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The Next Pandemic Will Be Arriving Shortly

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Deadly diseases like Ebola and the avian flu are only one flight away. The U.S. government must start taking preparedness seriously.

There are plenty of security threats that could keep a former homeland security advisor awake. There is the possibility of a terrorist attack, a cyber-cataclysm, or any number of natural disasters—all threats that are capable of visiting destruction on entire communities in a matter of hours. Right at the top of that list is the threat of a deadly pandemic—an outbreak of infectious disease that rapidly crosses international borders.

In January 2017, while one of us was serving as a homeland security advisor to outgoing President Barack Obama, a deadly pandemic was among the scenarios that the outgoing and incoming U.S. Cabinet officials discussed in a daylong exercise that focused on honing interagency coordination and rapid federal response to potential crises. The exercise is an important element of the preparations during transitions between administrations, and it seemed things were off to a good start with a commitment to continuity and a focus on biodefense, preparedness, and the Global Health Security Agenda—an initiative begun by the Obama administration to help build health security capacity in the most critically at-risk countries around the world and to prevent the spread of infectious disease. But that commitment was short-lived.

Pandemic disease is arguably one of the greatest threats to global stability and security.

Pandemic disease is arguably one of the greatest threats to global stability and security.

But investments to contend with such outbreaks have declined to their lowest levels since the height of the Ebola response in 2014, with U.S. federal dollars cut by over 50 percent from those peak levels.

The prevailing laissez-faire attitude toward funding pandemic preparedness within President Donald Trump’s White House is creating new vulnerabilities in the health infrastructure of the United States and leaving the world with critical gaps to contend with when the next global outbreak of infectious disease hits.

The investments made after the 2014 Ebola crisis have been slashed in recent proposed federal budgets from the Centers for Disease Control, the agency that works to stop deadly diseases in their tracks, and the U.S. Agency for International Development, which responds to international disasters, including the Ebola outbreak. Moreover, Timothy Ziemer, the top White House official in charge of pandemic preparedness, has left his job, and the biosecurity office he ran was summarily disbanded.

This lack of focus and relative decline in funding is dangerous, given the steady stream of global reports suggesting that transmission of potentially deadly zoonotic diseases, where pathogens move from animals to humans, is rising at an alarming rate. Some attribute this to climate change, with warmer climates everywhere extending the life cycles of mosquito-borne diseases and allowing them to reach higher altitudes and more temperate latitudes. This means that viral diseases such as Zika, dengue fever, and the West Nile virus are transmittable across a larger geographical area later into the year.

As a result, in 2018, it is impossible to reconcile the redirection of funds away from preparing for pandemics with these realities on the ground. Ebola, the quintessential zoonotic killer, has risen again, now in the Democratic Republic of the Congo, with World Health Organization officials describing the outbreak as on the “precipice” of a potential spread to neighboring countries. While this year’s response was far more rapid and effective than responses to prior outbreaks in Africa, cases continue to rise in hard-to-reach places with little health care infrastructure near Congo’s borders with Rwanda and Uganda, prompting fears of regional spread.

Perhaps most terrifying, difficult to treat and highly fatal strains of H7N9 avian influenza are spreading throughout China.

Perhaps most terrifying, difficult to treat and highly fatal strains of H7N9 avian influenza are spreading throughout China.

This strain of bird flu causes rapid respiratory illness with associated multiorgan dysfunction that’s easily spread by a small droplet. That’s why it’s so difficult to control and why recurrent epidemics continue to crop up: There have been five epidemics of H7N9 since 2013 in China alone, the most recent between the fall of 2016 and fall of 2017. Across these epidemics, among the 1,565 confirmed cases, about 40 percent of infected individuals died.

That is a staggering number that should frighten us all—particularly given that China, unlike other resource-limited states in Asia, has at least some capability to rapidly respond to emerging crises through its own Center for Disease Control and Prevention, which can deploy critical care and other public health emergency services.

Consider that it takes only one infected carrier of bird flu to escape screening or detection at a train station or airport to transform a local health crisis into a global pandemic. As there are over 60 nonstop flights between China and the United States daily, with an estimated total of 30,000 passengers traveling between the two countries each day, this possibility is more than a remote and existential threat. Transmission of bird flu to the United States is just a flight away, which is why durable investments in the Global Health Security Agenda are so important, allowing the U.S. government to address deadly pathogen transmission early and hopefully to do so before it reaches U.S. shores.

The WHO has tried to increase attention and enhance preparedness by strongly supporting the Joint External Evaluation, an assessment of each country’s capabilities in preventing, detecting, and responding to a potential outbreak. According to the first analyses of these results, global readiness to combat the next pandemic is broadly lacking. The starkest finding was that nearly 90 percent of the core public health capacities regarded as essential to pandemic preparedness, across a broad cross-section of countries, are not sufficiently developed to cope with the next major outbreak.

