Pandemic prevention

Pandemic prevention is the organization and management of preventive measures against pandemics. Those include measures to reduce causes of new infectious diseases and measures to prevent outbreaks and epidemics from becoming pandemics.

It is not to be mistaken for pandemic preparedness or mitigation which largely seek to mitigate the magnitude of negative effects of pandemics, although the topics may overlap with pandemic prevention in some respects.

HistoryEdit

2002–2004 SARS outbreakEdit

During the 2002–2004 SARS outbreak, the SARS-CoV-1 virus was prevented from causing a pandemic of Severe acute respiratory syndrome (SARS). Rapid action by national and international health authorities such as the World Health Organization helped to slow transmission and eventually broke the chain of transmission, which ended the localized epidemics before they could become a pandemic. Human-to-human transmission of SARS may be considered eradicated, however, it could re-emerge as SARS-CoV-1 probably persists as a potential zoonotic threat in its original animal reservoir.[1][2] This warrants monitoring and reporting of suspicious cases of atypical pneumonia.[3] Effective isolation of patients was enough to control spread because infected individuals usually do not transmit the virus until several days after symptoms begin and are most infectious only after developing severe symptoms.[4]

MeasuresEdit

Infrastructure and international developmentEdit

Robust, collaborating public health systems that have the capacity for active surveillance for early detection of cases and to mobilize their health care coordination capacity may be required to be able stop contagion promptly.[5][6][7] After an outbreak there is a certain window of time during which a pandemic can still be stopped by the competent authorities isolating the first infected and/or fighting the pathogen. A good global infrastructure, consequent information exchange, minimal delays due to bureaucracy and effective, targeted treatment measures can be prepared.[8] 2012 it has been proposed to consider pandemic prevention as an aspect of international development in terms of health-care infrastructure and changes to the pathogen-related dynamics between humans and their environment including animals.[9] Often local authority carers or doctors in Africa, Asia or Latin America register uncommon accumulations (or clusterings) of symptoms but lack options for more detailed investigations.[10] Scientists state that "research relevant to countries with weaker surveillance, lab facilities and health systems should be prioritized" and that "in those regions, vaccine supply routes should not rely on refrigeration, and diagnostics should be available at the point of care".[11]

TechnologiesEdit

Pathogen detection and predictionEdit

In a 2012 study it is claimed that "new mathematical modelling, diagnostic, communications, and informatics technologies can identify and report hitherto unknown microbes in other species, and thus new risk assessment approaches are needed to identify microbes most likely to cause human disease". The study investigates challenges in moving the global pandemic strategy from response to pre-emption.[12] Some scientists are screening blood samples from wildlife for new viruses.[13] The international Global Virome Project (GVP) aims to identify the causes of fatal new diseases before emergence in human hosts by genetically characterizing viruses found in wild animals.[14] The project aims to enlist an international network of scientists to collect hundreds of thousands of viruses, map their genomes, characterize and risk-stratify them to identify which ones to pay attention to. However, some infectious disease experts have criticized the project as too broad and expensive due to limited global scientific and financial resources and because only a small percentage of the world's zoonotic viruses may cross into humans and pose a threat. They argue for prioritizing rapidly detecting diseases when they cross into humans and an improving the understanding of their mechanisms.[15] A successful prevention of a pandemic from specific viruses may also require ensuring that it does not re-emerge – for instance by sustaining itself in domestic animals.[16]

Pathogen detection mechanisms may allow the construction of an early warning system which could make use of artificial intelligence surveillance and outbreak investigation.[7] Edward Rubin notes that after sufficient data has been gathered artificial intelligence could be used to identify common features and develop countermeasures and vaccines against whole categories of viruses.[14] It might be possible to predict viral evolution using machine learning.[17] In April 2020 it was reported that researchers developed a predictive algorithm which can show in visualizations how combinations of genetic mutations can make proteins highly effective or ineffective in organisms – including for viral evolution for viruses like SARS-CoV-2.[18][19] An artificial "global immune system"-like technological system that includes pathogen detection may be able to substantially reduce the time required to take on a biothreat agent.[20] A system of that sort would also include a network of well-trained epidemiologists who could be rapidly deployed to investigate and contain an outbreak.[7]

Funding for the United States' PREDICT government research program that sought to identify animal pathogens that might infect humans and to prevent new pandemics was cut in 2019.[21] Funding for United States' CDC programs that trained workers in outbreak detection and strengthened laboratory and emergency response systems in countries where disease risks are greatest to stop outbreaks at the source was cut by 80% in 2018.[22]

Despite recent advances in pandemic modeling, experts using mostly experience and intuition are still more accurate in predicting the spread of disease than strictly mathematical models.[23]

CRISPR-based immune subsystemsEdit

In March 2020 scientists of Stanford University presented a CRISPR-based system, called PAC-MAN (Prophylactic Antiviral Crispr in huMAN cells), that can find and destroy viruses in vitro. However, they weren't able to test PAC-MAN on the actual SARS-CoV-2, use a targeting-mechanism that uses only a very limited RNA-region, haven't developed a system to deliver it into human cells and would need a lot of time until another version of it or a potential successor system might pass clinical trials. In the study published as a preprint they write that it could be used prophylactically as well as therapeutically. The CRISPR-Cas13d-based system could be agnostic to which virus it's fighting so novel viruses would only require a small change.[24][25] In an editorial published in February 2020 another group of scientists claimed that they have implemented a flexible and efficient approach for targeting RNA with CRISPR-Cas13d which they have put under review and propose that the system can be used to also target SARS-CoV-2 in specific.[26] There have also been earlier successful efforts in fighting viruses with CRISPR-based technology in human cells.[27][28] In March 2020 researchers reported that they have developed a new kind of CRISPR-Cas13d screening platform for effective guide RNA design to target RNA. They used their model to predict optimized Cas13 guide RNAs for all protein-coding RNA-transcripts of the human genome's DNA. Their technology could be used in molecular biology and in medical applications such as for better targeting of virus RNA or human RNA. Targeting human RNA after it's been transcribed from DNA, rather than DNA, would allow for more temporary effects than permanent changes to human genomes. The technology is made available to researchers through an interactive website and free and open source software and is accompanied by a guide on how to create guide RNAs to target the SARS-CoV-2 RNA genome.[29][30]

Scientists report to be able to identify the genomic pathogen signature of all 29 different SARS-CoV-2 RNA sequences available to them using machine learning and a dataset of 5000 unique viral genomic sequences. They suggest that their approach can be used as a reliable real-time option for taxonomic classification of novel pathogens.[31][32]

