Apr 23, 2020 - Health

What pandemic prep experts have learned from this coronavirus so far

Illustration of medical doctor’s bag with stethoscope and pluses

Illustration: Eniola Odetunde/Axios

We may not have seen a global pandemic like this for the past century — but that doesn't mean we won't see another one for another 100 years.

The big picture: Experts expect infectious disease outbreaks to increase in frequency and are already noting how we can improve moving forward.

Background: Six months ago, 15 government and business leaders took part in Event 201, a simulated pandemic exercise presented by the Johns Hopkins Center for Health Security, World Economic Forum, and the Bill & Melinda Gates Foundation.

  • The participants from multiple countries made "decisions" based on the spread of a fake coronavirus called CAPS, which turned out to be similar to the SARS-CoV-2 virus causing the current COVID-19 pandemic.
  • By the end, CAPS killed 65 million people worldwide as countries argued over scarce vaccines and treatments and dealt with disinformation campaigns amongst other problems.
  • The global economy was wrecked as people refused to work or travel, leading to a shutdown of communications, basic sanitation and health care, not to mention the devastation of entire economies dependent on tourism.

While COVID-19 is not expected to cause that level of devastation, Johns Hopkins' Tara Sell and Eric Toner, who led Event 201, tell Axios there's already a lot to learn from this pandemic, and how it differs from what they had prepared for in the exercise.

What's working: Social distancing is "flattening the curve" of infection rates and the U.S. health care system has not yet been as overwhelmed as originally anticipated.

  • "One thing that's quite different from what we had envisioned was the degree of social distancing which has been possible and the degree of surge capacity augmentation in the health care system which has been possible," Toner says.
  • Plus, international collaboration among scientists has grown — leading to new papers and discoveries, Sell says. It's "been an incredible thing to observe."

What's not working: There's been disparate messaging between different authorities, leading to confusion and growing distrust in the government, Sell says. This has led to a void that's being filled with misinformation in what the World Health Organization has dubbed an "infodemic."

  • Leaders need to "flood the zone with true information, transparent information and accurate and timely information," she says.
  • Event 201 also found private-public partnership was key in handling problems, and this wasn't really seen in the first three months of the COVID-19 outbreak, Toner says. "It's not just the government finding the solution ... many of the things we need to fight this outbreak are coming out of the private sector," Sell adds.

Another wild card in pandemics is how little is known about any novel pathogen. "We've found in this outbreak that it's so hard to make decisions because there's so much uncertainty" about how it spreads and case fatality among other things, Sell says.

What's next: Recent focus on how well (or not) the WHO handled the crisis may lead to an examination on whether changes need to be made.

  • After Event 201, there was a consensus among most leaders in the exercise on the need for a new entity connected to, but not part of, the WHO that could take charge during pandemics.
  • "Because of the constraints WHO has, there needs to be some sort of [separate] body that can do this coordinating work that would have some political heft and some degree of authority in both the private and public sectors," Toner says.
  • Event 201 resulted in a plan to work out details of how that might work over the next year, but COVID-19 interrupted that idea, he adds.

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