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Four ways to beat the next pandemic

The COVID-19 crisis has given us a blueprint for a better global response. Here’s what we’ve learned.

By Erick Trickey

It’s January 2027, and reports are emerging of a deadly new virus. Perhaps it’s a new strain of flu, or another coronavirus. Maybe it’s been detected in Africa or Europe or North America. Like COVID-19 seven years before, the new disease spreads fast, makes many people seriously ill, and leads to death among the most vulnerable. People all around the world brace for another pandemic, as bad as COVID-19 or worse.

But it’s different this time. Between 2022 and 2026, scientists, governments, nonprofits, and international organizations have come together to build a worldwide system for stopping the next pandemic: everything from forecasting the disease’s spread to creating vaccines in advance and distributing them swiftly around the world.

The result is an entirely different pandemic experience, across the globe. Social distancing and other restrictions end sooner, lessening the pandemic’s economic and emotional impact. Global disparities in vaccination rates all but disappear. In the end, the new pandemic claims many fewer victims than the more than 5 million people who, by early 2022, have died of COVID-19.

This optimistic scenario is hardly guaranteed. But it is within reach, scientists say — if the world applies four lessons from the COVID-19 crisis. We have the blueprint right now for halting the next pandemic in its tracks. In fact, preparations are already underway.

The National Hurricane Center could be a model for pandemic response. Photo by Saul Loeb / AFP via Getty Images

1. Build a global warning system

The first lesson of COVID-19 was that a slow response costs lives. And in the first months of the pandemic, from Alessandro Vespignani’s standpoint, the response across Western nations was maddeningly slow.

Vespignani, a Northeastern University professor of network science who has spent years forecasting the spread of infectious diseases, was among the first scientists to predict the global impact of COVID-19. By February 2020 — two months after a new coronavirus had emerged in Wuhan, China — Vespignani and other data scientists were sharing forecasts that showed the virus spreading worldwide. But those forecasts came from disparate academic teams, with little coordination. Media reports often focused on a single group’s predictions, rather than a consensus. It took until mid-March for government leaders to take serious action, such as warning people to stay home.

“We lost very precious time to prepare the system for the worst,” Vespignani says. He points to a study estimating that if U.S. leaders had introduced social-distancing rules just two weeks earlier, they would have saved 60,000 lives.

Now, the U.S. government is building the capabilities to respond to the next viral threat with a unified voice. The Center for Forecasting and Outbreak Analytics, slated to launch full operations later this year, is intended to forecast epidemics’ spread, collect data, and inform leaders and the public. Part of the Atlanta-based Centers for Disease Control and Prevention, the $200 million outbreak center will employ epidemiologists to analyze data from sources including hospital records, public health databases, prescription drug sales, and cellphone location tracking. Vespignani compares the effort to the National Hurricane Center, which uses several forecasting models to predict a storm’s path and then reports a scientific consensus. “As soon as there is some risk, it springs into action,” he says.

The outbreak center will offer epidemic forecasts, which can look weeks ahead, and scenario modeling, which will look at possibilities months ahead, incorporating variables like a new variant’s transmissibility and immune evasion. Though it’s still scaling up, the center released its first projections a few days before Christmas 2021, offering fast-growth and slow-growth scenarios for the omicron variant’s spread in the U.S. The fast-growth scenario — new infections exceeding previous peaks in January 2022 — quickly proved accurate.

The outbreak center could also decide “how we can build those pipelines of data analysis, how we create global surveillance systems for the disease,” says Vespignani. That’s important because when COVID-19 struck, data scientists like him had to figure out those questions on their own amid the crisis. For instance, they had to persuade cellphone companies and other location providers to share data that traces people’s movements while preserving each person’s privacy. 

A comprehensive system, Vespignani hopes, could help CDC officials and local leaders within the U.S. make good decisions. But to be truly effective, it would need data from other countries as well. It’s like a weather forecast, he says: If you only focus on patterns inside a nation’s borders, you won’t do it right.

