measures early. It's meant specifically for poorer regions and has been used for the fight against a
monkeypox Mpox (, ; formerly known as monkeypox) is an infectious viral disease that can occur in humans and other animals. Symptoms include a rash that forms blisters and then crusts over, fever, and lymphadenopathy, swollen lymph nodes. The illness ...
outbreak in Nigeria. Improving "frontline healthcare provision and testing capacity for deprived communities around the world" could enable detecting, identifying and controlling outbreaks without delays .


=Syndromic surveillance and border control

= Expert on infectious diseases at the Johns Hopkins Center for Health Security, Amesh Adalja states that the most immediate way to predict a pandemic is with deeper surveillance of symptoms that fit the virus' profile. The scientific and technological ways of quickly detecting a spillover could be improved so that an outbreak can be isolated before it becomes an epidemic or pandemic. David Quammen states that he heard about the idea to develop technology to screen people at airport security points for whether or not they carry an infectious disease ten years ago and thought it was going to be done by now. Thermometers whose measurement data is directly shared via the Internet and medical guidance apps have been used to plot and map unusual fever levels to detect anomalous outbreaks. Various forms of data-sharing could be added to health care institutions such as hospitals so that e.g. anonymized data about symptoms and incidences found to be unusual or characteristic of a pandemic threat could enable high-resolution "syndromic surveillance" as an
early warning system An early warning system is a warning system that can be implemented as a chain of information communication systems and comprises sensors, event detection and decision subsystems for early identification of hazards. They work together to fore ...
. In 1947, the World Health Organization established such a global network of some hospitals. Such sharing and off-site evaluation of symptoms and possibly related medical data may have complementary benefits such as improving livelihoods of workers who work with livestock and improving the accuracy, timeliness and costs of disease prognoses. The WHO Hub for Pandemic and Epidemic Intelligence is an early-warning center that attempts to aggregate data and quickly analyze it to predict, prevent, detect, prepare for, and respond to outbreaks and was set up Berlin in September 2021. It uses machine learning and may analyze data about animal health, unusual symptoms in humans, migration and other related developments that may contain detectable patterns.


= Mutation surveillance

= In December 2020 during the COVID-19 pandemic, national and international officials reported mutated variants of SARS-CoV-2, including some with higher transmissibility and worldwide spread. While mutations are common for viruses and the spread of some of the virus' mutations have been tracked earlier, mutations that make it more transmittable or severe can be problematic. Resources for disease surveillance have improved during the pandemic so that medical systems around the world are starting to be equipped to detect such mutations with genomic surveillance in a manner relevant to pandemic mitigation and the prevention of sub-pandemics of specific variants or types of variants. As of December 2020, contemporary measures such as
COVID-19 vaccine A COVID19 vaccine is a vaccine intended to provide acquired immunity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 ( COVID19). Knowledge about the structure and fun ...
s and medications seem to be effective in the treatment of infections with the tracked mutated variants compared to earlier forms that are closer to the original virus/es. Tools used in the pandemized outbreak of COVID-19 included
PANGOLIN Pangolins, sometimes known as scaly anteaters, are mammals of the order Pholidota (). The one extant family, the Manidae, has three genera: '' Manis'', '' Phataginus'', and '' Smutsia''. ''Manis'' comprises four species found in Asia, while ' ...
and
Nextstrain Nextstrain is a collaboration between researchers in Seattle, United States and Basel, Switzerland which provides a collection of open-source tools for visualising the genetics behind the spread of viral outbreaks. Its aim is to support public h ...
. In July 2021, scientists reported the detection of anomalous unnamed unknown-host SARS-CoV-2 lineages via wastewater surveillance. Genomic surveillance refers to monitoring pathogens and analyzing their genetic similarities and differences, which may enable (early) alerts and tailoring interventions, countermeasures and recommendations for the public, like vaccines. In terms of pandemic prevention, it may be especially useful for vaccine-preventable diseases. A problem with the surveillance for mutated variants during the COVID-19 pandemic was that entities don't have sufficient incentives (and/or requirements) to report such variants. A global treaty proposed by the E.U. includes such incentives. A further issue was that vaccines did not provide a high enduring protection against the variants. One approach to solve this problem are pan-virus vaccines that protect against many strains (in this case a pan-SARS-CoV-2-like/variant-coronavirus vaccine), possibly including variants that do not yet exist.


