Global Health: Back to Pandemics? | ISPI
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The World in 2022

Pandemics: Back to a Forever Virus?

David Quammen
22 December 2021

The pandemic will still be at the center stage of international relations. It’ll be imperative to improve health systems and cooperation.

 

Predicting the vagaries of evolution is a risky game, maybe riskier even than other forms of prediction, and it’s best left to the wisest of seers. Charles Darwin predicted the existence of a moth with an eleven-inch proboscis, after inspecting a blossom of the Star of Bethlehem orchid, from Madagascar, and seeing its eleven-inch-deep nectary spur. There must be a corresponding moth in Madagascar, suitabtly evolved to pollinate that flower, Darwin wrote. Twenty year later, the moth was discovered. But of course Darwin was predicting, from tangible evidence, something that had already happened, an easier feat than predicting the evolutionary future.

The evolutionary future of the Covid pandemic virus, SARS-CoV-2, is harder to know, even as we watch a succession of variants—Alpha, Beta, Gamma, Delta, and most recently Omicron—arise and spread by multiple mutation and Darwinian natural selection. We have questions, and the scientists need more data before they can offer even provisional answers to those questions. Will the Omicron variant prove to be more transmissible? Maybe. Will it be capable of evading immune defenses? Maybe. Other questions are easier to answer. Will the Omicron variant be the last? Not likely. Will we be able to defend ourselves if it does evade immune defenses? Probably, yes, by creating new boosters and vaccines designed specifically to impede this variant. Will there be more variants after Omicron? Almost certainly. The biggest threats to human health, to economic health, and to the stability of our societies in 2022 will come not from the evolution of SARS-CoV-2 and the rise of new variants, in my expectation, but from the continuing problems of vaccine resistance, vaccine inequity among nations, and science denial among segments of our citizenries who get their “news” and their “research” from politically and financially driven obfuscators, on television and the web, and who confuse lies and bias with empirical reporting.

Not everyone who can type a search word into Google or operate the remote of a television is an expert in molecular evolutionary virology. We need those experts, and we need to listen to them with attention, because they can tell us—if not precisely what is coming, and when—then at least generally what is coming, sooner or later.

Some people have been led toward complacency, about the COVID-19 virus, by what they take for the conventional wisdom on dangerous new viruses: that they gradually but inevitably evolve toward lesser virulence, lesser harmfulness, as they adapt to the human population. This is false. There is no such inevitability. Some viruses may evolve toward lesser virulence in humans over time; others don’t. Smallpox virus was still a terrible threat, after at least two thousand years of infecting people, when it was eradicated from the wild around 1980. Polio is still ferocious, again after thousands of years. A virus does not evolve toward milder infections, lesser lethality, unless there is advantage for the virus, in terms of its own transmission and survival, to do that. A virus such as SARS-CoV-2, which causes only mild symptoms in most of its victims and which kills about one person in a hundred, would seem to have no reason for evolving toward lesser virulence. Replicating itself abundantly, spreading widely through populations, and avoiding total extinction—these are the only imperatives that govern how a virus evolves. Viruses have that in common with rats, and with dandelions, and with humans. We are all driven by our genes to multiply, to spread, and to survive.

Unlike smallpox, unlike polio, which are viruses uniquely adapted to humans, SARS-CoV-2 is a zoonotic virus, meaning that it has spilled into humans, in the very recent past, from its nonhuman animal host, either directly or through some intermediate creature or (if you are inclined to embrace the laboratory-leak hypothesis of its origins, which I am not) intermediate process. Its reservoir host seems to have been a population of bats. But it has shown itself to be a generalist virus, capable of infecting not just bats and humans but also many other kinds of animals, if they are exposed to the virus by human contact: house cats, mink on fur farms, tigers and gorillas and snow leopards in zoos, even white-tailed deer in the forests of North America. SARS-CoV-2 is now not just in us but around us. It has circled the Earth, thanks to human travel and interconnectedness, and gone back to the wild. It will almost certainly be with us forever.

In the coming year, 2022, and in years beyond that, we will need to continue our efforts against it, calmly but with intelligence and resolve. Those efforts will need to include not just better vaccines and better drugs but other improvements as well: greater equity in our healthcare systems, more open international collaborations on science and health, and at least a little clearer understanding in the minds of the public as to how evolution works. We will need also to be better prepared for the next dangerous new virus that spills into humans from animals.

We don’t need to predict the future to anticipate such an event. We can simply predict what has already happened, like Darwin predicting the long-tongued moth of Madagascar. We know that such lurking viruses exist. Scientists have already detected them—in the bats and rodents and other animals with which we share our world. We just don’t know what they will do. But if we continue our disruptive interactions with wild ecosystems and the animals that inhabit them—as we capture wildlife for the illegal international trade, extract timber and minerals from landscapes rich in biological diversity, increase our human population, feed our necessary hungers and our frivolous wants, giving animal viruses the opportunity to become human viruses—we can guess.

 

Read The World in 2022

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The World in 2022: Back to the Future?
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AUTHORS

David Quammen
Author of Spillover

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