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Escaping the ‘Era of Pandemics’: Experts warn worse crises to come options offered to reduce risk

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Future pandemics will emerge more often, spread more rapidly, do more damage to the world economy and kill more people than COVID-19 unless there is a transformative change in the global approach to dealing with infectious diseases, warns a major new report on biodiversity and pandemics by 22 leading experts from around the world. 

Convened by the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) for an urgent virtual workshop about the links between degradation of nature and increasing pandemic risks, the experts agree that escaping the era of pandemics is possible, but that this will require a seismic shift in approach from reaction to prevention.

COVID-19 is at least the sixth global health pandemic since the Great Influenza Pandemic of 1918, and although it has its origins in microbes carried by animals, like all pandemics its emergence has been entirely driven by human activities, says the report released on Thursday. It is estimated that another 1.7 million currently ‘undiscovered’ viruses exist in mammals and birds – of which up to 850,000 could have the ability to infect people.

“There is no great mystery about the cause of the COVID-19 pandemic – or of any modern pandemic”, said Dr. Peter Daszak, President of EcoHealth Alliance and Chair of the IPBES workshop. “The same human activities that drive climate change and biodiversity loss also drive pandemic risk through their impacts on our environment. Changes in the way we use land; the expansion and intensification of agriculture; and unsustainable trade, production and consumption disrupt nature and increase contact between wildlife, livestock, pathogens and people. This is the path to pandemics.” 

Pandemic risk can be significantly lowered by reducing the human activities that drive the loss of biodiversity, by greater conservation of protected areas, and through measures that reduce unsustainable exploitation of high biodiversity regions. This will reduce wildlife-livestock-human contact and help prevent the spillover of new diseases, says the report. 

“The overwhelming scientific evidence points to a very positive conclusion,” said Dr. Daszak. “We have the increasing ability to prevent pandemics – but the way we are tackling them right now largely ignores that ability. Our approach has effectively stagnated – we still rely on attempts to contain and control diseases after they emerge, through vaccines and therapeutics. We can escape the era of pandemics, but this requires a much greater focus on prevention in addition to reaction.” 

“The fact that human activity has been able to so fundamentally change our natural environment need not always be a negative outcome. It also provides convincing proof of our power to drive the change needed to reduce the risk of future pandemics – while simultaneously benefiting conservation and reducing climate change.” 

 The report says that relying on responses to diseases after their emergence, such as public health measures and technological solutions, in particular the rapid design and distribution of new vaccines and therapeutics, is a “slow and uncertain path”, underscoring both the widespread human suffering and the tens of billions of dollars in annual economic damage to the global economy of reacting to pandemics. 

Pointing to the likely cost of COVID-19 of $8-16 trillion globally by July 2020, it is further estimated that costs in the United States alone may reach as high as $16 trillion by the 4th quarter of 2021. The experts estimate the cost of reducing risks to prevent pandemics to be 100 times less than the cost of responding to such pandemics, “providing strong economic incentives for transformative change.”

The report also offers a number of policy options that would help to reduce and address pandemic risk. Among these are: 

  • Launching a high-level intergovernmental council on pandemic prevention to provide decision-makers with the best science and evidence on emerging diseases; predict high-risk areas; evaluate the economic impact of potential pandemics and to highlight research gaps. Such a council could also coordinate the design of a global monitoring framework.
  • Countries setting mutually-agreed goals or targets within the framework of an international accord or agreement – with clear benefits for people, animals and the environment.
  • Institutionalizing the ‘One Health’ approach in national governments to build pandemic preparedness, enhance pandemic prevention programs, and to investigate and control outbreaks across sectors.
  • Developing and incorporating pandemic and emerging disease risk health impact assessments in major development and land-use projects, while reforming financial aid for land-use so that benefits and risks to biodiversity and health are recognized and explicitly targeted.
  • Ensuring that the economic cost of pandemics is factored into consumption, production, and government policies and budgets.
  • Enabling changes to reduce the types of consumption, globalized agricultural expansion and trade that have led to pandemics – this could include taxes or levies on meat consumption, livestock production and other forms of high pandemic-risk activities.
  • Reducing zoonotic disease risks in the international wildlife trade through a new intergovernmental ‘health and trade’ partnership; reducing or removing high disease-risk species in the wildlife trade; enhancing law enforcement in all aspects of the illegal wildlife trade and improving community education in disease hotspots about the health risks of wildlife trade.
  • Valuing Indigenous Peoples and local communities’ engagement and knowledge in pandemic prevention programs, achieving greater food security, and reducing consumption of wildlife.
  • Closing critical knowledge gaps such as those about key risk behaviors, the relative importance of illegal, unregulated, and the legal and regulated wildlife trade in disease risk, and improving understanding of the relationship between ecosystem degradation and restoration, landscape structure and the risk of disease emergence.