Although countries in Africa and Southeast Asia performed worse, on average, than those elsewhere, preparedness levels were insufficient to varying degrees almost everywhere.

Although countries in Africa and Southeast Asia performed worse, on average, than those elsewhere, preparedness levels were insufficient to varying degrees almost everywhere.

The indicators in need of most attention related to antimicrobial drug resistance. The provision of vaccines for preventable diseases was a rare bright spot, with most countries now meeting basic thresholds for coverage of priority diseases among their populations.

This latter finding shows us what can work: Vaccine coverage rates have improved since the early 2000s in some of the hardest-to-reach places in no small part because of the Global Alliance for Vaccines and Immunization (GAVI)—a bipartisan-supported multinational effort dating back nearly two decades. GAVI helps redirect private and publicly allocated philanthropy and technical expertise to countries suffering from high burdens of vaccine-preventable diseases. Their impressive gains have been undeniable, most notably broad reductions in preventable causes of mortality for those under 5 years old from diarrheal and respiratory diseases.

The Global Health Security Agenda was designed, in part, to do for pandemic preparedness what GAVI has done so well for improved vaccination rates. In the wake of Ebola, the goal was to bolster preparedness response and detection and, most of all, to focus on prevention abroad so the United States wouldn’t have to fight a pandemic at home.

Unfortunately, the financial commitments to the agenda have been dramatically reduced under Trump, leaving us all vulnerable to an unparalleled array of emerging health threats the likes of which we haven’t seen since 1918, when an outbreak of a deadly disease known as “Spanish flu” killed nearly 50 million people globally. In the face of clear signs that the world is unprepared for the next outbreak, that devastating epidemics are a flight away, and that funding to combat these realities has been significantly cut back, the failure to take this crisis seriously is potentially deadly.

Global health security should not be seen solely as the pursuit of development do-gooders or international policy wonks.

Global health security should not be seen solely as the pursuit of development do-gooders or international policy wonks.

Rather, the clear lessons of Ebola and prior pandemics for the current U.S. administration should be that fighting disease outbreaks requires the sort of consensus-building and galvanization of global resources that last week’s U.N. General Assembly was meant to celebrate and sustain. Cynical critiques of such cooperation ignore the mutual interdependence of our global community, which can’t be overturned by a speech or temporary set of inward-looking policy platforms.

Pandemic preparedness is a matter of national security and needs to be treated that way. The greater the complacency, the bigger the next crisis will be.


12 Comments on "The Next Pandemic Will Be Arriving Shortly"

  1. Sissyfuss on Sun, 30th Sep 2018 5:02 pm 

    Why the worry? Gaia in concert with Man is concocting a devils brew, a koolaid that Jim Jones would be proud of. Gaia doesn’t need our help for she has proven her mettle on numerous occasions. But with Man as her ally the choices available will be suitable to the ominous task of destroying overshoot.

  2. makati1 on Sun, 30th Sep 2018 7:34 pm 

    Another excuse to take away more privacy and freedoms in the name of “security”. That disease can travel all over the world in a few hours is not new, but the excuse is.

    Anyone who has travels outside the Us recently can tell you that it is becoming a real pain to leave and another to return. It is getting worse every day.

    I am about done with returning to visit my friends and family. If they want to see me they can come to the Philippines. Coming into the Philippines and Hong Kong is easy. You don’t have to strip or get x-rayed or questioned. And they serve with a smile, not the uneducated drooling of the TSA drones.

  3. makati1 on Sun, 30th Sep 2018 7:40 pm 

    BTW: If you want to see how many planes are in the air at any time:,105.92/2

    Stop a pandemic? LMAO

  4. DMyers on Sun, 30th Sep 2018 8:59 pm 

    The only preparation possible here is providing an effective means of disposing of dead bodies. There won’t be a cure for this thing. There is no cure for flu, and for bacterial threats, these are described in the article as being mainly antibiotic-resistant infections. So, there is nothing we can do about those, either.

    Of course, medicine can always help relieve the suffering of the dying, but there won’t be sufficient facilities or personnel to provide that kind of social entitlement for most people.

    The real danger to the population in this country is immune system decline from diet, chemical additives, and overuse of antibiotics. Whatever germ comes along will have an easy target, i.e., one without its own natural defenses.

    Immunization is a false hope. Vaccines do not have to be proven effective before sale. They may or may not work as intended. Remember how the small pox vaccine eradicated the small pox virus back in the eighties? Well, it’s back. Rather than acknowledge that eradication was not really achieved, they are explaining the reemergence as being a species newly created in a laboratory. You can’t make this shit up.

