Top science advisers: Prepare now for next pandemic

Threat level: Public memory can be short, and people have a tendency to want to move on after a crisis, but it's essential that policymakers learn from the last 19 months and take steps to prepare for the next pandemic, White House science adviser Eric Lander and the U.K.'s chief scientific officer Patrick Vallance said during an event on Tuesday hosted by the British Embassy in Washington.

• Lander recently laid out the Biden administration's pandemic preparedness plan, which comes with an ask for $65 billion from Congress over the next seven to 10 years. Michael Osterholm, an infectious disease expert at the University of Minnesota, told Science, "It's a good down payment, but it hardly will provide enough resources for a real plan."
• Reality check: The Senate is reportedly looking at funding pandemic preparedness with closer to $8 billion.
• The U.K.'s Vallance is behind the 100 Days Mission, which aims to spur governments, industry and organizations to collaborate on making diagnostic tests, treatments and vaccines available within 100 days the next time a pathogen with pandemic potential emerges.

The big picture: Developing those countermeasures on that tight of a timeline hinges on spotting an emerging pathogen as soon as possible, Rick Bright, who leads the Rockefeller Foundation's Pandemic Prevention Institute, said during the event (which I moderated).

• There are different global, national and local surveillance systems in place today, with more in the works, including a new WHO pandemic intelligence hub in Berlin and a network of surveillance hubs being launched by the U.K. and WHO. The White House plan seeks to direct $3.1 billion of the $65 billion requested to emerging pathogen detection efforts.
• Right now, those systems are "not connected, the information is not shared and there are no global common standards or infrastructure to share that information," Bright said.
• He added that traditional epidemiological information could be coupled with new data about people's travel patterns and social behavior, or even from wastewater systems, all to provide earlier signals of an emerging threat.

The COVID-19 pandemic is strengthening calls to expand monitoring for pathogens to include animals that humans interact with and that can be the source of pathogens that spill over to humans, a leading hypothesis for the origins of SARS-CoV-2.

• Conservationists worry about reverse spillovers — humans infecting endangered animals, like chimpanzees, in the wild.
• But there is also the risk of spill back. A pathogen that has already spread in humans and that can infect a broad range of hosts can enter wild populations of animals, mutate in them and create variants of a virus that could then potentially spill back to people and escape vaccines and treatments, says Thomas Gillespie, who studies disease ecology at Emory University.

• Without monitoring animal populations, those sources can escape under the radar. Efforts to eradicate Guinea worm, for example, were challenged when the parasite found a harbor in dogs and baboons. "No one was looking for it in other species," Gillespie says. When they did, "they started seeing the real biology of the organism."

What to watch: USAID last year launched the STOP Spillover program, a five-year project with wildlife and human disease experts on the ground in Uganda, Liberia, Bangladesh and Vietnam who monitor and characterize viruses like Ebola and influenza and coronaviruses from animals.

• But while animal monitoring is happening in some places, Gillespie says, "it hasn’t occurred to the degree yet that it needs to." Human medicine, he adds, hasn't embraced the full lifecycle of pathogens in and out of humans.

The catch: All the international efforts to coordinate and collaborate on surveillance will have limited effectiveness if countries don't share data and alert others when they spot a potential threat.

The bottom line: "The biggest barrier that we have to improving the system, be it surveillance, be it vaccine development or distribution, is we are still not addressing adequately the issues of collaboration, sharing and trust," Bright said.

• Nationalistic approaches to vaccine distribution and access to samples, tools and systems — in this pandemic and past outbreaks — have eroded trust that is necessary for a global, responsive surveillance system, he added.