Testing and containmentEdit

 
A SARS-CoV-2 laboratory test kit by the CDC

Timely use and development of quick testing systems for novel virus in combination with other measures might make it possible to end transmission lines of outbreaks before they become pandemics.[33][34][35][additional citation(s) needed] A high discovery-rate is important for tests. For instance this is the reason why no thermal scanners with a low discovery-rate were used in airports for containment during the 2009 swine flu pandemic.[36] The German program InfectControl 2020 seeks to develop strategies for prevention, early recognition and control of infectious diseases.[37][38] In one of its projects "HyFly" partners of industry and research work on strategies to contain chains of transmission in air traffic, to establish preventive countermeasures and to create concrete recommendations for actions of airport operators and airline companies. One approach of the project is to detect infections without molecular-biological methods during passenger screening. For this researchers of the Fraunhofer-Institut for cell therapy and immunology are developing a non-invasive procedure based on ion-mobility spectrometry (IMS).[39]

Surveillance and mappingEdit

Monitoring people who are exposed to animals in viral hotspots – including via virus monitoring stations – can register viruses at the moment they enter human populations - this might enable prevention of pandemics.[40] The most important transmission pathways often vary per underlying driver of emerging infectious diseases such as the vector-borne pathway and direct animal contact for land-use change – the leading driver for emerging zoonoses by number of emergence events as defined by Jones et al. (2008).[41] 75% of the reviewed 1415 species of infectious organisms known to be pathogenic to humans account for zoonoses by 2001.[42][43] Genomics could be used to precisely monitor virus evolution and transmission in real time across large, diverse populations by combining pathogen genomics with data about host genetics and about the unique transcriptional signature of infection.[44] The "Surveillance, Outbreak Response Management and Analysis System" (SORMAS) of the German Helmholtz-Zentrum für Infektionsforschung (HZI) and Deutsches Zentrum für Infektionsforschung (DZIF), who collaborate with Nigerian researchers, gathers and analyzes data during an outbreak, detects potential threats and allows to initiate protective measures early. It's meant specifically for poorer regions and has been used for the fight against a monkeypox outbreak in Nigeria.[45][46]

Expert on infectious diseases at the Johns Hopkins University Center for Health Security Amesh Adalja states that the most immediate way to predict a pandemic is with deeper surveillance of symptoms that fit the virus' profile.[15] The scientific and technological ways of quickly detecting a spillover could be improved so that an outbreak can be isolated before it becomes an epidemic or pandemic.[47] David Quammen states that he heard about the idea to develop technology to screen people at airport security points for whether or not they carry an infectious disease ten years ago and thought it was going to be done by now.[47] US health technology firm Kinsa developed and uses Internet-connected smart thermometers and medical guidance apps to plot and map unusual fever levels to detect anomalous outbreaks. The company's CEO claims that the system is the only effective early-warning system for COVID-19 spread.

Positive, negative, and neutral mutations of the evolution of coronaviruses like SARS-CoV-2.

In December 2020 during the COVID-19 pandemic national and international officials reported mutated variants of SARS-CoV-2, including some with higher transmissibility and worldwide spread. While mutations are common for viruses and the spread of some of the virus' mutations have been tracked earlier, mutations that make it more transmittable or severe can be problematic. Resources for disease surveillance have improved during the pandemic so that medical systems around the world are starting to be equipped to detect such mutations with genomic surveillance in a manner relevant to pandemic mitigation and the prevention of sub-pandemics of specific variants or types of variants. As of December 2020 contemporary measures such as COVID-19 vaccines and medications seem to be effective in the treatment of infections with the tracked mutated variants.[48][49][50]

Policy and economicsEdit

A 2014 analysis asserts that "the window of opportunity to deal with pandemics as a global community is within the next 27 years. Pandemic prevention therefore should be a critical health policy issue for the current generation of scientists and policymakers to address.[51] A 2007 study warns that "the presence of a large reservoir of SARS-CoV-like viruses in horseshoe bats, together with the culture of eating exotic mammals in southern China, is a time bomb. The possibility of the reemergence of SARS and other novel viruses from animals or laboratories and therefore the need for preparedness should not be ignored".[52][42] The US' National Security Council Directorate for Global Health Security and Biodefense, which worked on preparing for the next disease outbreak and preventing it from becoming an epidemic or pandemic, was closed in 2018.[53][54]

Environmental policy and economicsEdit

Some experts link pandemic prevention with environmental policy and caution that environmental destruction as well as climate change drives wildlife to live close to people.[42][55] For instance the WHO projects that climate change will also affect infectious disease occurrence.[56] A 2016 study reviews literature on the evidences for the impact of climate change on human infectious disease, suggests a number of proactive measures for controlling health impacts of climate change and finds that climate change impacts human infectious disease via alterations to pathogen, host and transmission.[57] Studies have shown that the risk of disease outbreaks can increase substantially after forests are cleared.[58][59][60][61] According to Kate Jones, chair of ecology and biodiversity at University College London, the disruption of pristine forests driven by logging, mining, road building through remote places, rapid urbanisation and population growth is bringing people into closer contact with animal species they may never have been near before, resulting in transmission of diseases from wildlife to humans.[62] An August 2020 study published in Nature concludes that the anthropogenic destruction of ecosystems for the purpose of expanding agriculture and human settlements reduces biodiversity and allows for smaller animals such as bats and rats, who are more adaptable to human pressures and also carry the most zoonotic diseases, to proliferate. This in turn can result in more pandemics.[63] In October 2020, the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services published its report on the 'era of pandemics' by 22 experts in a variety of fields, and concluded that anthropogenic destruction of biodiversity is paving the way to the pandemic era, and could result in as many as 850,000 viruses being transmitted from animals – in particular birds and mammals – to humans. The increased pressure on ecosystems is being driven by the "exponential rise" in consumption and trade of commodities such as meat, palm oil, and metals, largely facilitated by developed nations, and by a growing human population. According to Peter Daszak, the chair of the group who produced the report, "there is no great mystery about the cause of the Covid-19 pandemic, or of any modern pandemic. The same human activities that drive climate change and biodiversity loss also drive pandemic risk through their impacts on our environment."[64]

