Will There Be Another Pandemic?

With COVID-19 now safely behind us, scientists are anxious that a new pandemic may be just around the corner. Scratch that: many scientists agree that the next pandemic is almost certain to happen during our lifetimes.

The only question is whether it will be a disease already known to us – such as one of these diseases on the rise globally – or like COVID-19, an as-yet unknown disease.

Let’s take a look at what we know already and see what might be different if and when the next pandemic rolls around.

What could the next pandemic be?

Unfortunately, it is almost impossible to predict the next pandemic: both what it will be, and when it will occur.

What is a pandemic?

A pandemic is the widespread occurrence of a disease across multiple countries or continents, typically affecting a large proportion of the population. It involves the rapid spread of an infectious disease that poses a global public health threat.

Unlike an epidemic, which is confined to a specific region, a pandemic transcends borders, often leading to significant social, economic, and healthcare challenges worldwide.

Pandemics are declared by global health organizations, such as the World Health Organization (WHO), based on the disease’s geographic spread and its impact.

As with COVID-19, the next pandemic is more than likely to blindside the world, perhaps once more arriving in the form of a previously-unknown disease.

What we do know is that there are various candidates for the next pandemic, including:

Avian influenza

The H1N1 subtype of the influenza A virus, better known as ‘bird flu’, has already accounted for several pandemics, including the 1918 Spanish Flu outbreak and the 2009 Swine Flu pandemic.

While birds are the prime targets of the disease, humans and other mammals are susceptible after prolonged exposure. The disease presents itself with fever, coughing and diarrhoea, and can have a high mortality rate.

Cases of a new strain of bird flu, H5N1, are currently on the rise globally (the disease has already ravaged livestock in California) and governments have started to take precautions. Australia recently invested US$64 million on ‘biosecurity’ measures designed to protect the country specifically from bird flu, while France has launched a nationwide vaccination campaign.

H5N1 does not spread easily among humans, but can combine with seasonal influenza to produce a deadly combination. It remains to be seen how far the new variant will spread.

Zika

Zika is a virus that is spread by mosquitos. It originated in subsaharan Africa and has since spread throughout the Americas, Asia and the Pacific. While not particularly deadly, it can cause complications during pregnancy. Most people who contract Zika are asymptomatic, but it can cause symptoms such as rash, fever, conjunctivitis, muscle and joint pain, malaise and headaches in some patients.

Because Zika spreads via mosquitos, it is unlikely to spread through Europe and other parts of the world where mosquitos are less common, meaning there is a low chance of it becoming a pandemic in its current form. But since the virus has a high mutation rate, there is a chance it may adapt to become more transmissible in the future.

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Ebola

The Ebolavirus is a harrowing illness that spreads rapidly, causing hemorrhagic fever, nausea, vomiting, diarrhoea and abdominal pain. The mortality rate is around 50%, although some outbreaks have seen mortality as high as 90%.

From 2013–2016, ebola ripped through West Africa, causing over 11,000 deaths. Thankfully, intervention with support of the World Health Organization (WHO) helped to stop the transmission of the disease, giving scientists enough time to develop a vaccine, which can now be used to stop outbreaks before they become epidemics.

Ebola is not a prime candidate to become the next pandemic. However, should the virus mutate suddenly to become resistant to existing vaccines, there is a chance it could spread more easily around the world. And given its high rate of mortality, an ebola pandemic could be extremely deadly.

COVID-19

While the WHO officially ended the public health emergency of international concern (PHEIC) on 5th May 2023, effectively declaring the COVID-19 pandemic over, the disease remains a subject of high concern for epidemiologists worldwide.

Resurgences have been, and will remain common for the foreseeable future (in August 2024, over 20% of people in Europe contracted the disease) perhaps leading to another situation in which COVID-19 is once again declared a pandemic.

While 72% of the population of Earth is vaccinated against COVID-19, the virus has been known to rapidly mutate in order to make itself more infectious to bypass vaccinations. And while the disease is decreasing in lethality, one mutation may cause a full resurgence of the COVID-19 pandemic.

Disease X

Disease X is the moniker given to a currently unknown disease that could be a candidate for the next pandemic. Prior to the discovery of COVID-19 in 2019, this coronavirus was itself a Disease X. And, like COVID-19, scientists predict that the next Disease X may be a zoonotic virus (one that originates in animals) that spreads to humans.

