Preparing to conduct disinfection.
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Historically, global pandemics cause enormous suffering and death. The Black Death (1346–1353) killed an estimated 75 to 200 million people across Eurasia and North Africa. The 1918–1920 Spanish flu pandemic killed an estimated 25 to 50 million people worldwide, with some studies suggesting the death toll could be as high as 100 million. It infected roughly one-third of the global population, causing a mortality rate that potentially claimed one in every 20 people on Earth. Most recently and well within the memories of everyone reading this article, over 7.1 million confirmed COVID-19 deaths have been reported to the World Health Organization. However, the total death toll is estimated to be significantly higher at nearly 15 million, when accounting for indirect causes and unreported deaths, representing almost three times the official count. This still is a drop in the bucket compared to the older global pandemics. The primary reason we did so much better this time around is that we were better prepared (e.g., vaccines, advanced medical care, global real-time communication, and distributed manufacturing of PPE with 3D printing, etc.). We, of course, still have lots of room for improvement but it is clear that the more prepared we are against a pandemic, the better we can protect the lives of millions. That is where a study from Alliance to Feed the Earth in Disasters (ALLFED) published in Risk Analysis comes in – it was awarded ‘Best Paper’ last year for laying out where preparing for a pandemic is most important.
We can be smart about it. We have a much better understanding of infectious disease than the top scientists in early 1900s and certainly than even the best minds of the 1300s. We have the global Internet for quickly sharing useful information. We have biotechnology provide building blocks to reduce pandemic risk if deployed intelligently.
However, the global nature of infectious diseases, distribution of high risk labs, and increasing complexity of transmission dynamics due to travel networks make it difficult to determine how to best deploy mitigation efforts. The study notes that future pandemics could come from several sources – something like an emerging infectious diseases or leaks from high containment biological laboratories. We have to understand the risks for both emerging infections and leaks to reduce risk.
To do that the study develops a new country-level spatial network susceptible-infected-removed (recovered and dead) model based on global travel network data and relative risk measures of potential origin sources including the emerging diseases as well as the high containment biological laboratories with biological safety level 3+ and 4 labs. They then explore expected infections over the first 30 days of a pandemic.
Model outputs indicate that emerging diseases as well as the high containment biological laboratory leaks in India, the USA, and China are most impacted at day 30. The findings show that, by day 30, three countries consistently face the highest risk regardless of where a pandemic starts: the United States, China, and India, as they are significant travel hubs with large populations.
USA, China and India flag together on wall.
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For emerging diseases expected infections shift from high emerging diseases origin potential countries in Africa at day 10 to the USA, India, and China, while for lab leaks, the USA and India start with high lab leak potential. Large, wealthy countries are influential to pandemic risk from both emerging diseases and lab leaks, indicating they should be most closely focused on mitigation efforts.
That said, the take home message is that we are all connected now and everyone needs to be aware and prepare to maintain a sustainable global society.
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