Speaking about the workshop report, Dr. Anne Larigauderie, Executive Secretary of IPBES said: “The COVID-19 pandemic has highlighted the importance of science and expertise to inform policy and decision-making. Although it is not one of the typical IPBES intergovernmental assessments reports, this is an extraordinary peer reviewed expert publication, representing the perspectives of some of the world’s leading scientists, with the most up-to-date evidence and produced under significant time constraints.”

“We congratulate Dr. Daszak and the other authors of this workshop report and thank them for this vital contribution to our understanding of the emergence of pandemics and options for controlling and preventing future outbreaks. This will inform a number of IPBES assessments already underway, in addition to offering decision-makers new insights into pandemic risk reduction and options for prevention” she added.

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Delta variant, a warning the COVID-19 virus is getting ‘fitter and faster’

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Cases and deaths resulting from COVID-19 continue to climb worldwide, mostly fuelled by the highly transmissible Delta variant, which has spread to 132 countries, said the head of the World Health Organization (WHO) on Friday.

Almost 4 million cases worldwide were reported last week to WHO and the agency expects the total number of cases to pass 200 million, in the next two weeks.

“And we know this is an underestimate”, underscored Director-General Tedros Adhanom Gebreyesus during his regular COVID-19 briefing.

Infections have increased in every region of the world, with some even reaching 80 per cent more in the past month. In Africa, deaths have increased by 80 per cent over the same period, the official warned.

Overwhelmed

Tedros blamed the rise of cases on increased social mixing and mobility, the inconsistent use of public health and social measures, and inequitable vaccine use. He said “hard-won gains” are in jeopardy or being lost, and health systems in many countries are increasingly overwhelmed.

“WHO has warned that the COVID-19 virus has been changing since it was first reported, and it continues to change. So far, four variants of concern have emerged, and there will be more as long as the virus continues to spread”, he underscored.

A higher viral load

Lead WHO epidemiologist and COVID-19 technical lead, Dr. Maria Van Kerkhove, explained that the Delta variant has certain mutations that allow the virus to adhere to human cells more easily and that experts are also seeing a higher viral load in individuals infected.

She called Delta “dangerous and the most transmissible SARS-CoV-2 virus to date”. 

“There are some laboratory studies that suggest that there’s increase replication in some of the modelled human airway systems”, she added.

In terms of severity, Dr. Van Kerkhove highlighted that there has been an increase in hospitalizations in certain countries affected by the variant, “but we haven’t yet seen an increase in mortality”.

The WHO expert reminded that although there is some data that suggest that people vaccinated can get infected and transmit the variant, the likelihood is much reduced after the second dose has been administered and reached full effectiveness.

She also clarified that Delta is not specifically targeting children as some reports have suggested, but warned that as long as the variants are circulating, they will infect anybody that is not taking proper precautions.

Continuing to evolve

“It’s in the virus’s interests to evolve, viruses are not alive they don’t have a brain to think through this, but they become more fit the more they circulate, so the virus will likely become even more transmissible because this is what viruses do, they evolve they change overtime”, Dr. Van Kerkhove warned, echoing Tedros’ remarks.

We have to do what we can to drive it down”, she added, reminding that public health and social measures do work against the Delta variant, and that the vaccines do prevent disease and death.

Dr. Michael Ryan, Executive Director of WHO Health Emergencies, said that even with the virus getting “faster and fitter” the gameplan does not change, but It needs to be implemented more efficiently.

“Delta is a warning that this virus is evolving, but it is also a call to action before more dangerous variants emerge”, he said.

Shots for Africa

Last month, the WHO chief announced the setting up of a technology transfer hub for mRNA vaccines In South Africa as part of WHO’s efforts to scale up production of vaccines and their distribution in Africa.

“Today we have taken another step forward, with a letter of intent that sets out the terms of collaboration signed by the partners in the hub: WHO; the Medicines Patent Pool; Afrigen Biologics; the Biologicals and Vaccines Institute of Southern Africa; the South African Medical Research Council and the Africa Centres for Disease Control and Prevention”, Tedros explained.

He added that WHO’s goal remains to aid every country in vaccinating at least 10% of its population by the end of September, at least 40% by the end of this year, and 70% by the middle of next year.

“We are a long way off achieving those targets. So far, just over half of countries have fully vaccinated 10% of their population, less than a quarter of countries have vaccinated 40%, and only 3 countries have vaccinated 70%”, Tedros warned.

The WHO head reminded that the global distribution of vaccines remains unjust, despite expert warnings and appeals, and said that all regions remain at risk, “none more so, than Africa”.

“On current trends, nearly 70% of African countries will not reach the 10% vaccination target by the end of September”, he cautioned.

New tool to fight Delta

Tedros also announced that on response to the Delta surge, the WHO’s Access to COVID-19 Tools Accelerator is launching the Rapid ACT-Accelerator Delta Response, or RADAR, and issuing an urgent call for 7.7 billion U.S. dollars for tests, treatments and vaccines. 

