The Future of Pandemics: How Can We Prepare?

Pandemics have been a significant part of human history, playing a crucial role in shaping the story of our species. Professor Santiago González, an Associate Professor at the Faculty of Biomedical Sciences at Università della Svizzera italiana (USI) and Director of the Laboratory of Infection and Immunity at the Institute for Research in Biomedicine (IRB), discussed this topic in an article published in laRegione.

Pandemics are characterised by their periodic nature. Since the Plague of Athens, which occurred from 430 to 426 BC, we have experienced numerous pandemic episodes, many of which have had devastating effects. The most recent pandemic, COVID-19, has impacted nearly every aspect of our lives, including health, the economy, and our social interactions.

However, we are confident that COVID-19 will not be the last global health emergency. Scientific studies suggest that alterations in ecosystems due to climate change could increase the likelihood of new epidemics. Indeed, emerging infectious diseases are becoming more common.

Research indicates that most contagious diseases affecting humans are often transmitted from animals. Factors such as deforestation, urbanisation and wildlife trade increase the chances of transmission of animal pathogens to humans.

If humans continue to invade natural habitats, the risk of contact with unknown viruses increases. Additionally, climate change is making many regions more hospitable to disease-carrying insects, such as mosquitoes and ticks. This increases the likelihood of epidemics, such as Zika, malaria, or dengue fever, and the spread of these pathogens to new areas.

Therefore, preparing for future pandemics is not only essential but also urgent.

How can we, as a global society, better prepare for the next pandemic?

The first step is to monitor the most relevant candidate pathogens closely. The list of the most dangerous pathogens is primarily dominated by airborne pathogens, such as influenza and coronaviruses, due to their ability to spread quickly and rapidly produce new, lethal variants.

Influenza viruses: avian influenza is considered the greatest threat for a potential pandemic. The virus' high mutation rate and ability to create new variants through recombination with swine or human influenza viruses make them exceptionally dangerous. The influenza virus is estimated to have caused the largest pandemic in human history in the early 20th century, known as the "Spanish flu," which resulted in the deaths of over 50 million people worldwide. Despite significant efforts in recent years, we are still far from developing a universal vaccine or effective antiviral treatments to protect us from this potentially lethal strain. At IRB, we are committed to developing innovative therapies that offer long-lasting protection. On the one hand, Prof. Davide Robbiani's group employs cutting-edge technological approaches to identify new antibodies that could serve as therapies against the virus. On the other hand, our research group is exploring the potential use of natural plant-based compounds as novel treatments against the virus.

SARS-CoV-2: Despite the recent pandemic and the development of effective therapies such as RNA vaccines and antibody-based therapies, coronaviruses remain a significant concern. This family of viruses shares with influenza the ability to rapidly generate new variants that can escape the immune system. In addition, other SARS-related coronavirus strains circulating in bats have demonstrated the ability to infect human cells, suggesting that the risk of spillover persists. The IRB was at the forefront of research during the COVID-19 pandemic, in particular in the discovery by Prof. Federica Sallusto's group of monoclonal antibodies targeting conserved regions of the virus. Additionally, the work has been crucial in understanding how the immune system responds to infections and how vaccines against coronaviruses work.

Despite the likelihood of new pandemics emerging in the future, there are strategies we can adopt as a society to prepare for them.

Improving monitoring systems: Advanced surveillance systems that monitor threats in human and animal populations are needed to detect potential outbreaks before they spread. Several international initiatives, including the Global Virome Project, the WHO Global Outbreak and Response Network and the Global Emerging Infection Surveillance and Response System, focus on identifying unknown viruses and evaluating their potential to infect human populations. Additionally, ongoing surveillance programs are crucial for monitoring the presence of new strains of avian influenza, particularly those that are highly pathogenic.

Strengthening the public health system and research: The first line of defence against a pandemic is associated with a strong health and research system. During the last pandemic, the capacity of hospitals and major research infrastructures was severely tested. To prepare for future crises, it is essential to strengthen public health systems and identify key research infrastructures that can provide efficient and timely responses. This includes the creation of appropriate protocols, specific training of scientists and health workers and the establishment of efficient infrastructures capable of providing large-scale diagnostic tests and services.

Promoting international cooperation: containing an epidemic in a globalised country is becoming difficult. This is why global collaboration is crucial. The World Health Organisation (WHO) must be strengthened and supported to coordinate response efforts, share data and ensure equitable access to the tools needed to prevent pandemics (including vaccines, personal protective equipment, information and expertise). In addition, there is an urgent need for a global pandemic treaty to strengthen international response mechanisms.

Accelerating the discovery of new therapies: vaccines are the safest and most effective way to control and prevent epidemics. Their development, however, is timely and costly. Thanks to an unprecedented international effort, the COVID-19 vaccine was developed rapidly. Based on this progress, scientists are beginning work on potential vaccines for viruses known to be dangerous. The idea is to anticipate all the initial steps necessary for developing a new vaccine when a new virus emerges. This approach aims to significantly reduce the time required to produce a new vaccine.

Combating fake news and misinformation: An effective communication strategy with the public is crucial to preventing the spread of misinformation and fostering trust. Authorities, scientists, and the media must work together to implement transparent and clear communication strategies that provide accurate information and counteract fake news. By building public trust in official channels before a crisis arises, people are more likely to follow health guidelines and accept life-saving measures, such as vaccinations.

What can be done? Pandemic preparedness is a global effort, but individuals also play a crucial role. Staying informed through official channels, supporting science-based policies, getting vaccinated, and advocating for increased public health funding can all contribute to a safer future. Communities that prioritise health, education, and science will be more resilient in the face of future threats. The next pandemic is not a question of "if" but rather "when." With foresight, investment, and cooperation, we can be prepared and save millions of lives.

Content produced and published in cooperation with laRegione.