Stopping Pandemics Before They Start

Public health experts are strategizing for how to combat the next pandemic by learning from what failed to prevent the most recent coronavirus pandemic. From increasing surveillance of viruses to using diagnostic technologies to "screen for novel infections more systematically," there are a series of protocols that countries failed to utilize that can be enacted now as a preventative measure.

Having spent a number of years combatting Ebola and Marburg viruses, officials in Uganda were able to quickly set into a motion a series of proactive strategies such as restriction of movement, surveillance strategies, and widespread testing to help contain the coronavirus outbreak. Although the approach isn't without its limitations – many are stockpiling groceries out of fear – the rapid and aggressive measures have kept the country's caseload low compared to that of other African nations.

In March when fewer than 100 coronavirus infections had been found in the U.K, researchers in Cambridge decided to begin sequencing coronavirus samples as part of an "unparalleled surveillance system for Covid" that could identify and track possible mutations or the virus. This effort – which involves labs sending leftover material from testing swabs to the researcher's genomics lab where they are stored and analyzed – has culminated in hundreds of thousands of genome sequences and "sounded an alarm for the world" about the new fast-spreading variant.

Weeks before the coronavirus outbreak was declared to be a pandemic, Seoul, and other parts of South Korea set into motion a combination of "prevention and mitigation programs" that are now being touted as lessons for other countries struggling to contain the virus. Using technological advancements such as a national mobile phone alert system and mobile phone applications along with increased transparency around data collected, new reports of cases have slowed allowing the country to prepare for a potential surge later on.

When virologists and genomicists in Seattle, Washington realized that COVID-19 was likely to spread to the United States, they began to research ways to keep vulnerable poplulations safe. So far, early success has come from replicating the Seattle Flu Study, which uses a swab test to "reveal the trail that the flu takes as it passes around households, homeless shelters, office parks and communities in the city," and now investors are putting money towards getting these tests into households.

When a case of the Ebola disease struck a little girl in Africa, health officials in Mali collaborated with the Centers for Disease Control and Prevention and the World Health Organization to contain the illness and quarantine people. The episode also has changed social customs and expanded sanitation procedures so that more people are aware of how to keep themselves healthy.

In communities across Africa, health workers are going house to house with medicine to combat lymphatic filariasis, which is the world’s second-largest cause of chronic disability. They are participating in a strategy called mass drug administration, which treats everyone in an area where a disease is found – even if they aren’t sick or infected.

Local agencies tasked with controlling disease-spreading organisms are releasing sterile male mosquitoes to help reduce the pest’s population and prevent the spread of dengue. This strategy has decreased the mosquito population by about 82% in parts of Southern California, marking the first time in eight years that the population has declined instead of increased.

Since 2017, the Defeat TB (tuberculosis) program supported by USAID introduced a patient contact tracing program in Uganda wherein health workers and facilitators have been trained to trace a patient with multidrug-resistant TB back to their community to screen family members, conduct tests, and refer them for Xrays or treatment if needed. Introduced in the Mulago referral hospital, the program has since expanded to 16 other centers. Along with counseling, follow-ups, and provision of food assistance, it has helped increase the TB detection and treatment rate over the years.

From 1802 until 1895, Philadelphia ran a quarantine center that required all in-bound ships to stop and all on-board to be quarantined until cleared of any possible infectious diseases. Although the center is no longer in use, it provides a unique history lesson for the current coronavirus pandemic of the success that can come by restricting movement to prevent further spread.