Stanford biological anthropologist James Holland Jones notes that humanity has "engineer[ed] a world where emerging infectious diseases are both more likely and more likely to be consequential", referring to the modern world's prevalent highly mobile lifestyles, increasingly dense cities, various kinds of human interactions with wildlife and alterations of the natural world.[65] Furthermore, when multiple species that are not usually next to each other are driven to live closely together new diseases may emerge.[16] Research shows that abundant animals, plants, insects, and microbes living in complex, mature ecosystems can limit the spread of disease from animals to people.[66] The United Nations is formulating nature-focused action plans that could help to stop the next pandemic before it starts. These strategies include conserving ecosystems and wilderness that are still untouched by human activity, and restoring and protecting significant areas of land and ocean (i.e. through protected areas).[67][additional citation(s) needed] Protected areas (which may hold wildlife) also limits human presence and/or limits the exploitation of resources (including non-timber forest products such as game animals, fur-bearers, ...).[68] An article by the World Economic Forum states that studies have shown that deforestation and loss of wildlife cause increases in infectious diseases and concludes that the recovery from the COVID-19 pandemic should be linked to nature recovery, which it considers economically beneficial.[69]

A report by FAIRR global investor network found that more than 70% of the biggest meat, fish and dairy producers were in danger of fostering future zoonotic pandemics due to lax safety standards, closely confined animals and the overuse of antibiotics.[70] Some have recommended food system-change, behaviour change,[16] different lifestyle choices and altered consumer spending including moving away from factory farming and towards more plant-based diets.[70][47][71] Some traditional medicines (i.e. traditional African medicine, TCM) still use animal-based substances. Since these can trigger zoonosis,[72] a possible prevention could be changes to handbooks for practitioners of such traditional medicines (i.e. exclusion of animal-based substances). Senior adviser and veterinary epidemiologist at the National Food Institute at the Technical University of Denmark Ellis-Iversen states that in agricultural animal health "outbreaks of exotic disease in well-regulated countries rarely get big because we identify and control them right away".[16] New York City's Bronx Zoo's head veterinarian Paul Calle states that usually emerging infectious diseases from animals are the result from wildlife consumption and distribution on a commercial scale rather than a lone person hunting to feed their family.[16][additional citation(s) needed]

Dennis Caroll of the Global Virome Project states that the "extractive industry — oil and gas and minerals, and the expansion of agriculture, especially cattle" are the biggest predictors of where spillovers can be seen.[15]

Data on current causes of emerging diseasesEdit

A study which was published in April 2020 and is part of the PREDICT program found that "virus transmission risk has been highest from animal species that have increased in abundance and even expanded their range by adapting to human-dominated landscapes", identifying domesticated species, primates and bats as having more zoonotic viruses than other species and "provide further evidence that exploitation, as well as anthropogenic activities that have caused losses in wildlife habitat quality, have increased opportunities for animal–human interactions and facilitated zoonotic disease transmission".[73]

An UN Environment report presents the causes of the emerging diseases with a large share being environmental:[74]

Cause Part of emerging diseases caused by it (%)
Land-use change 31%
Agricultural industry changes 15%
International travel and commerce 13%
Medical industry changes 11%
War and Famine 7%
Climate and Weather 6%
Human demography and behavior 4%
Breakdown of public health 3%
Bushmeat 3%
Food industry change 2%
Other 4%

The report also lists some of the latest emerging diseases and their environmental causes:[74]

Disease Environmental cause
Rabies Forest activities in South America
Bat associated viruses Deforestation and Agricultural expansion
Lyme disease Forest fragmentation in North America
Nipah virus infection Pig farming and intensification of fruit production in Malaysia
Japanese encephalitis virus irrigated rice production and pig farming in Southeast Asia
Ebola virus disease Forest losses
Avian influenza Intensive Poultry farming
SARS virus contact with civet cats either in the wild or in live animal markets

According to a 2001 study and its criteria a total of 1415 species of infectious agents in 472 different genera have been reported to date to cause disease in humans. Out of these reviewed emerging pathogen species 75% are zoonotic. A total of 175 species of infectious agents from 96 different genera are associated with emerging diseases according its criteria. Some of these pathogens can be transmitted by more than one route. Data on 19 categories of the 26 categories which contained more than 10 species includes:[43][relevant?]

Transmission route Zoonotic status Taxonomic division Total number of species Number of emerging species Proportion of species emerging
indirect contact zoonotic viruses 37 17 0.459
indirect contact zoonotic protozoa 14 6 0.429
direct contact zoonotic viruses 63 26 0.413
direct contact non-zoonotic protozoa 15 6 0.400
indirect contact non-zoonotic viruses 13 4 0.308
direct contact non-zoonotic viruses 47 14 0.298
vector borne zoonotic viruses 99 29 0.293
vector borne zoonotic bacteria 40 9 0.225
indirect contact zoonotic bacteria 143 31 0.217
vector borne zoonotic protozoa 26 5 0.192
direct contact zoonotic bacteria 130 20 0.154
indirect contact zoonotic fungi 85 11 0.129
direct contact zoonotic fungi 105 13 0.124
vector borne zoonotic helminths 23 2 0.087
direct contact non-zoonotic bacteria 125 7 0.056
indirect contact non-zoonotic bacteria 63 3 0.048
indirect contact non-zoonotic fungi 120 3 0.025
direct contact non-zoonotic fungi 123 3 0.024
indirect contact zoonotic helminths 250 6 0.024

Biotechnology research and development regulationEdit

Toby Ord, author of the book The Precipice: Existential Risk and the Future of Humanity which addresses this issue, puts into question whether current public health and international conventions, and self-regulation by biotechnology companies and scientists are adequate.[75][76]

In the context of the 2019–2020 coronavirus pandemic Neal Baer writes that the "public, scientists, lawmakers, and others" "need to have thoughtful conversations about gene editing now".[77] Ensuring the biosafety level of laboratories may also be an important component of pandemic prevention. This issue may have gotten additional attention in 2020 after news outlets reported that U.S. State Department cables indicate that, although there may be no conclusive proof at the moment, the COVID-19 virus responsible for the COVID-19 pandemic may, possibly, have accidentally come from a Wuhan (China) laboratory, studying bat coronaviruses that included modifying virus genomes to enter human cells,[78][79] and determined to be unsafe by U.S. scientists in 2018, rather than from a natural source.[80][81][82] As of 18 May 2020, an official UN investigation into the origins of the COVID-19 virus, supported by over 120 countries, was being considered.[83] United States' president Donald Trump claimed to have seen evidence that gave him a "high degree of confidence" that the novel coronavirus originated in the Chinese laboratory but did not offer any evidence, data or details, contradicted statements by the United States' intelligence community and garnered a lot of harsh criticism and doubts.[84] As of 5 May, assessments and internal sources from the Five Eyes nations indicated that the coronavirus outbreak being the result of a laboratory accident was "highly unlikely", since the human infection was "highly likely" a result of natural human and animal interaction.[85] Many others have also criticized statements by US government officials and theories of laboratory release. Virologist and immunologist Vincent R. Racaniello said that "accident theories – and the lab-made theories before them – reflect a lack of understanding of the genetic make-up of Sars-CoV-2."[86] Virologist Peter Daszak states that an estimated 1–7 million people in Southeast Asia who live or work in proximity to bats are infected each year with bat coronaviruses.[87]