Across the world, similar forecast centers are already forming. The World Health Organization launched its Berlin-based Hub for Pandemic and Epidemic Intelligence in September 2021 with $100 million in funding from the German government. The Rockefeller Foundation pledged $150 million in October 2021 for a global Pandemic Preparedness Institute. The U.K. government announced plans in May 2021 for a global pandemic radar center. Its goal: to share data, detect the next potential pandemic, sound alarms, and help governments respond faster next time.

Then, the world could prepare the best protection: a vaccine.

Afrigen, a startup in South Africa, is trying to develop a COVID-19 vaccine based on publicly known information about Moderna’s vaccine. Photo by Rodger Bosch / AFP via Getty Images

2. Invent new vaccines before they’re needed

Arguably the biggest success story in the COVID-19 pandemic was the record-fast production of vaccines. It took 330 days, after COVID-19’s genetic sequence was released in January 2020, before the first vaccines were delivered to some of the public that December — condensing a development and testing process that usually takes years.

But that speed was built on scientific research that had been going on for decades. British epidemiologist Mark Woolhouse had observed that most new viruses infecting humans belonged to a relatively stable number of virus families. Research by hundreds of scientists was beginning to produce new vaccine technologies, such as experimental messenger-RNA vaccines, which could be manufactured quickly. And by 2017, Barney Graham, the longtime deputy director of the National Institutes of Health’s Vaccine Research Center, was proposing a way to develop vaccines in advance of future outbreaks.

In the mid-2010s, Graham and Jason McLellan, a professor at the University of Texas at Austin, had done pioneering work on the spike protein that coronaviruses like SARS and MERS use to infect human cells — figuring out how they could keep that protein from changing shape so that they could design a vaccine based on it.

“We knew that way of stabilizing the spike … would work across multiple coronaviruses,” Graham recalled in a recent interview. Today, most leading COVID-19 vaccines — Moderna, Pfizer, Johnson & Johnson and Novavax — use Graham and McLellan’s method of stabilizing the virus’ spike protein.

“It is of no help that just the rich countries vaccinate their populations. None of us are safe until all of us are safe.”

Christopher Viehbacher, a committee chair of COVAX, the World Health Organization-backed effort to vaccinate people in developing countries

Anthony Fauci, Graham’s boss at the National Institute of Allergy and Infectious Diseases, budgeted money for Graham’s lab to work on vaccines for coronaviruses — and also for Nipah, a virus from a different family that breaks out almost annually in India and Bangladesh. Graham’s lab established a collaboration with the pharmaceutical company Moderna. By the end of 2019, Graham says, they had prototypes ready.

The team had planned to start with the Nipah virus vaccine. But when COVID-19 emerged in early January 2020, Graham and Moderna CEO Stéphane Bancel decided to test the project on coronaviruses first.

A few days later, after Chinese researchers posted the genomic sequence of the COVID-19 virus, Graham and his collaborators redesigned their prototype coronavirus vaccine to fight it. Their redesign became part of Moderna’s mRNA vaccine, which instructs muscle cells to create a harmless version of the spike protein for our immune systems to combat.

“This really started as a demonstration project for our pandemic preparedness idea,” says Graham. “We did this before we ever had a case in the U.S. We didn’t really for sure know if it would be a global pandemic. And then as things evolved, it obviously was not just a drill; it was the real thing.”

Now Graham, who recently retired from the NIH, wants scientists to create vaccine templates for the 26 or so virus families that most threaten humans. “For maybe 20 to 22 of those viral families, there are some fairly obvious approaches that could be taken,” Graham says. A few other viral families will require further conceptual breakthroughs in immunology.

But Graham thinks that spending $3 billion to $5 billion a year over 20 years could lead to humanity having a complete lineup of prototype vaccines, ready to take off the shelf and adapt if another pandemic breaks out. “This is 20 years of work for about a thousand good scientists,” says Graham. “It’s a long-term, big project, but it’s feasible.”

