"Clear enemy": what virus will cause the next pandemic
Ebola, malaria, Zika virus.
We hear about the outbreaks of these diseases in the news.
But we are not worried when the foci are somewhere far away-in South America or Subequatorial Africa.
Due to the lack of interest in developed countries, pharmaceutical companies are not ready to invest in expensive vaccines against these diseases.
However, viruses evolve. Over time, their infection rates can increase, and the transmission method can change.
All this creates the conditions for the future deadly pandemic, which the world will be unprepared for.
Who are the authors?
The American epidemiologist Michael Osterholm wrote this book in collaboration with non-fiction writer Mark Olshaker.
For many years, Osterholm investigated the outbreaks of infections while working at the Center for Control of Diseases.
In November 2021, he entered the Covid-19 advisory council under the US president.
The authors began working on the book during The Ebola pandemic in West Africa in 2014-2016, and completed studying the Zika fever, which travelled from the Pacific Islands to the North and South Americas, during an outbreak.
What is this book about?
The American Center for Disease Control is behind the detection of diseases such as HIV, Toxic Shock Syndrome in women, as well as and many more outbreaks in the United States.
Part of the work of specialists is “in the fields”, studying of the causes of diseases and possible methods of infection.
Another part is prevention and fight against the most dangerous diseases for the population.
Talking about fatal infections, the authors focused on four main threats to humanity and possible ways to counteract them.
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The threat of the pandemic.
The first priority is given to counteracting infections that have the potential to become pandemics.
A new pandemic strain of influenza appears once every few years, which gradually mutates and then circulates around the world for several years as a seasonal disease.
The task of experts is to predict the strain of the next season and promote the release of a suitable vaccine.
Like influenza, coronavirus also has this possibility.
During the Covid-19 pandemic, decisions had to be made “from the wheels”, in practice to evaluate the effectiveness and constantly adjust them.
With influenza, it was well-known that the closure of schools and universities reduces the growth rate of incidence.
However, with coronavirus this measure was not so effective.
High mortality diseases, such as Ebola, do not have a pandemic potential due to the contingence rate being low.
Fortunately, they are usually not transmitted by the most contagious way-airborne droplets.
But the method of infection may change.
This is already happening with the Zika virus.
For a long time it was believed that the only way it was transmitted was through the bites of infected mosquitoes. But in recent years, new evidence suggests that the virus mutated and can be transmitted sexually as well.
Regional and endemic diseases
Thanks to the hard quarantine measures, the spread of Ebola fever, atypical pneumonia and the Middle Eastern Respiratory Syndrome (MERS) were contained within the regions of their occurrence.
However, there is no talk of complete eradication of these diseases.
During the last large outbreak of Ebola in Guinea, Sierra Leone and Liberia, more than 286 thousand cases of the disease were recorded. Almost 40% of them ended in death.
Such bursts of incidence cause direct damage.
Due to closed boundaries, the possibility of earnings for seasonal workers is reduced, crop disappears, and the absence during an outbreak of access to medical care leads to an increase in mortality from HIV, tuberculosis, and malaria.
Some regional infections – malaria, Dengue, Western Nile fever- are transmitted by mosquitoes.
There are a number of measures to contain these diseases, for example, by spraying chemicals on areas which are breeding grounds for mosquitoes, or an ambush in a population of genetically modified or sterilized individuals.
So far, not one of these measures has gained major success.
Meanwhile, mosquitoes of the genus Aedes, carriers of many transmissive diseases, in particular, yellow fever, returned to the Western hemisphere, from where they were expelled with a large triumph by the 1970s with large-scale hand processing.
If, after another outbreak of yellow fever in Angola or Congo, an infected person arrives in central or South America, this is fraught with a new epidemic for which no healthcare system in the region is ready.
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Bioterrorism and viruses leaks
The leak of the virus from the laboratory is not a plot of a popular science film, but a very real situation.
So, 50 years ago in the world, only one flu strain had circulated once.
However, in 1977, Soviet scientists, experimenting with vaccines against one of the weakened versions of the Spanish flu, allowed a leak among employees of the laboratory.
The strain instantly spread throughout Siberia and the Far East, and then the whole world.
With the development of genetic engineering, it became possible to recreate the virus in the laboratories of attackers and terrorists.
The notorious 2001 attack with Siberian ulcer disputes, focused on American media companies and government institutions, led to 22 people being infected, five of whom died.
The criminal was a researcher in the field of biological protection, suffering from a mental disorder.
Lack of drugs
The authors are most concerned about the development of microbial resistance.
Every year, the number of infections that cannot be treated with existing drugs is increasing.
In the United States, according to the Central Criminal Code, about 2 million people are infected with bacteria resistant to antibiotics, of which 23 thousand die.
In some states, up to 40% of streptococcus strains causing pneumonia are not treated with penicillin.
According to experts, in the next 35 years, resistance to antimicrobial drugs can lead to the death of 300 million people around the world.
There are many reasons for the development of resistance to drugs: from the unreasonable use of antibiotics for the treatment of viral diseases, including SARS and influenza, to uncontrolled use of antibacterial drugs in agriculture.
The development of a new class of antibacterial drugs is an expensive and extremely long process, and for pharmaceutical companies this work has moderate commercial interest.
These drugs will be used in special cases. They will have to compete with old and very cheap generics, and in order for them to maintain efficiency
Their use should be limited rather than encouraged.
The economic interest of pharmaceutical companies in the development of new vaccines is also low.
For example, five leading drugs in the world – for the treatment of autoimmune diseases, hepatitis C and diabetes – bring $ 49 billion.
For comparison: the total sales of the five largest vaccines amounted to $ 23.4 billion.
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How vaccines are developed from new diseases using the example of Covid-19 Quotes:
“Two highly developed city-states faced with the Covid-19 epidemic in the early stages of its development tried to respond to it as quickly and efficiently as possible.
Hong Kong closed schools.
Singapore didn’t.
As it turned out, there is practically no difference in the rate of distribution of infection.”
“If the current trend does not change, antimicrobial resistance can become the most ferocious killer, leaving far behind cardiovascular and oncological diseases.
Every year, more people die from MRS (methicillin-resisted golden staphylococcus, which often infects in hospitals), than AIDS.”
Why read the book?
To expand the picture of the world and learn about the most common infectious diseases of recent years: from HIV to Zika virus.
And the most useful may be a chapter may be the one dedicated to microbial resistance.
According to the authors, each of us can contribute to collective security.
The simplest thing is to refuse to take antibiotics “just in case” and reduce your stay in medical institutions if the risk of nosocomial infections exceeds potential benefits.
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