Martin Rees, author of the book Our Final Hour which also addresses this issue, states that while better understanding of viruses may allow for an improved capability to develop vaccines it may also lead to an increase in "the spread of 'dangerous knowledge' that would enable mavericks to make viruses more virulent and transmissible than they naturally are".[88] Different accelerations and priorizations of research may however be critical to pandemic prevention. A multitude of factors shape which knowledge about viruses with different use-cases, including vaccine-development, can be used by whom.[citation needed] Rees also states that "the global village will have its village idiots, and they will have global range".[89]

Food markets and wild animal tradeEdit

 
Fowl cages at wet market in Shenzhen, China

In January 2020 during the SARS-CoV 2 outbreak experts in and outside China warned that wild animal markets, where the virus originated from, should be banned worldwide.[42][90] On January 26 China banned the trade of wild animals until the end of the coronavirus epidemic at the time.[91] On February 24 China announced a permanent ban on wildlife trade and consumption with some exceptions.[92] Some scientists point out that banning informal wet markets worldwide isn't the appropriate solution as fridges aren't available in many places and because much of the food for Africa and Asia is provided through such traditional markets. Some also caution that simple bans may force traders underground, where they may pay less attention to hygiene and some state that it's wild animals rather than farmed animals that are the natural hosts of many viruses.[15][16][55] UN biodiversity chief, bipartisan lawmakers and experts have called for a global ban of wetmarkets and wildlife trade.[93][94][95] Jonathan Kolby cautions about the risks and vulnerabilities present in the massive legal wildlife trade.[96]

International coordinationEdit

The Global Health Security Agenda (GHSA) a network of countries, international organizations, NGOs and companies that aim to improve the world's ability to prevent, detect, and respond to infectious diseases. Sixty-seven countries have signed onto the GHSA framework.[97][98] Funding for the GHSA has been reduced since the launch in 2014, both in the US and globally.[53] In a 2018 lecture in Boston Bill Gates called for a global effort to build a comprehensive pandemic preparedness and response system.[99][100] During the COVID-19 pandemic he called upon world leaders to "take what has been learned from this tragedy and invest in systems to prevent future outbreaks".[20] In a 2015 TED Talk he warned that "if anything kills over 10 million people in the next few decades, it's most likely to be a highly infectious virus rather than a war".[101] Numerous prominent, authoritative, expert or otherwise influential figures have similarly warned about elevated, underprepared or contemporary risks of pandemics and the need for efforts on an "international scale" long before 2015 and since at least 1988.[102][103] Some have provided suggestions for organizational or coordinative preparedness for pandemic prevention including a mechanism by which many major economic powers pay into a global insurance fund which "could compensate a nation for economic losses if it acts quickly to close areas to trade and travel in order to stop a dangerous outbreak at its source"[104][additional citation(s) needed] or, similarly, sovereign or regional-level epidemic-insurance policies.[105] International collaboration including cooperative research and information-sharing has also been considered vital.[20]

According to Senator Dianne Feinstein called for the creation of a new interagency government entity, the Center for Combating Infectious Disease which would combine analytical and operational functions "to oversee all aspects of preventing, detecting, monitoring, and responding to major outbreaks such as coronavirus" and get provided with data and expertise by the Centers for Disease Control and Prevention.[16][106]

John Davenport advises to abandon widespread libertarian ideology which, according to him, "denies the importance of public goods or refuses to recognize their scope".[104] According to the CDC, investing in global health security and improving the organization's ability to prevent, detect, and respond to diseases could protect the health of American citizens as well as avert catastrophic costs.[107] Dennis Carroll argues for a "marriage" between scientific discovery and political decision-making and policy formulation.[15]

Artificial induction of immunity and/or biocidesEdit

Outbreaks could be contained or delayed – to enable other containment-measures – or prevented by artificial induction of immunity and/or biocides in combination with other measures that include prediction or early detection of infectious human diseases.[citation needed]

In a preprint published on March 24, 2020 researchers suggested that the unique transcriptional signature of SARS-CoV-2 in the human immune system may be responsible for the development of COVID-19: SARS-CoV-2 did not induce the antiviral genes that code for type I and type III interferons. This could be relevant for the development or repurposing of treatments.[108]

VaccinationEdit

Development and provision of new vaccines usually takes years.[99] The Coalition for Epidemic Preparedness Innovations, which was launched in 2017, works on reducing the time of vaccine-development.[99] The Global Health Innovative Technology Fund (GHIT) is a public-private partnership fund which involves a national government, a UN agency, a consortium of pharmaceutical and diagnostics companies, and international philanthropic foundations to accelerate the creation of new vaccines, drugs and diagnostic tools for global health.[109][110] It is unclear whether vaccines can play a role in pandemic prevention alongside pandemic mitigation. Nathan Wolfe proposes that pathogen detection and prediction may allow establishing viral libraries before novel epidemics emerge – substantially decreasing the time to develop a new vaccine.[105] Public health surveillance expert and professor at Harvard University, John Brownstein says that "vaccines are still our main weapon".[111] Besides more rapid vaccine development it may also be possible to develop more broader vaccines.[111] Misinformation and misconceptions about vaccines including about their side-effects may be a problem.[111]

AntibodiesEdit

Broad-spectrum antimicrobials and rapid drug development, repurposing and provisioningEdit

CullingEdit

Experts warned that depleting the numbers of species by culling to forestall human infections reduces genetic diversity and thereby puts future generations of the animals as well as people at risk while others contend that it's still the best, practical way to contain a virus of livestock.[112]