  5. Free Speech Forum on Mon, 1st Oct 2018 1:40 am 

    Americans said that they hated freedom 100 years ago because the environment was dirty, there were murders, and medicine was dangerous, but the US is now a police state and the environment is still dirty, there are still murders, and medicine is still dangerous.

  6. rockman on Mon, 1st Oct 2018 3:28 pm 

    “The CDC said between 291,000 and 646,000 people die from seasonal flu-linked respiratory illnesses.” And that’s every year. According to the same CDC with respect to Ebola: “Two and a half years after the first case was discovered, the outbreak ended with more than 28,600 cases and 11,325 deaths.” IOW during the same 2.5 year period between 725,000 and 1.6 million deaths from flu and 11,300 from Ebola.

    To mention Ebola in the same breath as a pandemic as the flu is ridiculous. Even comparing the current average global death rate to the truly pandemic Spanish flu outbreak of 1918 is ridiculous: “It is estimated that about 500 million people or one-third of the world’s population became infected with this virus, and the number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States. The pandemic was so severe that from 1917 to 1918, life expectancy in the United States fell by about 12 years, to 36.6 years for men and 42.2 years for women. There were high death rates in previously healthy people, including those between the ages of 20 and 40 years old, which was unusual because flu typically hits the very young and the very old more than young adults.”

    Spanish flu pandemic: 50,000,000
    Recent 2.5 year flu pandemic: 725,000 minimum
    Ebola pandemic: 11,325

    Spanish flu wins!

    The best case just another writer unable to come up with a significant subject to go after. The worst case: fear mongering propaganda for whatever reason. Definition of pandemic from M-W: “an outbreak of a disease that occurs over a wide geographic area and affects an exceptionally high proportion of the population”. So even the CONSISTANT annual 300,000/600,000 flu deaths don’t really rate as a pandemic since a true pandemic is viewed as a one-off unusual event. Ebola doesn’t even rate an honorable mention IMHO. But it did cause a lot of monies paid to various health and training organizations. Far more then what was contributed to fight the flu during the same period.

  7. Twocats on Mon, 1st Oct 2018 3:40 pm 

    Our hospital built an entire Ebola wing with seven isolated beds. In Ohio. Never used. They recently tore it out and converted to regular ED

  8. Go Speed Racer on Mon, 1st Oct 2018 6:31 pm 

    There is a way to stop the upcoming plague.

    If we set enough sofa’s on fire, the
    hot black smoke will kill all the
    airborne germs.

  9. makati1 on Mon, 1st Oct 2018 6:57 pm 

    DHMyers, the family that watches over our farm site has a boy, now about 12 years old, who was forced to get vaccines at age two, by the government here in the Philippines. He was a normal boy until a few years later when he began to lose his eyesight and hearing. Now he is blind and mostly deaf, crippled with deformed legs. His older siblings are all normal and in college here.

    Vaccines are Russian Roulette, sold as miracles and forced on stupid people by their governments/corporations.

  10. deadly on Mon, 1st Oct 2018 9:49 pm 

    When you burn tons of horse and mule manure at Fort Riley and then soldiers become sick, you know something went wrong.

    The death toll from the Spanish flu was more like one hundred million.

    Though the situation was unusual, both the government and the military were distracted by the war effort. Officials called it a pneumonia outbreak and chalked it up to the strange combination of conditions in Fort Riley that week. Not only had the camp been shrouded in a vicious prairie dust storm, soldiers had been breathing in something even more noxious: putrid black ash created by tons of burning manure courtesy of the camp’s thousands of horses and mules. In retrospect, the fact that countless swine and poultry were also living in close proximity to the soldiers may be a more likely place to lay blame since pigs can be susceptible to avian influenza viruses — those strains responsible for most serious forms of flu — which can then mutate and be transmitted to humans.

  11. Dooma on Mon, 1st Oct 2018 11:47 pm 

    Meanwhile back at the lab…. Big Pharma is still pushing anti-biotics to man and beast.

  12. makati1 on Tue, 2nd Oct 2018 12:01 am 

    “Although data are incomplete, existing evidence suggests that a significant portion of antibiotic use across U.S. health care settings is inappropriate—from primary care offices and emergency rooms to hospitals and long-term care facilities. …

    At least 30 percent of oral antibiotics prescribed in U.S. outpatient settings are unnecessary.7 Of the total excess prescriptions, nearly three-quarters are for acute respiratory conditions, including asthma, allergies, colds, and other infections not caused by bacteria, which therefore do not respond to antibiotics….

    Antibiotics are used in animal agriculture to treat, control, and prevent disease. Currently, little information is publicly available on the volume or appropriateness of that use in the U.S…

    In 2015, the last year for which data are available, approximately 9.7 million kilograms, or 21.4 million pounds, of antibiotics considered important for human use were sold for use in animal agriculture, a 26 percent total increase over 2009 sales.”

    And when they no longer work…?

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