Graham’s concept would require either a global effort or greatly expanded U.S. government funding to research vaccines. Still, the idea is catching on. The Biden administration has included it in a proposal to Congress. The World Health Organization and international health nonprofits have also endorsed it.

“There’s a huge possibility that this could work, because you know what piece to target for each of those virus families,” says Brandon Dionne, an associate professor at Northeastern University’s School of Pharmacy. “Once you have an epidemic, you can identify the specific genetic code for that version of the virus.”

Meanwhile, a plan is emerging to produce new vaccines even faster during future pandemics.

The U.S., the U.K., and the G-7 group of industrial nations have all endorsed the 100 Days Mission, an aspirational plan with the goal of developing rapid tests, a first round of drug treatments, and vaccines ready to be produced at a global scale, all within 100 days of a new pandemic threat. The vaccine advances that Graham and others developed give the project a formidable start. But it would also require massive spending that hasn’t been approved yet, future breakthroughs in technology, further efficiency in speeding up clinical trials, and solutions to very practical questions: how to set aside enough supplies (such as glass bottles), solve shipping challenges, and build enough manufacturing capacity to make the vaccines quickly.

“I think there’s promise,” says Dionne, “but I think it’s still a very ambitious goal.”

Afrigen Managing Director Petro Terblanche wants to produce vaccines for the next pandemic and teach others how to do so. Photo by Rodger Bosch / AFP via Getty Images

3. Produce vaccines on every continent

Years of prior research weren’t the only reason that scientists developed COVID-19 vaccines in record time. Sped-up clinical trials, subsidized with public and private funding, also helped. The U.S. government’s Operation Warp Speed, the world’s largest such effort, invested $18 billion in six vaccine candidates: funding the pharmaceutical companies’ research, subsidizing their early manufacturing, and purchasing doses.

But Dionne notes that one of the biggest challenges facing vaccination efforts in future pandemics is one that the world hasn’t yet solved during this one. Of all the lessons of COVID-19, perhaps the most important is that a pandemic likely won’t end until people around the world are vaccinated. Wherever the virus still rages, variants will emerge. That was true of the omicron variant’s spread in late 2021, at a moment when many citizens of wealthy countries were getting their third vaccine dose and half of humanity still hadn’t gotten its first.

“It is of no help that just the rich countries vaccinate their populations,” says Christopher Viehbacher, a veteran pharmaceutical executive and Northeastern University trustee who chaired the research, development, and manufacturing committee of COVAX, the World Health Organization-backed effort to vaccinate people in developing countries. “None of us are safe until all of us are safe.”

One reason for the vaccine inequity: Wealthy nations made deals, early in the pandemic, with the pharmaceutical companies producing the major vaccines. With Operation Warp Speed, for instance, the U.S. government reached advance-purchase agreements for hundreds of millions of vaccine doses. Poorer countries, outbid, ended up at the back of the line. COVAX aimed to deliver 2 billion doses by the end of 2021, but only delivered 900 million. “We need to make sure there is an equitable supply, particularly for those countries that don’t have any manufacturing capabilities,” says Viehbacher.

Brook Baker, a law professor at Northeastern University and a leading critic of global vaccine inequities, says future government subsidies or collaboration with pharmaceutical companies’ vaccine research should come with agreements to share technology and know-how, so that vaccines can be produced worldwide. “What we had this time around was massive public investments through Operation Warp Speed, and similar investments from other governments, that de-risk the product development for vaccines, but with no strings attached,” Baker says. 

An international pandemic-response accord might provide a different way to vaccinate the world next time. The WHO’s World Health Assembly voted to pursue such an accord in December 2021. Supporters say it could include agreements for more equitable vaccine distribution and the sharing of vaccine-making intellectual property and knowledge — possibly in exchange for pledges to contribute data to global outbreak surveillance.