Prevention versus mitigationEdit

Pandemic prevention seeks to prevent pandemics while mitigation of pandemics seeks to reduce their severity and negative impacts. Some have called for a shift from a treatment-oriented society to a prevention-oriented one.[113] Authors of a 2010 study write that contemporary "global disease control focuses almost exclusively on responding to pandemics after they have already spread globally" and argue that the "wait-and-respond approach is not sufficient and that the development of systems to prevent novel pandemics before they are established should be considered imperative to human health".[114] Peter Daszak comments on the COVID-19 pandemic, saying "[t]he problem isn't that prevention was impossible, [i]t was very possible. But we didn't do it. Governments thought it was too expensive. Pharmaceutical companies operate for profit". The WHO reportedly had mostly neither the funding nor the power to enforce the large-scale global collaboration necessary to combat it.[115] Nathan Wolfe criticizes that "our current global public health strategies are reminiscent of cardiology in the 1950s when doctors focused solely on responding to heart attacks and ignored the whole idea of prevention".[40]

See alsoEdit

ReferencesEdit

  1. ^ Morens DM, Fauci AS (September 2020). "Emerging Pandemic Diseases: How We Got to COVID-19". Cell. 182 (5): 1077–1092. doi:10.1016/j.cell.2020.08.021. PMC 7428724. PMID 32846157.
  2. ^ Smith R (December 2019). "Did we Eradicate SARS? Lessons Learned and the Way Forward". American Journal of Biomedical Science & Research. 6 (2): 152–155. doi:10.34297/AJBSR.2019.06.001017.
  3. ^ "WHO | SARS outbreak contained worldwide". WHO.
  4. ^ WHO. "SARS: How a global epidemic was stopped" (PDF). Retrieved 25 March 2020.
  5. ^ Group, World Bank (2014). The World Bank Group A to Z 2015. World Bank Publications. p. 119. ISBN 978-1-4648-0382-6. Retrieved 25 March 2020.
  6. ^ Tolliver, Sandy (3 April 2020). "Want to stop pandemics? Strengthen public health systems in poor countries". TheHill. Retrieved 7 June 2020.
  7. ^ a b c Lu, Michael C. "What the world can do to halt future pandemics". Newsday. The Washington Post. Retrieved 5 June 2020.
  8. ^ Sterzel, Eva (2006). "Pandemie-Prävention: Im Ernstfall Zeit gewinnen" [Pandemic prevention: save time in an emergency]. Nachrichten aus der Chemie. 54 (12): 1226–1227. doi:10.1002/nadc.20060541217. ISSN 1868-0054.
  9. ^ Jackson, Mark (2016). The Routledge History of Disease. Routledge. p. 140. ISBN 978-1-134-85787-6. Retrieved 25 March 2020.
  10. ^ "Pandemie-Bekämpfung Der nächste Ausbruch kommt bestimmt" [Pandemic control The next outbreak is sure to come]. Deutschlandfunk (in German). Retrieved 30 March 2020.
  11. ^ Watts, Charlotte H.; Vallance, Patrick; Whitty, Christopher J. M. (18 February 2020). "Coronavirus: global solutions to prevent a pandemic". Nature. 578 (7795): 363. Bibcode:2020Natur.578R.363W. doi:10.1038/d41586-020-00457-y. PMID 32071448. Retrieved 3 April 2020.
  12. ^ Morse, Stephen S; Mazet, Jonna AK; Woolhouse, Mark; Parrish, Colin R; Carroll, Dennis; Karesh, William B; Zambrana-Torrelio, Carlos; Lipkin, W Ian; Daszak, Peter (1 December 2012). "Prediction and prevention of the next pandemic zoonosis". The Lancet. 380 (9857): 1956–1965. doi:10.1016/S0140-6736(12)61684-5. ISSN 0140-6736. PMC 3712877. PMID 23200504.
  13. ^ Walsh, Bryan. "Virus Hunter: How One Scientist Is Preventing the Next Pandemic". Time. Retrieved 26 March 2020.
  14. ^ a b McKie, Robin (24 June 2018). "Scientists aim to stop the devastation of Zika-like pandemics". The Observer. Retrieved 3 April 2020.
  15. ^ a b c d e "Before the Next Pandemic, an Ambitious Push to Catalog Viruses in Wildlife". Yale E360. Retrieved 8 June 2020.
  16. ^ a b c d e f g "To prevent pandemics, bridging the human and animal health divide". Salon. 1 June 2020. Retrieved 8 June 2020.
  17. ^ Salama, Mostafa A.; Hassanien, Aboul Ella; Mostafa, Ahmad (13 May 2016). "The prediction of virus mutation using neural networks and rough set techniques". EURASIP Journal on Bioinformatics and Systems Biology. 2016 (1): 10. doi:10.1186/s13637-016-0042-0. ISSN 1687-4145. PMC 4867776. PMID 27257410.
  18. ^ "Predicting the evolution of genetic mutations". phys.org. Retrieved 16 May 2020.
  19. ^ Zhou, Juannan; McCandlish, David M. (14 April 2020). "Minimum epistasis interpolation for sequence-function relationships". Nature Communications. 11 (1): 1782. Bibcode:2020NatCo..11.1782Z. doi:10.1038/s41467-020-15512-5. ISSN 2041-1723. PMC 7156698. PMID 32286265.
  20. ^ a b c Kempe, Frederick (16 May 2020). "Op-ed: U.S. should enlist tech companies to build global quick response system to prevent future pandemic". CNBC. Retrieved 7 June 2020.
  21. ^ Jr, Donald G. McNeil (25 October 2019). "Scientists Were Hunting for the Next Ebola. Now the U.S. Has Cut Off Their Funding". The New York Times. Retrieved 25 March 2020.
  22. ^ Sun, Lena H. "CDC to cut by 80 percent efforts to prevent global disease outbreak". Washington Post. Retrieved 26 March 2020.
  23. ^ The Economist, April 4th 2020, page 14.
  24. ^ Levy, Steven. "Could Crispr Be Humanity's Next Virus Killer?". Wired. Retrieved 25 March 2020.