Policy and economics

A 2014 analysis asserts that "the
window of opportunity A window of opportunity, also called a margin of opportunity or critical window, is a period of time during which some action can be taken that will achieve a desired outcome. Once this period is over, or the "window is closed", the specified ...
to deal with pandemics as a global community is within the next 27 years. Pandemic prevention therefore should be a critical
health policy Health policy can be defined as the "decisions, plans, and actions that are undertaken to achieve specific healthcare goals within a society".World Health Organization''Health Policy'' accessed 22 March 2011(archived 5 February 2011) According ...
issue for the current generation of scientists and
policymakers Policy is a deliberate system of guidelines to guide decisions and achieve rational outcomes. A policy is a statement of intent and is implemented as a procedure or protocol. Policies are generally adopted by a governance body within an orga ...
to address. A 2007 study warns that "the presence of a large reservoir of SARS-CoV-like viruses in horseshoe bats, together with the culture of eating exotic mammals in southern China, is a time bomb. The possibility of the reemergence of SARS and other novel viruses from animals or laboratories and therefore the need for preparedness should not be ignored". The US' National Security Council Directorate for Global Health Security and Biodefense, which worked on preparing for the next disease outbreak and preventing it from becoming an epidemic or pandemic, was closed in 2018. A study concluded that the three practical actions "better surveillance of pathogen spillover and development of global databases of virus genomics and serology, better management of wildlife trade, and substantial reduction of deforestation" would have a highly favorable cost-benefit ratio. A second study affirms that if policy priorities were refocused from disease control to prevention, implementing such proactive actions would "cost a very small fraction of the reconstruction budgets".


Environmental policy and economics

Some experts link pandemic prevention with
environmental policy Environmental policy is the commitment of an organization or government to the laws, regulations, and other policy mechanisms concerning environmental issues. These issues generally include air and water pollution, waste management, ecosystem ...
and caution that environmental destruction as well as climate change drives wildlife to live close to people.


= Climate change

= The WHO projects that climate change will also affect infectious disease occurrence. It is projected that interspecies viral sharing, that can lead to novel viral spillovers, will increase due to ongoing climate change-caused geographic range-shifts of mammals (most importantly bats). Risk hotspots would mainly be located at "high elevations, in biodiversity hotspots, and in areas of high human population density in Asia and Africa". A 2016 study reviews literature on the evidences for the impact of climate change on human infectious disease, suggests a number of proactive measures for controlling health impacts of climate change and finds that climate change impacts human infectious disease via alterations to pathogen, host and transmission. Another way climate change may affect pandemic risks, is by pathogens in thawing permafrost (e.g. in the Arctic) that may have infected now-extinct ancestral humans in such regions. However, a scientist concluded that probably permafrost per se shouldn't host more pathogens than any other environment. Nevertheless, the risk from permafrost pathogens is unknown and viruses from the very first humans to populate the Arctic could emerge. Moreover, researchers have suggested more work on microbes soon to be released from melting glaciers across the world to identify and understand potential threats in advance.


