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October 28 - November 16, 2020
We put many billions of dollars a year into national security and defense, with budgets that span years at a time. Yet we seem to lose sight of the greatest national security threat of all—the threat of deadly microbes that cause infectious disease. We would never consider going to war against a human enemy and then ordering an aircraft carrier or weapon system from a defense contractor that would take years to design and build.
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With all of the illness, death, dislocation, and economic loss caused by the COVID-19 pandemic, the greatest tragedy would be if we “waste” this crisis by not learning from it and preparing for the future.
Two years is a very short amount of time to develop any vaccine,
My colleagues and I have often been criticized by politicians and the media for “making it up as we go along,” to which I plead 100 percent guilty. When we are in the midst of pursuing a serious outbreak of unknown origin or scope, we are making it up as we go along. Being a public health official leading a serious infectious disease outbreak investigation means you often have to make quick decisions about taking action in order to prevent additional cases and even deaths.
In a 2015 TED Talk, Bill Gates asserted, “If anything kills over 10 million people in the next few decades, it’s most likely to be a highly infectious virus rather than a war. Not missiles, but microbes. Now, part of the reason for this is that we’ve invested a huge amount in nuclear deterrents. But we’ve actually invested very little in a system to stop an epidemic. We’re not ready for the next epidemic.”
Yet our personal microbiome accounts for just about three pounds of our total body weight.
which infectious disease microbes can rapidly mutate or change their genetic codes effectively to avoid the host’s immune system, vaccines, or drugs, and can even lead to enhanced means of transmission, particularly through the respiratory route. This is why influenza viruses remain the leading candidates for causing a global pandemic.
Cytokines are small proteins that alert the appropriate white blood cells to rush to the site of infection and fight the invaders. In a cytokine storm, the continual feedback loop between cytokines and the defensive cells can clog airways and cause organ shutdown.
the 1918 flu was an influenza strain like none other in recorded history. Could something like this happen again? You bet it could.
While all of these mechanisms are significant spreaders of specific diseases, the ability to transmit a microbe by merely breathing it into our lungs is the most dangerous.
The term “vaccine” hearkens back to the work of Edward Jenner, who referred to cowpox, the disease to which he exposed patients to immunize them from smallpox, as Variolae vaccinae, Latin for “smallpox of the cow.”
most of the vaccine production for influenza requires a whole lot of chickens laying a whole lot of eggs. The more modern cell culture technology, in which a seed virus is introduced into an existing cell line and grown in capacity in a fermenter, is faster and more efficient, but it’s still a biologic process.
So is it worth getting the vaccination each year? I give that a qualified yes. It might or might not prevent you from getting flu. But even if it is only 30 to 60 percent effective, it sure beats zero protection.
We need a new paradigm—a new business model that pairs public money with private pharmaceutical company partnerships and foundation support and guidance.
In 2014, the most recent year for which statistics were available from the WHO, there were an estimated 36.9 million persons living with HIV worldwide and 1.2 million deaths from AIDS. There were an estimated 9.6 million cases of tuberculosis and 1.1 million deaths, according to 2015 statistics.
our assumption that infection from any recently circulating H1N1 strain would have provided protection from the devastating 1918 H1N1 strain was wrong. Second, it was a wake-up call that these artificially constructed viruses posed the potential for globally catastrophic effect.
Over the past five years, both the CDC and academic labs around the world have documented accidents where a variety of pathogens were, or may have been, released.
a bioterror event does occur, we need to have a public health and medical care system already in place to meet the immediate challenges of a situation that is no longer unthinkable.
60 percent of emerging infectious diseases are leaping into the human population through animals.
Ebola victims are not contagious until they actually begin showing symptoms. And those symptoms, as we have noted, are hard to miss.
If airborne transmission of Ebola virus to and by humans were to occur, it would be a game changer. That is a very, very big deal.
In suppressing reporting, China forfeited a critical opportunity to contain the disease in its earliest stage and later apologized to the WHO.
What eventually stopped the spread was not high-tech medicine, since there wasn’t any specific treatment for SARS. Instead it was implementing impeccable infection control, including isolating patients and making healthcare workers wear protective gear, and then intensive follow-up of both healthcare workers and community contacts, with immediate isolation if they showed any early symptoms of SARS.
could happen all over again if one of these bat viruses infects humans, most likely via another infected animal. We can’t for a moment believe that the SARS virus obituary has been written.
Recent studies by the CDC and Brazilian researchers found that between 1 and 13 percent of women infected during the first trimester of pregnancy deliver babies with microcephaly.
O’Neill and his highly talented team of researchers determined that, left unchecked, in the next thirty-five years antimicrobial resistance could kill 300 million people worldwide and stunt global economic output
With reassortment, major changes occur, resulting in a new virus that can be unlike anything that humans have experienced before and can become the viral strain that starts the next worldwide pandemic.
By early June, the surgeon general has gone on television from the White House to urge anyone who does not need acute care to stay home and not further burden the hospitals.
