2 weeks Ago By Tom Bawden
It is five years to the day since Boris Johnson took a deep breath and told the nation that it “must stay at home” to slow the spread of Covid-19.The long lockdown that followed had consequences – in terms of lost education, rising benefits and changes to the way we work – that are still with us today.A children’s playground in Manchester closed during the Covid-19 lockdown in April 2020 (Photo: Visionhaus)The pandemic ended up killing more than 200,000 people in the UK.
But academics had warned that such an outbreak was due, and in July 2020 one of then, Professor Tom Koch, predicted another pandemic “within five to eight years” with a much higher mortality rate.if(window.adverts) { window.
adverts.addToArray({"pos": "inread-hb-ros-inews"}); }Others agree it will be “soon”. Less certain is what form it will take.
But World Health Organisation ratings suggest contenders with a “high risk” oftriggering a pandemic could include Ebola – which is fatal in half of cases and causes external bleeding, bird flu, mpox (formerly known asmonkeypox) and the Zika virus.So now, half a decade on, is Britain any better prepared? Alarmingly, according to a range of experts that The i Paper spoke to, the answer is that, in many important ways, we are not.Which disease will trigger the next pandemic?The World Health Organisation (WHO) has rated the following diseases as “high risk” in terms of the chances of them triggering a pandemic.
Bird fluCaused by the influenza A virus, which can also infect humans. It is seen as the most likely source of the next pandemic because it has jumped to cattle – and spread widely within US cattle – and is now endemic in wild birds across the world with regular outbreaks on poultry farms.National Trust rangers wear protective suits and masks on Inner Farne Island in August 2022, in Seahouses, England.
Concern over avian flu continues to affect many islands and nature reserves around the UK. (Photo by Ken Jack/Getty Images)Human symptoms can range from mild flu-like illness to severe respiratory problems, including pneumonia and even death.EbolaEbola has so far only affected African countries, and occasional cases outside of the continent have been rapidly contained.
But the virus could mutate to spread more easily between people, making it more of a pandemic threat.Medical workers lead a man with suspected Ebola into an unconfirmed Ebola patients ward in August 2018, in Beni. (Photo by John Wessels/AFP)This is seen more likely following Donald Trump’s cuts to overseas aid that funds programmes of Ebola screening in Africa.
The more cases there are, the greater the chance of it mutating.Human symptoms include sudden fever, fatigue, muscle pain, headache, and sore throat, followed by vomiting, diarrhoea, rash, and in some cases, internal and external bleeding. It is fatal in around 50 per cent of cases.
Zika virusThe 2015-2016 Zika virus (ZIKV) outbreak in the Americas is over. But it continues to be a risk in many countries, and the possibility of future outbreaks, and even a pandemic, remains.Human symptoms are usually mild, like fever, rash, and joint pain.
But infection during pregnancy can lead to serious birth defects. It is also associated with neurological complications like Guillain-Barré syndrome, a rare condition in which a person’s immune system attacks the peripheral nerves. It can be fatal but this is extremely rare.
Mpox (formerly known as Monkey pox)While Mpox is a cause of concern around the world and is classed as high risk by the WHO, it is seen as less likely to become the next pandemic because it is harder to spread than Covid. It is typically passed on through skin-to-skin contact with rashes or infected body fluids, rather than airborne particles as with Covid.Mpox is less likely to become the next pandemic (Photo: Glody Murhabazi/Getty)For humans it typically begins with flu-like symptoms like fever, headache, and muscle aches, followed by a rash that starts as flat spots and progresses to blisters, pus-filled bumps, and eventually scabs.
It can occasionally be fatal, with the highest risk to newborns, children, pregnant women, and individuals with weakened immune systems.Disease XDisease X – sometimes referred to as Pathogen X – is the name given by scientists and WHO to an unknown pathogen that could emerge in future and cause a serious international epidemic or pandemic.Disease X itself is hypothetical: it does not exist.
No-one can predict where or when the next one will emerge. What is certain, however, is that a future Disease X is out there and could, at some point, spill over from animals into people and begin to spread in a disease outbreak. Climate change can increase the threat as animals move into new areas with cooler temperatures.
A Disease X could also come from bacteria, like TB and Cholera.They point out the many factors that determine how widely an infection will spread – and how serious it is to those infected – have actually got worse since Covid, making us more vulnerable to a serious global outbreak of disease.UK has major resilience problemsThey warn that we fall down on everything from NHS capacity and the general health of the population to social deprivation, public behaviour and trust in politicians.
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addToArray({"pos": "mpu_tablet_l1"}); }“We’re nowhere near as well prepared for the next pandemic as we should be,” Professor Martin McKee, chair of the WHO’s European pandemic scientific advisory committee, told The i Paper.“We definitely were not prepared when the Covid pandemic arose. And while the scientific community is definitely better prepared for the next one there are still major problems in terms of the resilience of the country as a whole.
“We know more, we understand more but we have incredibly weak public health – we don’t know what’s going to happen with the public health function of NHS England. Public health in local government has been starved of resources.”He says “the scale of the challenge to the NHS is huge”.
The academic is particularly concerned that growing deprivation in many parts of the country – driven by the cost-of-living crisis and the impact of Covid on people’s finances – could help fuel the next pandemic.Reservoirs of infection“Areas of deprivation create the conditions for viruses to spread to become reservoirs of infection in the population,” said Professor McKee, who is based at the London School of Hygiene & Tropical Medicine. “We have a clear problem of high levels of deprivation in some parts of the country.