= Ecosystem degradation and consumption

= Studies have shown that the risk of disease outbreaks can increase substantially after forests are cleared. The likelihood of human-nonhuman primates contact events is increased jointly by forest landscape fragmentation and certain smallholders' behaviors in forest patches. A study identified the mechanistic connections among habitat loss, climate, and increased bat virus spillover risk. Loss of biodiversity may remove natural regulation of viruses and make fleeing animals meet other species for the first time. According to Kate Jones, chair of ecology and biodiversity at
University College London University College London (Trade name, branded as UCL) is a Public university, public research university in London, England. It is a Member institutions of the University of London, member institution of the Federal university, federal Uni ...
, the disruption of pristine forests driven by logging, mining, road building through remote places, rapid urbanisation and population growth is bringing people into closer contact with animal species they may never have been near before, resulting in transmission of diseases from wildlife to humans. An August 2020 study published in ''
Nature Nature is an inherent character or constitution, particularly of the Ecosphere (planetary), ecosphere or the universe as a whole. In this general sense nature refers to the Scientific law, laws, elements and phenomenon, phenomena of the physic ...
'' concludes that the anthropogenic destruction of ecosystems for the purpose of expanding agriculture and human settlements reduces biodiversity and allows for smaller animals such as bats and rats, who are more adaptable to human pressures and also carry the most zoonotic diseases, to proliferate. This in turn can result in more pandemics. In October 2020, the
Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services The Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) is an intergovernmental organization established to improve communication between science and policy on issues of biodiversity and ecosystem services. It ...
published its report on the 'era of pandemics' by 22 experts in a variety of fields, and concluded that anthropogenic destruction of
biodiversity Biodiversity is the variability of life, life on Earth. It can be measured on various levels. There is for example genetic variability, species diversity, ecosystem diversity and Phylogenetics, phylogenetic diversity. Diversity is not distribut ...
is paving the way to the pandemic era, and could result in as many as 850,000 viruses being transmitted from animals – in particular birds and mammals – to humans. The increased pressure on ecosystems is being driven by the "exponential rise" in consumption and trade of commodities such as meat, palm oil, and metals, largely facilitated by developed nations, and by a growing human population. According to Peter Daszak, the chair of the group who produced the report, "there is no great mystery about the cause of the Covid-19 pandemic, or of any modern pandemic. The same human activities that drive climate change and biodiversity loss also drive pandemic risk through their impacts on our environment." Stanford biological anthropologist James Holland Jones notes that humanity has "engineer da world where emerging infectious diseases are both more likely and more likely to be consequential", referring to the modern world's prevalent highly mobile lifestyles, increasingly dense cities, various kinds of human interactions with wildlife and alterations of the natural world. Furthermore, when multiple species that are not usually next to each other are driven to live closely together new diseases may emerge. Research shows that abundant animals, plants, insects, and microbes living in complex, mature ecosystems can limit the spread of disease from animals to people. The
United Nations The United Nations (UN) is the Earth, global intergovernmental organization established by the signing of the Charter of the United Nations, UN Charter on 26 June 1945 with the stated purpose of maintaining international peace and internationa ...
is formulating nature-focused action plans that could help to stop the next pandemic before it starts. These strategies include conserving ecosystems and wilderness that are still untouched by human activity, and restoring and protecting significant areas of land and ocean (i.e. through
protected area Protected areas or conservation areas are locations which receive protection because of their recognized natural or cultural values. Protected areas are those areas in which human presence or the exploitation of natural resources (e.g. firewood ...
s). Protected areas (which may hold wildlife) also limits
human Humans (''Homo sapiens'') or modern humans are the most common and widespread species of primate, and the last surviving species of the genus ''Homo''. They are Hominidae, great apes characterized by their Prehistory of nakedness and clothing ...
presence and/or limits the exploitation of resources (including
non-timber forest product Non-timber forest products (NTFPs) are useful foods, substances, materials and/or commodities obtained from forests other than timber. Harvest ranges from wild collection to farming. They typically include game animals, fur-bearers, nuts, see ...
s such as game animals, fur-bearers, ...). An article by the World Economic Forum states that studies have shown that deforestation and loss of wildlife cause increases in infectious diseases and concludes that the recovery from the COVID-19 pandemic should be linked to nature recovery, which it considers economically beneficial. Dennis Caroll of the Global Virome Project stated that the " extractive industry — oil and gas and minerals, and the expansion of agriculture, especially cattle" are the biggest predictors of where spillovers can be seen. A study proposes that policy responses "addressing zoonotic threats should include ecosystem regeneration". In the 2000s, a WHO spokesperson summarized the animal-related aspects of pandemics, stating "the whole relationship between the animal kingdom and the human kingdom is coming under stress". The integrated, unifying approach of One Health addresses health of people, animals and the environment at once. It could "boost risk identification, reduction, and surveillance in animals and at the human-animal-environment interface".