As well as being the most likely scenario, Disease X is also the most fearsome prospect for the next pandemic. As we saw with COVID-19, the early stages of a novel pandemic are marked by confusion. Without an existing vaccine or cure available, reactive measures including strict lockdowns are required to prevent the spread of the disease while scientists scramble to find treatments.

While the world learned some valuable lessons from the COVID-19 pandemic, a new Disease X pandemic could throw all those learnings out the window – if the disease is more contagious and more deadly, the next pandemic may be considerably more formidable than the last.

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Are we already experiencing the next pandemic?

Another school of thought is that the next pandemic is already upon us. However, instead of a virus or bacterial infection, the list of ongoing pandemics is largely composed of chronic conditions – ones that may worsen over time to become full-blown global health crises.

Some of the conditions already mooted to be defined as ongoing pandemics include:

Obesity

While the WHO officially classes obesity as an epidemic, some scientists have gone a step further to declare it a pandemic. Globally, more than one billion people are now classed as obese, with the World Obesity Federation warning that half the population of the world may be obese by 2035, as our diets become less and less healthy.

Obesity is not only a cause of death in and of itself, but exacerbates a number of other diseases – from heart disease, to stroke, diabetes and even COVID-19. Reversing the worrying rise of obesity around the world is a huge priority for the WHO, which has implemented an Acceleration Plan to stem the upcoming global health crisis.

HIV/AIDS

The HIV/AIDS pandemic officially started in 1981, and has been ongoing ever since. While cases have been declining since 1996, still more than 39 million people worldwide were living with HIV at the end of 2023, with 630,000 HIV-related deaths in that year alone.

Thankfully, various treatments are now available for HIV, including post-exposure prophylaxis (PEP) and antiretrovirals (ARVs). These are designed to repress HIV levels until they are practically undetectable, thus preventing both the transmission of the disease, and stopping HIV from developing into lethal AIDS.

However, as of yet no cure or vaccine exists for HIV/AIDS, and the spread of the disease is still prevalent in Africa. It is therefore likely HIV/AIDS will remain a pandemic for the foreseeable future.

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Cholera

The first cholera pandemic started as far back as 1817, while the current pandemic has been ongoing since the 1960s. While the disease is rare in developed countries, cholera continues to be a mainstay illness in less-developed parts of Asia and Africa. Researchers estimate there to be around 1.3 million to 4 million cases of cholera and anywhere between 21,000 to 143,000 deaths each year.

The WHO has set out to put an end to the cholera pandemic, with a roadmap to reduce cases by up to 90% by 2030. Until then, cholera remains a highly contagious illness that is a key cause of public health concern in many countries.

Hypertension

Hypertension (high blood pressure) is the number one risk factor for deaths globally, and directly responsible for around 10 million deaths every year.

It’s also a growing concern: in the last 30 years, the number of adults aged 30–79 years exhibiting high blood pressure has increased from 650 million to 1.28 billion globally. The US Office of Disease Prevention and Health Promotion has therefore declared: “The data unequivocally paint the picture of a global pandemic.”

High blood pressure is known as the silent killer because it can go undetected or underestimated until it reveals itself in the form of a major event, such as heart attack, stroke or vascular dementia. The WHO has committed itself to strengthening responses to the global spread of hypertension with its Global Hearts initiative.

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Can we predict the next pandemic?

While pandemics are currently impossible to predict, scientists around the world are attempting to create tools that will help them to figure out patterns in public health data and identify pandemics sooner rather than later. If successful, they may even help point the way towards an understanding of how, why, where and when pandemics begin.

One such tool, developed by Harvard Medical School and the University of Oxford, is EVEscape. Using artificial intelligence, EVEscape predicts the future mutation of diseases such as coronavirus, HIV and influenza, which could allow pharmacists to proactively develop vaccines and stop the spread of diseases faster.

Elsewhere, scientists at the University of California, Irvine (UCI) and the University of California, Los Angeles (UCLA) are using AI models to chart the spread of diseases through social media content. By monitoring patterns of self-reported symptoms through people’s social media posts, they hope to be able to map the early stages of an outbreak, identifying the markers that could lead to it becoming a pandemic.

“People overshare on social media all the time, but that can be exploited to our advantage,” says Andrew Noymer, associate professor of population health and disease prevention at UCI. “If we noticed patterns of hundreds of people all of a sudden tweeting about fever or pneumonia in such and such a city, that might be useful information.”