  25. ^ Abbott, Timothy R.; Dhamdhere, Girija; Liu, Yanxia; Lin, Xueqiu; Goudy, Laine; Zeng, Leiping; Chemparathy, Augustine; Chmura, Stephen; Heaton, Nicholas S.; Debs, Robert; Pande, Tara; Endy, Drew; Russa, Marie La; Lewis, David B.; Qi, Lei S. (14 March 2020). "Development of CRISPR as a prophylactic strategy to combat novel coronavirus and influenza". bioRxiv: 2020.03.13.991307. doi:10.1101/2020.03.13.991307. Retrieved 25 March 2020.
  26. ^ Nguyen, Tuan M.; Zhang, Yang; Pandolfi, Pier Paolo (March 2020). "Virus against virus: a potential treatment for 2019-nCov (SARS-CoV-2) and other RNA viruses". Cell Research. 30 (3): 189–190. doi:10.1038/s41422-020-0290-0. PMC 7054296. PMID 32071427.
  27. ^ Lewis, Tanya (23 October 2019). "Scientists Program CRISPR to Fight Viruses in Human Cells". Scientific American. Retrieved 1 April 2020.
  28. ^ "Combatting Viruses with RNA-Targeted CRISPR". The Scientist Magazine®. Retrieved 1 April 2020.
  29. ^ "New kind of CRISPR technology to target RNA, including RNA viruses like coronavirus". phys.org. Retrieved 3 April 2020.
  30. ^ Wessels, Hans-Hermann; Méndez-Mancilla, Alejandro; Guo, Xinyi; Legut, Mateusz; Daniloski, Zharko; Sanjana, Neville E. (16 March 2020). "Massively parallel Cas13 screens reveal principles for guide RNA design". Nature Biotechnology. 38 (6): 722–727. doi:10.1038/s41587-020-0456-9. ISSN 1546-1696. PMC 7294996. PMID 32518401.
  31. ^ "Researchers crack COVID-19 genome signature". phys.org. Retrieved 18 May 2020.
  32. ^ Randhawa, Gurjit S.; Soltysiak, Maximillian P. M.; Roz, Hadi El; Souza, Camila P. E. de; Hill, Kathleen A.; Kari, Lila (24 April 2020). "Machine learning using intrinsic genomic signatures for rapid classification of novel pathogens: COVID-19 case study". PLOS ONE. 15 (4): e0232391. Bibcode:2020PLoSO..1532391R. doi:10.1371/journal.pone.0232391. ISSN 1932-6203. PMC 7182198. PMID 32330208.
  33. ^ Souf, Selma (1 January 2016). "Recent advances in diagnostic testing for viral infections". Bioscience Horizons. 9. doi:10.1093/biohorizons/hzw010. Retrieved 26 March 2020.
  34. ^ Tang, Patrick; Chiu, Charles (1 February 2010). "Metagenomics for the discovery of novel human viruses". Future Microbiology. 5 (2): 177–189. doi:10.2217/fmb.09.120. ISSN 1746-0913. PMID 20143943.
  35. ^ Bearinger, Jane P.; Dugan, Lawrence C.; Baker, Brian R.; Hall, Sara B.; Ebert, Katja; Mioulet, Valerie; Madi, Mikidache; King, Donald P. (March 2011). "Development and Initial Results of a Low Cost, Disposable, Point-of-Care Testing Device for Pathogen Detection". IEEE Transactions on Biomedical Engineering. 58 (3): 805–808. doi:10.1109/TBME.2010.2089054. ISSN 1558-2531. PMC 3071014. PMID 21342806.
  36. ^ "Pandemie-Prävention: Experten gegen Wärmescanner auf Flughäfe" [Pandemic prevention: experts against heat scanners at airports] (in German). DER SPIEGEL. Retrieved 30 March 2020.
  37. ^ "InfectControl 2020 - InfectControl 2020". www.infectcontrol.de. Retrieved 1 April 2020.
  38. ^ "Hygiene durch Architektur statt Antibiotika" [Hygiene through architecture instead of antibiotics]. Medizin Aspekte (in German). 1 April 2020. Retrieved 1 April 2020.
  39. ^ "Pandemie-Prävention am Flughafen" [Pandemic prevention at the airport]. Fraunhofer-Gesellschaft (in German). Retrieved 30 March 2020.
  40. ^ a b Wolfe, Nathan (29 April 2009). "Opinion | How to Prevent a Pandemic". The New York Times. Retrieved 25 March 2020.
  41. ^ Loh, Elizabeth H.; Zambrana-Torrelio, Carlos; Olival, Kevin J.; Bogich, Tiffany L.; Johnson, Christine K.; Mazet, Jonna A. K.; Karesh, William; Daszak, Peter (1 July 2015). "Targeting Transmission Pathways for Emerging Zoonotic Disease Surveillance and Control". Vector Borne and Zoonotic Diseases. 15 (7): 432–437. doi:10.1089/vbz.2013.1563. ISSN 1530-3667. PMC 4507309. PMID 26186515.
  42. ^ a b c d Carrington, Damian (25 March 2020). "Coronavirus: 'Nature is sending us a message', says UN environment chief". The Guardian. Retrieved 25 March 2020.
  43. ^ a b Taylor, L. H.; Latham, S. M.; Woolhouse, M. E. (29 July 2001). "Risk factors for human disease emergence". Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences. 356 (1411): 983–989. doi:10.1098/rstb.2001.0888. ISSN 0962-8436. PMC 1088493. PMID 11516376.
  44. ^ Rasmussen, Angela L.; Katze, Michael G. (11 May 2016). "Genomic Signatures of Emerging Viruses: A New Era of Systems Epidemiology". Cell Host & Microbe. 19 (5): 611–618. doi:10.1016/j.chom.2016.04.016. ISSN 1931-3128. PMC 7104983. PMID 27173929.
  45. ^ "Pandemie-Prävention in Nigeria". www.umweltdialog.de. Retrieved 30 March 2020.
  46. ^ "Official Website of SORMAS". sormasorg.helmholtz-hzi.de. Retrieved 30 March 2020.
  47. ^ a b c "Spillover Warning: How We Can Prevent the Next Pandemic". Yale E360. Retrieved 8 June 2020.
  48. ^ Zimmer, Carl; Carey, Benedict (21 December 2020). "The U.K. Coronavirus Variant: What We Know". The New York Times. Retrieved 16 January 2021.
  49. ^ "WHO | SARS-CoV-2 Variants". WHO. Retrieved 16 January 2021.
  50. ^ "Update On Covid-19 (18th December 2020) - SA Corona Virus Online Portal". SA Corona Virus Online Portal. Retrieved 16 January 2021.
  51. ^ Pike, Jamison; Bogich, Tiffany; Elwood, Sarah; Finnoff, David C.; Daszak, Peter (30 December 2014). "Economic optimization of a global strategy to address the pandemic threat". Proceedings of the National Academy of Sciences. 111 (52): 18519–18523. Bibcode:2014PNAS..11118519P. doi:10.1073/pnas.1412661112. ISSN 0027-8424. PMC 4284561. PMID 25512538.
