After more than a year of struggling against COVID-19, vaccines have been developed and deployed in record time and we are starting to see a rational path out of the pandemic. As momentous as this is, the truth is that COVID-19 is only one battle in an expanding, long-term war between humanity and viruses. We must make good use of the approaching momentary pause to prepare for the next onslaught.
The accelerating emergence of deadly viruses has become an increasingly urgent problem for mankind as we push deeper into the natural habitat of animals that are the primary source of such outbreaks. In the century since the influenza pandemic of 1918, the pace of virus emergence and spread has progressively quickened. Beginning in the 1980s, we were hit by the global HIV/AIDS pandemic. The SARS coronavirus respiratory syndrome emerged in Asia in 2003 and, nine years later, MERS appeared in the Middle East. International outbreaks of the Ebola and Zika viruses made terrifying headlines during the past decade.
Confident predictions by epidemiologists and virologists that such emerging viruses would lead to deadly pandemics were dramatically realized with COVID-19 — and prospects for future pandemics are only increasing.
Timely action now should help to greatly cushion the impact of, or perhaps to prevent, the next pandemic. Such action includes allocating appropriate resources to priorities such as funding much-needed advances in critical basic research areas and expanding public health infrastructure.
The terrible toll in lives and money that COVID-19 inflicted underscores the importance of acting to protect our future. The United States alone, with 4 percent of the world’s population, suffered 20 percent of COVID-19 deaths — now well over a staggering half-million people — comparable to the total number of Americans killed in World War II and the Vietnam and Korean wars combined. The devastating hit to the U.S. economy was estimated to reach $16 trillion. For comparison, U.S. military spending on the “war on terror” in Iraq and Afghanistan over the past 20 years was approximately $6.4 trillion.
Given the massive damage caused by COVID-19, the amount that we spend on combating viruses is extremely modest, especially compared to other government outlays. The United States spends at least $700 billion a year on defense, more than our rivals China and Russia and our friends the United Kingdom and Germany combined. Although vital for many aspects of our national security, that spending is not intended to and did not protect us from COVID-19. The National Institute of Allergy and Infectious Diseases, led by Dr. Anthony Fauci, the primary funder of U.S. viral, bacterial, general microbiology and immunology research, has a budget under $6 billion — less than 1 percent of core defense spending.
Further investments in relevant basic research, medicine and public health are critically needed and could provide game-changing advances in pandemic protections.
Fortunately, critical breakthroughs in understanding and controlling viruses are within our grasp, and investment in these areas will bring handsome rewards. Recent tremendous progress in general virology and understanding of the MERS and SARS viruses, for example, gave us a valuable running start in combating COVID-19.
Among other benefits, research will crucially extend recent discoveries on how viruses replicate and attack their hosts. One exciting outcome of such work is the growing revelation of similar features shared across multiple viruses, or even virus classes, including shared dependence on common host cell pathways. Similar to the way that many antibiotics work against multiple kinds of bacteria, these shared features can serve as targets for developing vaccines and antiviral drugs that inhibit not just one but a whole group of viruses, which would be a major step forward. For lack of such abilities, the world went into lockdown while scientists and doctors struggled mightily to generate, validate and deliver specific vaccines against COVID-19.
Developing a growing toolbox of broad-spectrum antivirals would much better position us to deal with emerging viruses, providing a good chance that some broad-spectrum agents could work against a new virus threat, individually and likely more powerfully in combination. Generating such broad-use antiviral tools is particularly important since we cannot predict what type of virus will cause the next pandemic. Indeed, the most dangerous pathogenic viruses that emerged in the past century — influenza virus, HIV, coronaviruses, etc. — were all from very different virus families previously considered largely innocuous to humans.
Providing a response commensurate with the scale of emerging viral dangers will take concerted, collaborative efforts similar to the “space race” of the 1960s. Similar to that effort, a “space race” against pandemics would embody ambitious goals to understand and control viruses, consistent financial support, innovative approaches, and public/private partnerships. We also would need to strengthen public health education and that infrastructure essential to deliver resulting vaccines and drugs to the public. Also like the original space race, such a program would provide many valuable spinoff benefits — in this case, to medicine, biotechnology and other areas. For example, the new mRNA vaccine technology being used to protect people from COVID-19 promises valuable applications to fight cancer and other diseases.
The COVID-19 pandemic is not an isolated event but one step in an accelerating progression of viral threats. While overcoming COVID-19 must remain our immediate priority, we also must recognize this as a wake-up call to address some of the greatest continuing dangers to human health, the economy, and national security. The good news is that we can succeed if we are willing to support the crucial actions and investments needed to learn the strengths and weaknesses of our diverse viral adversaries and how to control them.
Paul Ahlquist, Ph.D., is director of the John W. and Jeanne M. Rowe Center for Research in Virology at the Morgridge Institute for Research in Madison, Wis., and a professor at the University of Wisconsin-Madison.