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COVAX and World Bank to Accelerate Vaccine Access for Developing Countries

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COVAX and the World Bank will accelerate COVID-19 vaccine supply for developing countries through a new financing mechanism that builds on Gavi’s newly designed AMC cost-sharing arrangement. This allows AMC countries to purchase doses beyond the fully donor-subsidized doses they are already receiving from COVAX.

COVAX will now be able to make advance purchases from vaccine manufacturers based on aggregated demand across countries, using financing from the World Bank and other multilateral development banks. Participating developing countries will have greater visibility of available vaccines, quantities available, and future delivery schedules, enabling them to secure doses earlier, and prepare and implement vaccination plans more effectively.

This important and timely financing mechanism, made possible now by the World Bank and Gavi teaming up on the AMC cost-sharing arrangement, will allow COVAX to unlock additional doses for low- and middle-income countries,” said Dr. Seth Berkley, CEO, Gavi, the Vaccine Alliance. “As we move beyond initial targets and work to support countries’ efforts to protect increasingly large portions of their populations, World Bank financing will help us advance further towards our goal of bringing COVID-19 under control.”

The scalable mechanism brings together COVAX’s ability to negotiate advance purchase agreements with vaccine manufacturers with the World Bank’s ability to provide predictable financing to countries for vaccine purchase, deployment and broader health systems investments. The new mechanism will mitigate risks and uncertainties in country demand and financing ability.

Accessing vaccines remains the single greatest challenge that developing countries face in protecting their people from the health, social, and economic impacts of the COVID-19 pandemic,” said World Bank Group President David Malpass. “This mechanism will enable new supplies and allow countries to speed up the purchase of vaccines. It will also provide transparency about vaccine availability, prices, and delivery schedules. This is crucial information as governments implement their vaccination plans.”

Countries with approved World Bank vaccine projects that confirm the purchase of additional doses through COVAX will agree with COVAX on the number of doses of a specific vaccine as well as related windows of delivery. On receiving a request from the country, the World Bank will provide COVAX a payment confirmation, allowing COVAX to make advance purchases of large amounts of vaccine doses with manufacturers at competitive prices.

Under the cost-sharing arrangement for AMC countries (92 low- and middle-income countries), COVAX plans to make available up to 430 million additional doses, or enough to fully vaccinate 250 million people, for delivery between late 2021 and mid-2022. There will be several supply offerings where countries will have the opportunity to select and commit to procuring specific vaccines that align with their preferences.

COVAX is co-led by the Coalition for Epidemic Preparedness Innovations (CEPI), Gavi, the Vaccine Alliance and the World Health Organization (WHO). The World Bank and COVAX will work in partnership with UNICEF and the PAHO Revolving Fund as key implementing partners to ensure safe vaccine delivery and supply of materials such as syringes, safety boxes and other items essential for vaccination campaigns.

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Study Finds That India Might Have Half Of All Covid-19 Deaths Worldwide

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On July 20th, an analysis that was published of India’s “excess mortality estimates from three different data sources from the pandemic’s start through June 2021 … yields an estimate of 4.9 million excess deaths.” As-of July 20th, the total number of deaths that had been officially reported worldwide from Covid-19 was 4,115,391, and only 414,513 (10%) of those were in India. If this new study is correct, then the possibility exists that around half of all deaths that have occurred, thus far, from Covid-19, could be in India, not merely the currently existing 10% that’s shown in the official figures.

This study doesn’t discuss why the actual number of deaths in India from Covid-19 might be around ten times higher than the official Indian figures, but one reason might be a false attribution of India’s greatly increased death-rate from the Covid-19 epidemic not to Covid-19 but to other causes, such as to Covid-19-related illnesses.

The new study is titled “Three New Estimates of India’s All-Cause Excess Mortality during the COVID-19 Pandemic”, and the detailed version of it can be downloaded here.   The study was funded by U.S.-and-allied billionaires and their foundations and corporations, and by governments that those billionaires also might control. However, this doesn’t necessarily mean that its methodology is in any way unscientific or otherwise dubious. The study raises serious questions — it does not, in and of itself, answer any. It’s a serious scientific study.

On 1 August 2020, I headlined “India and Brazil Are Now the Global Worst Coronavirus Nations”, and reported that, “India and Brazil have now overtaken the United States as the world’s worst performers at controlling the cononavirus-19 plague. The chart of the numbers of daily new cases in India shows the daily count soaring more than in any other country except Brazil, whereas in the United States, the daily number of new cases has plateaued ever since it hit 72,278 on July 10th, three weeks ago.” At that time, there was great pressure upon India’s Government to stop the alarming acceleration in the daily numbers of people who were officially counted as being patients (active cases) from the disease, and of dying from it. One way that a government can deal with such pressures is by mis-classifying cases, and deaths, from a disease, as being due to other causes, instead.

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