  52. ^ Cheng, Vincent C. C.; Lau, Susanna K. P.; Woo, Patrick C. Y.; Yuen, Kwok Yung (1 October 2007). "Severe Acute Respiratory Syndrome Coronavirus as an Agent of Emerging and Reemerging Infection". Clinical Microbiology Reviews. 20 (4): 660–694. doi:10.1128/CMR.00023-07. ISSN 0893-8512. PMC 2176051. PMID 17934078.
  53. ^ a b Jenkins, Bonnie (27 March 2020). "Now is the time to revisit the Global Health Security Agenda". Brookings. Retrieved 1 April 2020.
  54. ^ Cameron, Beth. "Perspective | I ran the White House pandemic office. Trump closed it". Washington Post. Retrieved 1 April 2020.
  55. ^ a b Vidal, John (18 March 2020). "'Tip of the iceberg': is our destruction of nature responsible for Covid-19?". The Guardian. Retrieved 28 March 2020.
  56. ^ "WHO | Climate change and human health - risks and responses. Summary". WHO. Retrieved 27 March 2020.
  57. ^ Wu, Xiaoxu; Lu, Yongmei; Zhou, Sen; Chen, Lifan; Xu, Bing (1 January 2016). "Impact of climate change on human infectious diseases: Empirical evidence and human adaptation". Environment International. 86: 14–23. doi:10.1016/j.envint.2015.09.007. ISSN 0160-4120. PMID 26479830. Retrieved 27 March 2020.
  58. ^ "How Forest Loss Is Leading To a Rise in Human Disease". Yale E360. Retrieved 27 March 2020.
  59. ^ "Deforestation is leading to more infectious diseases in humans". Science. 22 November 2019. Retrieved 27 March 2020.
  60. ^ Olivero, Jesús; Fa, John E.; Real, Raimundo; Márquez, Ana L.; Farfán, Miguel A.; Vargas, J. Mario; Gaveau, David; Salim, Mohammad A.; Park, Douglas; Suter, Jamison; King, Shona; Leendertz, Siv Aina; Sheil, Douglas; Nasi, Robert (30 October 2017). "Recent loss of closed forests is associated with Ebola virus disease outbreaks". Scientific Reports. 7 (1): 14291. Bibcode:2017NatSR...714291O. doi:10.1038/s41598-017-14727-9. ISSN 2045-2322. PMC 5662765. PMID 29085050.
  61. ^ Sehgal, R. N. M. (15 March 2010). "Deforestation and avian infectious diseases". The Journal of Experimental Biology. 213 (6): 955–960. doi:10.1242/jeb.037663. ISSN 0022-0949. PMC 2829318. PMID 20190120.
  62. ^ Vidal, John (2020-03-18). "'Tip of the iceberg': is our destruction of nature responsible for Covid-19?". The Guardian. ISSN 0261-3077. Retrieved 2020-11-10.
  63. ^ "Deadly diseases from wildlife thrive when nature is destroyed, study finds". the Guardian. 2020-08-05. Retrieved 2020-11-10.
  64. ^ Fisher, Judith Lorraine; Woolaston, Katie. "UN report says up to 850,000 animal viruses could be caught by humans, unless we protect nature". The Conversation. Retrieved 2020-11-10.
  65. ^ "Stanford: How Humanity Has 'Engineered a World Ripe for Pandemics'". SciTechDaily. 28 March 2020. Retrieved 3 April 2020.
  66. ^ Biodiversity loss and the ecology of infectious disease
  67. ^ The best way to avoid future pandemics? Protect the natural world
  68. ^ Beyond exclusion: alternative approaches to biodiversity conservation in the developing tropics
  69. ^ "COVID-19 and nature are linked. So should be the recovery". World Economic Forum. Retrieved 5 June 2020.
  70. ^ a b "Jane Goodall: humanity is finished if it fails to adapt after Covid-19". the Guardian. 3 June 2020. Retrieved 7 June 2020.
  71. ^ "We Need to Rethink Our Food System to Prevent the Next Pandemic". Time. Retrieved 7 June 2020.
  72. ^ Africa’s growing risk of diseases that spread from animals to people
  73. ^ Johnson, Christine K.; Hitchens, Peta L.; Pandit, Pranav S.; Rushmore, Julie; Evans, Tierra Smiley; Young, Cristin C. W.; Doyle, Megan M. (8 April 2020). "Global shifts in mammalian population trends reveal key predictors of virus spillover risk". Proceedings of the Royal Society B: Biological Sciences. 287 (1924): 20192736. doi:10.1098/rspb.2019.2736. PMC 7209068. PMID 32259475.
  74. ^ a b UNEP Frontiers 2016 Report: Emerging Issues of Environmental Concern (PDF). Nairoby: United Nations Environment Programme. 2016. pp. 18–32. ISBN 978-92-807-3553-6. Retrieved 1 May 2020.   Text is available under a Creative Commons Attribution 4.0 International License
  75. ^ Ord, Toby (6 March 2020). "Why we need worst-case thinking to prevent pandemics". The Guardian. Retrieved 1 April 2020.
  76. ^ Ord, Toby (2021-03-23). "Covid-19 has shown humanity how close we are to the edge". The Guardian. Retrieved 2021-03-26.
  77. ^ "Could a rogue scientist use CRISPR to conjure another pandemic?". STAT. 26 March 2020. Retrieved 27 March 2020.
  78. ^ Yang, Yang; et al. (June 10, 2015). "Two Mutations Were Critical for Bat-to-Human Transmission of Middle East Respiratory Syndrome Coronavirus". Journal of Virology. 89 (17): 9119–9123. doi:10.1128/JVI.01279-15. PMC 4524054. PMID 26063432.
  79. ^ Chen, Stephen (6 February 2020). "Coronavirus: bat scientist's cave exploits offer hope to beat virus 'sneakier than Sars' - Shi Zhengli is one of the scores of scientists joining a global effort to hunt down the new coronavirus - But some people have blamed her for creating it in the first place". South China Morning Post. Retrieved 15 April 2020.
  80. ^ Rogin, Josh (14 April 2020). "State Department cables warned of safety issues at Wuhan lab studying bat coronaviruses". The Washington Post. Retrieved 15 April 2020.
  81. ^ Campbell, Josh; Atwood, Kylie; Perez, Evan (16 April 2020). "US explores possibility that coronavirus spread started in Chinese lab, not a market". CNN News. Retrieved 16 April 2020.
