An excellent perspective from Michael Specter in The New Yorker: The New Coronavirus and Preparing for the Next Viral Pandemic. Excerpt:
These viruses all pose special threats because they are new, which means that humans have no antibodies to defend against them. The 2009 H1N1 epidemic infected at least 1.4 billion people, most of them before vaccines or treatments for the virus were available. And that was in a year when, by most accounts, the W.H.O. moved as expeditiously as it ever has. That strain of influenza killed as many as two hundred thousand people in the world—but it could have been many times worse.
In 1957, for example, the Asian flu pandemic killed more than a million people. In 1968, the Hong Kong flu pandemic killed between one and four million. Maybe we will also be lucky this year. (It ought to be remembered that, even now, the seasonal flu poses a much greater threat to the health of the average American.) Unless covid-19 proves to be uniquely virulent, it will likely subside within a few months, and the danger it poses will be substantially forgotten, like that of sars, mers, avian influenza, and other zoonotic diseases. But it is too soon to know for certain.
Scientists are moving with great speed to stop this pandemic. They sequenced the virus in less than two weeks—an essential step in creating diagnostics, drugs, and vaccines, and one that only a few years ago would have taken months. But, even with expedited trials and drug development, it could take a year to create a vaccine. If this virus were to swerve out of control before then, the death rate could soar.
In addition to the human toll, the economic damage to China—and, eventually, to the rest of the world—would be enormous. Industrial supply chains throughout the world have already been badly disrupted. Travel to and from China has all but stopped, and xenophobic attacks against Asians are rising. Although New York City has not reported a single confirmed case of covid-19, business in Chinatown has reportedly fallen by more than fifty per cent since the epidemic began.
Not all of this has to happen; we can do a much better job of preparing for these epidemics, just as we no longer wait to have heart attacks before we use our knowledge to limit their risk. Prevention works, and it can work with viral epidemics. For now we can be much more vigilant about improving sanitary conditions and regulating livestock in the kinds of markets where outbreaks are likely to occur. Sufficient and reliable tests for people who may have been exposed must be made readily available. There are scores of similar viruses found in host reservoirs—most notably, bats. Many of those viruses have genetic similarity to this coronavirus, and also to sars and mers.
The time has come to use the modern tools of molecular and synthetic biology to make drugs and vaccines to protect us from them. We can make DNA vaccines in laboratories and store them as spare parts, just as we do with parts for a phone or a laptop. Why not work on making vaccines that would protect broadly against this entire class of virus, rather than waiting for each one to attack us, and then try to fight back? Today, with the annual flu, we grow most of our vaccines in eggs, just as we have for decades. It’s time to move on.
At some point, not many years from now, we will have the capacity to instantly sequence viruses and to make and operate diagnostic tests anywhere, not just in a lab. Biology is becoming digital information, and it needn’t be stored only in Cambridge, or Palo Alto, or Paris. It is already possible to transmit and print a DNA sequence using the molecular equivalent of 3-D printers—a process that could enable scientists almost anywhere to construct vaccines. Making this technique readily available should be a national and, in fact, an international priority.
There are other possible solutions, such as editing the genes of pigs (and bats) to repulse the viruses that can transfer to humans. This kind of ecological intervention would be scientifically difficult, and ethically questionable. But it will inevitably be discussed, so let’s do it rationally.
Even if this pandemic passes quickly, there will be another one, possibly far more catastrophic, next year, or in ten years’ time, or twenty. All we can know for sure is that if we have any hope of containing it, the time to prepare is now.
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