SARS-CoV-2. monkeypox. poliomyelitis. Marburg. Not only are these viruses familiar to public health experts, but they have become household names around the world, thanks to their recent incursions into humans. People have always encountered pathogens of all kinds, but attacks are more common and more severe than ever.
“We’re in the era of epidemics and epidemics, and it’s going to be more complex and more frequent,” says Jeremy Farrar, director of Wellcome, a global health charity that deals with health challenges. “We tend to see both of them [outbreak] By itself, as a single episode. But the truth is that they are almost all symptoms of basic drives, and they are all part of 21st century life.”
The world has seen outbreaks of polio before, for example, as well as clusters of monkeypox and cases of Marburg, the killer’s cousin. Ebola virus. We’ve also seen earlier versions of SARS-CoV-2 in the coronavirus outbreak 2002 And the 2012. So why are these outbreaks piling up, seemingly suddenly, all at the same time?
The explanation lies in assembling a perfect storm of factors that influence nearly every way we live our contemporary lives—from the spread of travel across the globe to humans’ deeper encroachment on previously untouched natural habitats and the modernization that has led to climate change, urbanization, and congestion. Even the immediate and unfiltered way we communicate on social media contributes to this, as disinformation is often shared, validated, and elevated to the same level as trustworthy messages. Then there is the mercurial and increasingly unstable balance of geopolitics that is pushing millions from their homes into refugee camps and migrant housing, which are fertile ground for the spread of infectious diseases.
Put simply, many of the infectious diseases facing the world today are “just the evolution of microbes and humans are coming on a collision course,” Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy.
This interface occurs frequently as people approach nature. Corona viruses, for example, live in bats, while influenza viruses inhabit birds; Both viruses spread anywhere animals roam, which increasingly includes areas where they come into contact with humans.
Deforestation, climate change and urbanization increase the likelihood of such interactions. In the case of Ebola, experts say, the largest outbreak in West Africa in 2014 was likely compounded by the fact that urbanization concentrated more people in overcrowded cities than when the virus was first reported in people in the seventies. “In the 1990s and 2000s, Ebola didn’t change; what changed was that Ebola was a rural disease in a rural village that affected isolated villages, but didn’t reach the large urban centers,” says Osterholm. Urbanization and overcrowding in large cities where sanitation and social distancing are not always practiced means that viruses and bacteria find it easier to seek out new hosts.
Improvements in travel also came with urbanization. And air travel doesn’t just transport people; It also brings any viruses and bacteria you might harbor to other parts of the world within hours. The recent outbreak of monkeypox, which Spread 94 countries in three months, is one example. The virus, which is endemic to Central and West Africa, passed from people from that region to festivals around the world, and then reached countries where cases of infection are rarely reported. “If monkeypox had occurred 100 years ago, the world would not have seen any real global challenge, because transport was so slow and incomplete that it would not have spread the way modern air travel can,” Osterholm says.
There may be another powerful force at work that makes such encounters between people and pathogens more significant and even more deadly. Viruses and other microbes are not individual agents of disease, but exist as a dynamic, ever-evolving community. Every encounter with a human is an opportunity for pathogens like viruses to become fitter and more adept at infecting people and making them sick. This is likely the case with coronaviruses. For example, SARS and MERS cause infections with high mortality rates but are not effectively transmitted from person to person. However, the next generation virus SARS-CoV-2 has finally found a way to spread easily from one human host to another.
Something similar might happen with monkeypox. American scientists, working with their counterparts in Nigeria, where the virus is endemic, began seeing changes in the virus several years ago. “They were of the view that the virus was more efficient at transmitting disease from human to human,” says Dr. Raj Punjabi, senior director of global security and biodefense at the White House National Security Council. “This is an alarm bell. It indicates that the transmission of the virus may have changed because the virus has adapted better [live] between us.” Farrar notes that with each previous outbreak of monkeypox in Africa, the chain of infection — where it infects another person — gradually lengthens, “and the infection lasts longer,” he says. “Instead of infecting one or two people, it’s now five to six people, then from 10 to 12 people.”
All of these converging factors, Osterholm says, put the world in a precarious place. “Any one of those alone is a public health problem,” he says. “Add them all together, and you get a crunch.”
Do humans have a chance? “I think we’re in the most vulnerable category ever in my career,” Farrar says. He argues that the greatest threat to people’s ability to stave off major epidemics comes from our inability to cooperate, share public health information, and mount an effective defense against infectious disease. “Apart from biodiversity, land use, habitat protection, and social media, the biggest challenge is geopolitics,” he says, citing aggression in Eastern Europe, East-West tensions, and inequalities in health resources and health infrastructure among developed countries. and developing. Countries. “Unless we solve geopolitical issues, I am afraid we will not see what emerges from China, Europe, Africa, the Americas and Southeast Asia. We have to get back to understanding that the world is very small, and we are interconnected.”
He is optimistic that COVID-19 and other ongoing outbreaks may finally awaken global awareness of this need for cooperation. The World Bank recently mobilized $10 billion annually to help countries in the developing world improve their surveillance methods for detecting and — most importantly — sharing information about unusual cases of infectious diseases that could represent new public health threats. The funds will support these countries’ networks of community health workers and lab testing capabilities, as well as their access to tests, vaccines, and treatments. Farrar notes that global contributions to the fund, including those from China, are hopeful signs that “maybe this is one way to reunite the world again” around the challenge of pandemic preparedness.
But developed countries need to lead by example. The United States is taking some steps. President Biden has revived the Directorate for Global Health Security and Biodefense, which Punjabi chairs, after it was dissolved during the Trump administration. Biden proposed a record $88 billion investment in preparing the country against the threat of the next pandemic, over five years, that would prioritize investment in tests, vaccines and treatment research, as well as in monitoring new diseases and building supplies of personal protective equipment and health care workers. Trainers who can be deployed during a public health emergency. “There has never been this much money required for pandemic preparedness and global health security,” Punjabi says.
Securing that money will be a formidable challenge. But such an investment is ultimately the most cost-effective way to combat public health threats, before new disease cases turn into clusters — then outbreaks and epidemics. “The more we do to strengthen the National Institutes of Public Health — not just in the US but around the world — the more prepared we will be,” Punjabi says. “Building these investments toward ambitious goals, such as developing effective vaccines and treatments within 100 days of a threat being identified, producing sufficient quantities to vaccinate the US population within 130 days, and supporting increased production to meet global needs rapidly.”
A rapid and effective response must become routine if we are to beat the onslaught of outbreaks definitely on our way. “Microbial evolution is alive and well,” Osterholm says. “We are fighting an enemy that is growing and changing every day to adapt to the changing world.”
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