  82. ^ Rincon, Paul (16 April 2020). "Coronavirus: Is there any evidence for lab release theory?". BBC News. Retrieved 17 April 2020.
  83. ^ Porter, Tom (18 May 2020). "More than 120 countries are backing a UN motion to investigate the origins of the coronavirus, despite China's objections". Business Insider. Retrieved 18 May 2020.
  84. ^ "Trump contradicts US intel community by claiming he's seen evidence coronavirus originated in Chinese lab". CNN. Retrieved 7 June 2020.
  85. ^ Marquardt, Alex; Atwood, Kylie; Cohen, Zachary (5 May 2020). "Intel shared among US allies indicates virus outbreak more likely came from market, not a Chinese lab". CNN. Retrieved 7 May 2020.
  86. ^ McCarthy S, Chen S (11 April 2020). "Bat virus? Bioweapon? What the science says about Covid-19 origins". South China Morning Post.
  87. ^ Barclay, Eliza (23 April 2020). "Why these scientists still doubt the coronavirus leaked from a Chinese lab". Vox.
  88. ^ Overbye, Dennis (2 June 2020). "Going Viral, or Not, in the Milky Way". The New York Times. Retrieved 7 June 2020.
  89. ^ "Coronavirus: 'Recipe for instability', says futurist who predicted extinction event". The National. 2 June 2020. Retrieved 7 June 2020.
  90. ^ Boseley, Sarah (24 January 2020). "Calls for global ban on wild animal markets amid coronavirus outbreak". The Guardian. Retrieved 25 March 2020.
  91. ^ Denyer, Simon. "China bans wild animal trade until coronavirus epidemic is eliminated". Washington Post. Retrieved 25 March 2020.
  92. ^ Gorman, James (27 February 2020). "China's Ban on Wildlife Trade a Big Step, but Has Loopholes, Conservationists Say". The New York Times. Retrieved 25 March 2020.
  93. ^ "Experts call for global ban on live animal markets, wildlife trade amidst coronavirus outbreak". CBC. Retrieved 5 June 2020.
  94. ^ Greenfield, Patrick (6 April 2020). "Ban wildlife markets to avert pandemics, says UN biodiversity chief". The Guardian. Retrieved 5 June 2020.
  95. ^ Wise, Justin (9 April 2020). "Bipartisan lawmakers call for global 'wet markets' ban amid coronavirus crisis". TheHill. Retrieved 5 June 2020.
  96. ^ "To prevent the next pandemic, it's the legal wildlife trade we should worry about". NationalGeographic. 7 May 2020. Retrieved 5 June 2020.
  97. ^ "CDC Global Health - CDC and the Global Health Security Agenda". www.cdc.gov. 19 February 2020. Retrieved 1 April 2020.
  98. ^ "Global Health Security Agenda". Global Health Security Agenda. Retrieved 1 April 2020.
  99. ^ a b c Tindera, Michela. "Bill Gates Calls For, And Funds, Steps To Prevent A Global Pandemic". Forbes. Retrieved 1 April 2020.
  100. ^ Gates, Bill. "The next epidemic is coming. Here's how we can make sure we're ready". gatesnotes.com. Retrieved 1 April 2020.
  101. ^ "Bill Gates warned of a deadly pandemic for years — and said we wouldn't be ready to handle it". www.cbsnews.com. Retrieved 5 June 2020.
  102. ^ Lederberg, Joshua (5 August 1988). "Medical Science, Infectious Disease, and the Unity of Humankind". JAMA. 260 (5): 684–685. doi:10.1001/jama.1988.03410050104039. ISSN 0098-7484. PMID 3392795. Retrieved 6 October 2020.
  103. ^ Henig, Robin Marantz (8 April 2020). "Experts warned of a pandemic decades ago. Why weren't we ready?". National Geographic. Retrieved 6 October 2020.
  104. ^ a b "How an alliance of democracies can prevent future pandemics". Salon. 26 April 2020. Retrieved 5 June 2020.
  105. ^ a b "COVID-19 Won't Be the Last Pandemic. Here's What We Can Do to Protect Ourselves". Time. Retrieved 5 June 2020.
  106. ^ "Feinstein: The U.S. wasn't ready for coronavirus. We must learn from that". Los Angeles Times. 27 March 2020. Retrieved 8 June 2020.
  107. ^ "Why It Matters: The Pandemic Threat | Division of Global Health Protection | Global Health | CDC". www.cdc.gov. 4 May 2020. Retrieved 5 June 2020.
  108. ^ "Cells' Response to SARS-CoV-2 Different from Flu, RSV". The Scientist Magazine®. Retrieved 1 April 2020.
  109. ^ Slingsby, BT; Kurokawa, Kiyoshi (2013). "The Global Health Innovative Technology (GHIT) Fund: Financing medical innovations for neglected populations". The Lancet Global Health. 1 (4): e184–5. doi:10.1016/S2214-109X(13)70055-X. PMID 25104343.
  110. ^ "Investing In Drugs That Won't Make Money", Forbes, April 30, 2015, accessed on 9/28/2015
  111. ^ a b c Guynup, Sharon. "Preparing for the Next Pandemic". Scientific American. Retrieved 8 June 2020.
  112. ^ Waltz, Emily (1 June 2006). "Pandemic prevention schemes threaten diversity, experts warn". Nature Medicine. 12 (6): 598. doi:10.1038/nm0606-598a. PMID 16760992. S2CID 1145076. Retrieved 25 March 2020.
  113. ^ Manika, D.; Golden, L. (2011). "Self-efficacy, Threat, Knowledge, and Information Receptivity: Exploring Pandemic Prevention Behaviors to Enhance Societal Welfare". Academy of Health Care Management Journal. Retrieved 25 March 2020.
  114. ^ Hughes, James M.; Wilson, Mary E.; Pike, Brian L.; Saylors, Karen E.; Fair, Joseph N.; LeBreton, Matthew; Tamoufe, Ubald; Djoko, Cyrille F.; Rimoin, Anne W.; Wolfe, Nathan D. (15 June 2010). "The Origin and Prevention of Pandemics". Clinical Infectious Diseases. 50 (12): 1636–1640. doi:10.1086/652860. ISSN 1058-4838. PMC 2874076. PMID 20450416.
  115. ^ Kahn, Jennifer (21 April 2020). "How Scientists Could Stop the Next Pandemic Before It Starts". The New York Times. Retrieved 8 June 2020.