Data on current causes of emerging diseases

A study which was published in April 2020 and is part of the PREDICT program found that "virus transmission risk has been highest from animal species that have increased in abundance and even expanded their range by adapting to human-dominated landscapes", identifying domesticated species, primates and bats as having more zoonotic viruses than other species and "provide further evidence that exploitation, as well as anthropogenic activities that have caused losses in wildlife habitat quality, have increased opportunities for animal–human interactions and facilitated zoonotic disease transmission". An UN Environment report presents the causes of the emerging diseases with a large share being environmental: Text is available under
Creative Commons Attribution 4.0 International License
/ref> The report also lists some of the latest emerging diseases and their environmental causes: According to a 2001 study and its criteria a total of 1415 species of infectious agents in 472 different genera have been reported to date to cause disease in humans. Out of these reviewed emerging pathogen species 75% are zoonotic. A total of 175 species of infectious agents from 96 different genera are associated with emerging diseases according its criteria. Some of these pathogens can be transmitted by more than one route. Data on 19 categories of the 26 categories which contained more than 10 species includes:


Bioresearch and development regulation

In a
paywall A paywall is a method of restricting access to content (media), content, with a purchase or a subscription business model, paid subscription, especially news. Beginning in the mid-2010s, newspapers started implementing paywalls on their website ...
ed article, American scientists proposed
policy Policy is a deliberate system of guidelines to guide decisions and achieve rational outcomes. A policy is a statement of intent and is implemented as a procedure or protocol. Policies are generally adopted by a governance body within an or ...
-based measures to reduce large risks from life sciences research – including pandemics through accident or misapplication.
Risk management Risk management is the identification, evaluation, and prioritization of risks, followed by the minimization, monitoring, and control of the impact or probability of those risks occurring. Risks can come from various sources (i.e, Threat (sec ...
measures may include novel international guidelines and standards of conduct, effective oversight, improvement of US policies to influence policies globally, and identification of gaps in
biosecurity Biosecurity refers to measures aimed at preventing the introduction or spread of harmful organisms (e.g. viruses, bacteria, plants, animals etc.) intentionally or unintentionally outside their native range or within new environments. In agricult ...
policies along with potential approaches to address them. * University press release: Concerning systematic comprehensive identification of challenges, the
Centre for the Study of Existential Risk The Centre for the Study of Existential Risk (CSER) is a research centre at the University of Cambridge, intended to study possible extinction-level threats posed by present or future technology. The co-founders of the centre are Huw Price (B ...
(CSER) convened policy-makers and academics to identify challenges for the
Biological Weapons Convention The Biological Weapons Convention (BWC), or Biological and Toxin Weapons Convention (BTWC), is a disarmament treaty that effectively bans Biological weapons, biological and toxin weapons by prohibiting their development, production, acquisition, ...
(BWC) in 2017. A key issue identified was that the rapid rate of
progress Progress is movement towards a perceived refined, improved, or otherwise desired state. It is central to the philosophy of progressivism, which interprets progress as the set of advancements in technology, science, and social organization effic ...
in relevant sciences and technologies has made it very difficult for governance bodies including the BWC to keep pace. Luke Kemp, a member of CSER, notes that "just a few key countries reblocking regulation of catastrophic hazards" and that " r biological weapons it was the US who was the primary culprit in preventing the adoption of a global verification scheme under the Biological Weapons Convention" and suggests that "attempts at regulation are often delayed, distorted or destroyed". A 2021
Nuclear Threat Initiative The Nuclear Threat Initiative, generally referred to as NTI, is a non-profit organization located in Washington, D.C. NTI was founded in 2001 by former U.S. Senator Sam Nunn and philanthropist Ted Turner and describes itself as a "a nonprofit, ...
(NTI) report concluded that " e international system for governing dual-use biological research is neither prepared to meet today’s security requirements, nor is it ready for significantly expanded challenges in the future". Toby Ord, author of the book '' The Precipice: Existential Risk and the Future of Humanity'' which addresses the issue, puts into question whether current public health and international conventions, and self-regulation by biotechnology companies and scientists are adequate. As of 2017, there is "no concerted international approach to identify, collect, analyze, and disseminate lessons and best practices in strengthening the organizational culture of life sciences research laboratories worldwide" in terms of biosafety, biosecurity, and responsible conduct, albeit a number of international treaties and partnerships do exist. Around 2022, the International Biosecurity and Biosafety Initiative for Science (IBBIS) was set up by the NTI to improve biosecurity and biosafety, calling i.a. for tighter controls on custom-order DNA companies. The WHO has published the "''Global guidance framework for the responsible use of the life sciences: mitigating biorisks and governing dual-use research''" in 2022. In the context of the 2019–2020 coronavirus pandemic
