When it comes to pandemics, COVID-19 might not be ‘the big one’: WHO

TORONTO — Experts say that as bad as the novel coronavirus pandemic has been, worse outbreaks may be coming.

At the final World Health Organization (WHO) press conference on COVID-19 in 2020, Dr. Mike Ryan, head of the WHO emergencies program, called the current pandemic a “wake-up call” on emergency preparedness.

“It may come as a shock to people that this pandemic has been very severe — it’s spread around the world extremely quickly, it’s affected every corner of this planet — but this is not necessarily ‘the big one,'” Ryan said.

Ryan noted that while SARS-CoV-2 “is very transmissible” and has killed many, its rate of fatality is “reasonably low in comparison to other emerging diseases.”

Ryan’s comments echo a statement made by United Nations Secretary-General Antonio Guterres from Sunday, when the UN marked its first International Day of Epidemic Preparedness.

“As we strive to control and recover from the current pandemic, we must think about the next,” he wrote. “Unfortunately, it is easy to imagine a virus just as infectious but even more lethal.”

The WHO uses a tool to provide its research and development team with a focused list of pathogens that pose a risk to the public due to their epidemic potential or due to the lack of countermeasures available to combat the pathogen’s associated disease.

Some of the current priority diseases include COVID-19, SARS, Ebola, Zika and ‘Disease X,’ a designation used for unknown pathogens that could lead to a serious epidemic.

Maria Van Kerkhove, the COVID-19 technical lead of the WHO Health Emergencies Programme, said that countries that have already dealt with these kinds of pathogens are an example of how to best prepare for a future epidemic.

“Those that have dealt with SARS-CoV in 2003, those that have dealt with MERS-CoV, those that have dealt with Ebola, yellow fever, measles and polio and so many other infections have had a ‘muscle memory’ and have had a trauma almost in dealing with these kinds of outbreaks,” she said.

“They have used that experience to build a public health infrastructure, have used this to build a community health workforce, and to have trained health professionals at local levels.”

Van Kerkhove said that when these countries heard the warnings about COVID-19 from WHO in January, they heeded the calls to action and used that “muscle memory” to “kick those systems in gear.”



While many countries around the world may not have previously had this kind of experience, Van Kerkhove said that the systems currently in place to curb COVID-19 should be evaluated and used in future epidemics.

These systems, she said, include a trained and protected workforce, community workers to carry out contact tracing and cluster investigations, laboratory technicians with access to innovative and robust technologies, and communities that are engaged and informed.

But one element of emergency preparedness that needs to improve before the next outbreak, Ryan said, was the ability of the public to be able to follow guidelines.

“We’re still not there yet on equity,” Ryan said. “That’s the final part of this that requires equitable distribution of all this knowledge, all this learning and all of these tools.”

WHO experts said that when it comes to preventing the next outbreak, there is a constant learning process at play, and that systems in place for the COVID-19 pandemic will be needed again in the future.

“If there’s one thing we need to take from this pandemic, with all of the tragedy and loss, it’s that we need to get our act together,” Ryan said. “We need to get ready for something that may even be more severe in the future. In this, we must honour those we’ve lost by getting better at what we do every day.” 

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