There are multiple factors and vectors that could lead to the next pandemic, but they all have one thing in common…
One could be forgiven for thinking that three years into an ongoing pandemic, people would be far more cautious – not less – when it comes to public health. Unfortunately, our collective actions are making it quite clear that most people have learned nothing from the sacrifices we endured. Remember isolating in our homes, missing holidays and gatherings, to keep everyone safer? When we cheered for the checkout clerks and medical personnel who bravely worked the front lines? The refrigerator trucks full of corpses? The friends and relatives we lost? After all of this, why are we not eager to stop the next pandemic?
It may not come tomorrow. Or next year. It will, however, roll over us eventually. And we’re doing so very little to stop it. If we really want to prevent the next pandemic, we’re going to have to act like it.
The first and best way to avert the next pandemic would be to prevent it before it starts. Consider this NPR article from 2017, a couple years before the emergence of SARS-CoV-2 (the virus we now think of as COVID). The author, along with experts in infectious diseases, is exploring Gomantong, a bat-filled cave in Malaysia. They’re wearing masks and trying not to touch their faces (sound familiar?) because the air and all the surfaces around them are potentially biologically hazardous. The bats, the guano, the cave, and the rainforest around it, host a multitude of new viruses, including ones related to SARS.
In 2003, a deadly SARS outbreak spread from China to Singapore and Hong Kong before someone on an airplane brought it to North America. Luckily, public health authorities in multiple countries were able to mount a robust, coordinated response to insure that a potential SARS pandemic never really got off the ground. That SARS became almost a non-event due to an abundance of competence from the World Health Organization and response teams around the world belies the actual effort it took, contributing, surely, to the way people may take public health for granted.
The viruses, however, are still out there, waiting for a chance to come into contact with a new host and cause the next pandemic. Often, the hottest spots for chance meetings between viruses and people are “edge” spaces, where humans and wildlife come into close contact, providing opportunities for enterprising viruses to jump from one species to another. Turning a guano-slick Malaysian cave into a tourist trap to boost the local economy is one example. Cutting down patches of tropical rainforest for subsistence farming is another.
In 2013, a village in Guinea, where 31 homes nestle within a forest, became ground zero for the worst outbreak of Ebola the world has yet experienced. Perhaps it came from the bats sheltering (and excreting) in a hollow tree where children played. Keyhole plots carved out of the forest for growing rice and other subsistence crops could also have played a role. However the virus reached humans there, the resulting Ebola outbreak spread to ten countries, infecting over 28,000 people and killing more than 11,300. It took two years and at least $3.6 billion to stop the spread.
After the doctors left, nothing else really changed. In historically exploited areas like western Africa, where entrenched poverty drives the need to hunt bushmeat or slash forest in order to put food on the table, people are still venturing into situations that could spawn the next pandemic. Sure, advice poured in, like planting cover crops to enrich the soil instead of cutting more forest plots, or getting rid of the bats, but seeds cost money, and bats are needed to pollinate cacao trees, a cash crop that provides needed income in an economy where people can no longer live happily on what the local landbase provides. If solutions aren’t economically practical, they aren’t going to happen.
Poverty will almost certainly be a root cause of the next pandemic. Not only the lack of wealth that drives people to subsistence farming or exploiting dodgy caves as tourist traps, but hardship in the overly-developed world, too. How many essential front line workers were there not because they wanted as much human contact as possible during a plague, but because they couldn’t afford to eat or pay an extortionate level of rent without putting their lives on the line? Further, poverty underlies poor health outcomes even outside of widespread public health emergencies, all of which is worsened in the absence of available and affordable health care for all.
Finally, politics must be considered anytime we’re dealing with populations of any size, their material conditions, and the policies that either make the next pandemic more or less likely to spread. Politics is one of the main reasons that people are still getting sick, becoming long-term disabled, and dying of COVID in the United States. Much ink and many pixels have been spilled discussing the politicization of the pandemic, from Jared Kushner’s pandemic response team deciding that a national COVID policy was unnecessary since it was hitting blue states hardest and blaming Democratic governors for the death toll could score political points, to a plan hatched by extremists to kidnap Michigan Governor Gretchen Whitmer and execute her on television in part due to anger over Michigan’s COVID restrictions. Identity politics, expressed as refusal to mask in public and vaccine avoidance, led to continued spread and a higher death toll.
What do these all have in common? Money. Wealth.
A history of exploitation that leads to endemic poverty is a big part of what drives people to encroach on wilderness, expanding the human presence in areas where novel viruses can jump from wildlife to humans.
Strong worldwide public health organizations, the kind that can identify, isolate, and eradicate the next pandemic before it literally goes viral, require a level of prosperity to support those organizations to the degree that they can immediately mount a global response when needed. As inequality increases and people struggle to make ends meet, it becomes harder to fund such organizations, eliminating a critical line of defense.
Financial desperation and the fear of losing their homes or being unable to feed their family contributed to the necessity to continue working and public mingling that spreads illness during a pandemic, as well as protests to “reopen” the economy despite the danger.
Resistance to “socialist” policies like universal healthcare, rent subsidies, and food distribution fuels conservative identity politics and manifests as the “freedom” to gather unmasked and refuse vaccinations. Adhering to ideologies that increase inequality in order to funnel more wealth to the already-wealthy, therefore, both indirectly and directly, made the current pandemic more deadly in the United States than it had to be.
Beyond the medical expertise required for modern public health are other material realities we can’t afford to ignore. Until some means of reallocating wealth more equitably is found (both locally and globally) in order to remedy these factors, it’s only a matter of time until the next pandemic emerges and leverages our social and economic weaknesses to immiserate us while ensuring its own genetic survival. Any rational, capable civilization would take whatever action is necessary to save itself from this eventuality. But will we?