Neal Baer Neal Baer (born 1955) is an American pediatrician and television writer and producer. He is best known for his work on the television shows '' Designated Survivor'', '' ER'' and '' Law & Order: Special Victims Unit''. Early life and education ...
writes that the "public, scientists, lawmakers, and others" "need to have thoughtful conversations about gene editing now". Ensuring the biosafety level of laboratories may also be an important component of pandemic prevention. This issue may have gotten additional attention in 2020 after news outlets reported that U.S. State Department cables indicate that, although there may be no conclusive proof at the moment, the
COVID-19 Coronavirus disease 2019 (COVID-19) is a contagious disease caused by the coronavirus SARS-CoV-2. In January 2020, the disease spread worldwide, resulting in the COVID-19 pandemic. The symptoms of COVID‑19 can vary but often include fever ...
virus A virus is a submicroscopic infectious agent that replicates only inside the living Cell (biology), cells of an organism. Viruses infect all life forms, from animals and plants to microorganisms, including bacteria and archaea. Viruses are ...
responsible for the
COVID-19 pandemic The COVID-19 pandemic (also known as the coronavirus pandemic and COVID pandemic), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), began with an disease outbreak, outbreak of COVID-19 in Wuhan, China, in December ...
may, possibly, have accidentally come from a Wuhan (China) laboratory, studying bat
coronavirus Coronaviruses are a group of related RNA viruses that cause diseases in mammals and birds. In humans and birds, they cause respiratory tract infections that can range from mild to lethal. Mild illnesses in humans include some cases of the comm ...
es that included modifying virus genomes to enter human cells, and determined to be unsafe by U.S. scientists in 2018, rather than from a natural source. As of 18 May 2020, an official UN investigation into the origins of the COVID-19 virus, supported by over 120 countries, was being considered. United States' president Donald Trump claimed to have seen evidence that gave him a "high degree of confidence" that the novel coronavirus originated in the Chinese laboratory but did not offer any evidence, data or details, contradicted statements by the United States' intelligence community and garnered a lot of harsh criticism and doubts. As of 5 May, assessments and internal sources from the Five Eyes nations indicated that the coronavirus outbreak being the result of a laboratory accident was "highly unlikely", since the human infection was "highly likely" a result of natural human and animal interaction. Many others have also criticized statements by US government officials and theories of laboratory release. Virologist and immunologist Vincent R. Racaniello said that "accident theories – and the lab-made theories before them – reflect a lack of understanding of the genetic make-up of Sars-CoV-2." Virologist Peter Daszak stated that an estimated 1–7 million people in Southeast Asia who live or work in proximity to bats are infected each year with bat coronaviruses. In January 2021, the WHO's investigations into the origin of COVID-19 was launched. In early 2021, the hypothesis of a laboratory cause of the pandemic received renewed interest and expert consideration due to renewed media discussion. On 6 May 2024, the
White House The White House is the official residence and workplace of the president of the United States. Located at 1600 Pennsylvania Avenue Northwest (Washington, D.C.), NW in Washington, D.C., it has served as the residence of every U.S. president ...
released an official policy to more safely manage medical research projects involving potentially hazardous pathogens, including
viruses A virus is a submicroscopic infectious agent that replicates only inside the living cells of an organism. Viruses infect all life forms, from animals and plants to microorganisms, including bacteria and archaea. Viruses are found in almo ...
and
bacteria Bacteria (; : bacterium) are ubiquitous, mostly free-living organisms often consisting of one Cell (biology), biological cell. They constitute a large domain (biology), domain of Prokaryote, prokaryotic microorganisms. Typically a few micr ...
, that may pose a risk of a
pandemic A pandemic ( ) is an epidemic of an infectious disease that has a sudden increase in cases and spreads across a large region, for instance multiple continents or worldwide, affecting a substantial number of individuals. Widespread endemic (epi ...
. While biotechnology policies can substantially reduce the risk of a serious catastrophe, it may be important that relevant steps are initiated immediately and on a global basis.


= Dual-use knowledge and research

=
Martin Rees Martin John Rees, Baron Rees of Ludlow,