“We’ve had export restrictions; we’ve had countries acting on a very nationalistic basis,” Baker says. “Other regions of the world need to have some degree of self-sufficiency.”

Petro Terblanche is trying to make that happen. She’s the managing director of Afrigen, a vaccine-making startup in Cape Town, South Africa. The World Health Organization has made Afrigen the center of its first technology transfer hub for COVID-19 messenger-RNA vaccines. Currently, Afrigen’s 28 employees are trying to develop a COVID-19 vaccine based on publicly known information about Moderna’s vaccine. Terblanche estimates it will take about three years, which could be cut to one year if Moderna would agree to share its vaccine technology and knowledge. Afrigen’s longer-term goal, says Terblanche, is to be ready for the next pandemic, and to help others prepare, too.

“Our role would be to develop a complete technology package, train people in low- and middle-income countries, and transfer that technology for commercial-scale production,” says Terblanche. The aim is to have several factories making mRNA-based vaccines in low- and middle-income countries by the time the next pandemic strikes.

If the WHO and Afrigen’s plan succeeds, and companies that create vaccines share technology and know-how, poorer countries will someday be able to rely on vaccine manufacturers on their own continents. When the world isn’t fighting a pandemic, the regional manufacturers would produce vaccines for locally centered diseases. Africa, where fewer than one in five people are vaccinated against COVID-19, has identified 22 essential current and future vaccines for its population’s health, says Terblanche, including vaccines for Ebola, HIV, and malaria. “Many of these diseases do not exist in the high-income countries,” Terblanche says. “It does not make economic sense for a Moderna or a BioNTech or a Johnson & Johnson to invest in these small vaccines, unless they have a humanitarian outlook.” 

Helping Africa develop vaccine manufacturing is now Barney Graham’s top goal. He hopes to use his scientific connections to encourage academic partnerships, philanthropic organizations, and governments to contribute knowledge and investment there. 

“We take a lot of things for granted here,” Graham says: technicians to fix equipment, supplies available overnight, and reliable electricity. “Can we take that privilege that we’ve had and try to use that to change some things [in] other parts of the world?”

4. Don’t get complacent

As many sci-fi movies and academic papers as there were before 2019, warning of the potential for a deadly pandemic, COVID-19 still caught the world by surprise. So before the next pandemic, a massive global change needs to come, not just in scientific advancement, but in mindset.

Vespignani is certain there won’t be another century-long gap between pandemics, like there was between the 1918 flu and COVID-19. “Because of globalization, we are reaching places in remote corners of jungles or the mountains, where we don’t know what kind of pathogens or viruses are harbored in animal species,” he says. “And now these viruses can get, in 24 hours, all over the world, or in big urban areas in a short time.”

And as terrible as COVID has been, with its ever-rising death count and waves of outbreaks, scientists agree that another disease could be worse. COVID’s unusual age impact — it’s more dangerous to catch if you’re older — limited its devastation. A future virus could have a higher fatality rate. “We were lucky this time,” Vespignani says.

Tackling the next pandemic — and being prepared for a set of less-favorable circumstances — will require more than technical know-how. It will demand a keen awareness of the risks of acting too slowly. It will require successful communication to build greater trust in vaccines. And it will demand international coordination, far beyond what we’ve seen so far.

But if the world succeeds in making those changes, humanity’s fight against the next pandemic could look very different than the long battle against COVID-19. Stations across the globe could identify the new virus quickly. Scientists could stand ready to plug its DNA sequence into a new crop of vaccines. Vaccine factories on every continent would switch from their day-to-day work into wartime mode. Within 100 days, authorities might approve the new vaccine, and people around the world could line up to get inoculated.

“Viruses have a way of escaping if you don’t really crush them,” says Graham. To beat the next virus, the mistakes we made with COVID-19 will need to be seared into our consciousness: reminders of what we did wrong, so we know how to do things right. 

“We need to buy our insurances for the future now,” Vespignani says, “and make a treasure of the lessons of this pandemic.”

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