”He cites “inner cities and deindustrialised areas in the north west and north east, with multiple houses and multiple occupancy and people living in the gig economy, where it is incredibly difficult to eradicate the infection”. And he says coastal towns like Blackpool and rural areas of Lincolnshire are also “classic examples”.if(window.
adverts) { window.adverts.addToArray({"pos": "mpu_mobile_l2"}); }if(window.
adverts) { window.adverts.addToArray({"pos": "mpu_tablet_l2"}); }Blackpool, one of the areas of Britain that Professor Martin McKee thinks could be a ‘reservoir of infection’ (Photo: Danny Lawson/PA Wire)“The effect of the pandemic was to leave these places behind even further,” warns Professor McKee who says the next one “is likely to be sooner rather than later”.
Science is a bright spot. Dame Professor Jenny Harries, Chief Executive of the UK Health Security Agency, cited the UKHSA Vaccine Development and Evaluation Centre at Porton Down “providing state-of-the-art facilities to support the UK’s impressive vaccine research capability, and enable the rapid development of new vaccines to combat current and emerging threats”.There was also a specialist team working to improve the speed at which new and existing types of tests such as lateral flow tests and “molecular point of care tests”, can be “made ready at rapid scale for a wider range of different pathogens”, she told The i Paper.
‘The NHS is weaker, health poorer and trust lower’Professor Christina Pagel, of University College London, said: “I think we are better placed in terms of rapid development – partly because of the knowledge gained during Covid.”But, warned the health care researcher, “in terms of public health response we are definitely worse off”. “The NHS is weaker, national health is poorer and public trust is lower.
”And Professor McKee warns that universities that “really stepped up to the plate” during the last pandemic “providing laboratory facilities, doing research, providing expert advice” are now “suffering terribly because of the visa rules on students” which have hit their funding.No-one The i Paper spoke to had any idea exactly when the next pandemic will strike – although they were in no doubt that one would at some point.if(window.
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adverts) { window.adverts.addToArray({"pos": "mpu_tablet_l3"}); }And they were confident it would be a ‘zoonotic’ disease – which spreads from animals to humans – with flu seen as a prime contender.
“The next pandemic is more likely to be a flu one than not,” said Professor Pagel – pointing to “the prevalence of bird flu in the US cattle population right now and the fact it is now endemic in wild birds across the world with regular outbreaks on poultry farms”.She noted that “we already know a lot about flu vaccines and have existing human H5 flu vaccines [based on the current H5 avian influenza virus] to start from”.Fears Trump cuts could trigger Ebola pandemicProfessor Lawrence Young, a virologist at Warwick University, suggested a range of possibilities: “A new version of flu, the impact of climate change in spreading otherwise rare infections in the West such as Ebola, or something completely new that flips from animals into humans.
”There are fears that President Trump’s cuts to US foreign aid budgets could help foster the conditions for a new pandemic, for example by hitting programmes that screen for Ebola in Africa.There are concerns that the rise of misinformation – in the US, the UK and around the world could make it harder to tackle the next pandemic (Photo: Patrick Meinhardt/Getty)And there are concerns that the rise of misinformation – in the US, the UK and around the world – could make it harder to tackle the next pandemic when it does arrive, with experts saying there has been a noticeable increase in this even since Covid.“Misinformation is rife and it will only get worse.
No doubt there will be vaccine hesitancy to any new pandemic vaccines,” said Simon Williams, a behavioural scientist and public health expert at Swansea University.if(window.adverts) { window.
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adverts.addToArray({"pos": "mpu_tablet_l4"}); }‘I’m worried about fatigue. We haven’t got over Covid’“And if it’s something that happens in the not-too-distant future, I’m worried about fatigue.
I think as a society we have largely forgotten, but not recovered from, the pandemic and its effects on our lives.“I think it drained us in many ways – both in terms of the direct and indirect effects and the strains that were placed on the NHS. I don’t think the healthcare system could handle a pandemic anytime soon.
”And, as Professor Paul Hunter, who specialises in medical protection at the University of East Anglia, points out: “We are still far from consensus on non-pharmaceutical interventions such as lockdowns, school closures, mask wearing, air treatment, travel controls, self-isolation and quarantine. “This has not been helped by many taking fairly entrenched views and then judging research quality primarily on whether or not a study confirms their prior belief.”‘If children are at risk people will accept a new lockdown’Boris Johnson has told how he was “full of astonishment and regret” at having to place the UK into the first-ever nationwide lockdown of its kind, going against “the freedom-loving instincts of the British people”.
And the general consensus among scientists is that lockdowns should not be undertaken lightly. But when a disease is severe and there are no effective vaccines or treatments there may be no option about having to do it again.Professor Paul Hunter said: “Whether lockdowns would be implemented in any future pandemic will depend on the nature of infection, how and how rapidly it’s spread, how lethal it is or how likely it is to lead to severe disability and whether lockdown would actually work.
”Professor Christina Pagel, of University College London believes that in the right circumstances people would accept another one.“Regardless of what people say now, if hospitals were overflowing and there were people dying all over the place, or if there was a disease that primarily affected children, or one that had rapid and nasty effects like bleeding out of your eyes and nose – then I’m pretty sure people would accept a lockdown,” she told The i Paper.“But if we planned better and started protective measures very early, we should be able to avoid a lockdown.
”Ultimately, however, Dr Williams hopes that there is something essential in humanity that ensures we would pull out the stops when the next pandemic hits.“Looking back, it’s remarkable how many people were willing to sacrifice so much for so long, in order to protect themselves and others, including strangers, from Covid.“We learned that most people were ultimately willing to follow guidance and rules and so, while there are some reasons to believe people wouldn’t be as willing to follow and trust rules and health authorities ‘next time’, my best guess is that people would do it again if they really needed to.
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