It is worth remembering that research is still in its early phases and we are still many years away from being able to accurately forecast pandemics. Until then, we must remain vigilant and ready to respond to pandemics, if and when they rear their ugly heads.

What can we do to prepare?

If there’s one thing the world learned from the COVID-19 pandemic, it’s that we are radically underprepared for a pandemic.

In the words of The Lancet, “widespread failures during the COVID-19 pandemic at multiple levels worldwide led to millions of preventable deaths and a reversal in progress towards sustainable development for many countries.” That’s saying nothing of the trust many people lost in their governments’ pandemic preparedness programmes.

Thankfully, valuable lessons were learned, and the world is already taking steps to ensure the next pandemic can be dealt with far more swiftly and effectively. The responsibility to prepare for the next pandemic rests on the shoulders of both policymakers at intranational and governmental levels, and individuals like you.

Let’s look at how the world can start to prepare for the next pandemic.

How are governments preparing for the next pandemic?

After seeing the human and economic costs of the COVID-19 pandemic, many governments are committing to plans to ensure they will be adequately prepared for the next pandemic.

One such plan, which is currently being debated and drafted, is the WHO’s Pandemic Preparedness Treaty – the exact terms of this treaty are yet to be seen, but will likely establish a global standard for how individual countries prepare for and react to the emergence of a new global pandemic.

One of the WHO’s key priorities is that individual governments will mobilise their populations to start preparing for the next pandemic well ahead of time. The WHO’s Health Emergencies Programme (HEP) is supporting states in order to do this.

Elsewhere, the World Bank is committing funds to under-developed countries to support them in vaccine preparedness.

And the Coalition for Epidemic Preparedness Innovations (CEPI), supported by the G7, has set itself a landmark target for the next pandemic: to organise a vaccine response within 100 days of the next outbreak. Using advanced pathogen modelling techniques, and by encouraging governments to work together to share data, they aim to create a system through which future pandemics can be mitigated in time to save millions of lives.

In short, various agencies and governments are taking broad steps to prepare for the next pandemic. While there is, as yet, no single methodology that all countries are aligned to, a number of programmes are already being drafted. It remains to be seen whether the world will align to a single pandemic preparedness strategy, but early signs are positive.

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How can individuals prepare for the next pandemic?

There is no right way to prepare for the next pandemic, other than to remind ourselves of the lessons we have learned from COVID-19.

Contact tracing

Knowing if and when you were in the vicinity of an infected person was important during the COVID-19 pandemic to ensure that anyone who had been exposed to the disease could self-isolate in order to limit the spread of the disease.

During the next pandemic, contact tracing will be just as important. As the technology of contact tracing evolves, we may be able to more easily, accurately and quickly identify exposures, and reduce the spread of the disease with even greater efficiency.

Self-isolating

Quarantining was another essential mechanism by which individuals helped to stem the spread of COVID-19. But, coming as a bit of a shock, it’s fair to say that many of us were unprepared to spend weeks and months at a time locked in our homes. Mental health took a nosedive around the world as a result – the WHO estimates depression and anxiety skyrocketed by around 25% worldwide.

When the next pandemic rears its head, it will be up to each of us to ensure we are ready for self-isolation once more. This means preparing ourselves mentally for the step change in our lifestyles, and using mechanisms learned from the last pandemic to ensure that we remain positive and focused in spite of the lack of social contact.

Vaccinations

Vaccines are not only the fastest and surest way to end a pandemic, they are also the best means we have to preventing them. It was vaccines that ultimately brought the COVID-19 pandemic under control – and if we are fortunate, the next pandemic may be stopped in its tracks by a vaccine before it becomes a global crisis.

Unfortunately, when it comes to vaccines, misinformation is rife. And while it is important to be well-informed about your medical options, it is also important to remember that it is our own responsibility to self-present for vaccinations as and when we are called. Only by ensuring a spread of immunity within the population can we bring a pandemic under control for everyone’s benefit. Therefore, listen to the advice of reputable medical professionals and follow instructions as best you can.

Look out for number one

The last and perhaps most important lesson we learned from COVID-19 was that it is up to each and every one of us to protect ourselves and those around us. We have all learned the proper techniques to prevent the spread of disease – maintaining social distancing, wearing a facemask, washing our hands, and so on. When the next pandemic comes, we must be ready to repeat this behaviour, and to do it sooner rather than later.

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Will There Be Another Pandemic And What Can We Do About It?

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What could the next pandemic be?