There are important public health aspects that we have learned from Covid-19 during the past 18 months, which can help us prevent future pandemics.
The most significant ones are that mutual cooperation between universities, government and industrial companies is instrumental in the development of vaccines and treatments through applied research into basic and applied molecular biology and that governmental agencies are needed to establish sound scientific protocols and supervise field trials of these vaccines and therapeutics.
Progress in research dealing with the pathogenesis of viruses, diagnostic procedures, therapy and vaccine development has contributed to progress in suppressing Covid-19, regarded as the most serious public health emergency in a century and responsible for disruption of our economy.
The continual development of mRNA vaccines, similar to Pfizer and Moderna, and recombinant vaccines, similar to Johnson and Johnson and AstraZeneca, are needed. They are based on sound scientific research using basic molecular biology conducted over the past 25 years. This illustrates the importance of cooperation among scientists from universities, federal agencies and private enterprise. Continual collective and synergistic efforts among scientists and bioengineers are needed to compress years to develop vaccines and therapeutics that are tested against natural exposure. Recruiting subjects for vaccine trials through the Community Engagement Alliance (CEAL) is extremely valuable. Scientists at the National Institutes of Health must continue including diverse ethnic groups in trials, which is critical both for evaluation and subsequent acceptance of vaccines.
Collaboration of universities, governmental agencies and pharmaceutical companies is important to develop, evaluate and distribute antiviral drugs, such as was done with remdesivir, immunosuppressive drugs, including dexamethasone, anticoagulants and monoclonal antibodies. In the U.S., the Accelerating Covid-19 Therapeutic Interventions and Vaccines (ACTIV) is important in the initiation to coordinate activities of federal agencies, academia and pharmaceutical companies. Protocols to evaluate therapeutics and commercialize products to treat patients must follow FDA Emergency Use Authorization. Inadequately designed trials — many of which were intended to justify the use of quick-fix solutions for Covid-19, including vitamin and mineral supplementation, hydroxychloroquine and ivermectin — should be prevented to circulate in social media and to become a political issue.
As an alternative to attempting to repurpose existing drugs, there is a need to develop new antiviral drugs against a wide range of potential pathogens so that phase 2 and phase 3 trials can be initiated quickly following the emergence of a novel infection. However, relying solely on therapeutic treatments rather than prevention through vaccination could result in the development of viral resistance to these new medicines.
The U.S. needs to be at the forefront in developing more rapid and accurate pathogen test systems. Although the PCR assay is highly sensitive and specific, it can result in delays between collecting a specimen and receiving results, which invalidate the test, and quarantine approach to containing an infection, especially during an early stage of any outbreak. Recognizing the need for rapid testing and in-home test kits, the NIH Rapid Acceleration of Diagnostics program was developed to encourage commercial companies to present proposals.
There is the need for continual international cooperation to acquire and share knowledge and experience from scientific groups in other nations faced with similar or slightly different circumstances. In this respect the World Health Organization needs to be fully funded and play an important role in addressing an understanding and geneses of a pandemic without country favoritism. Countries with the knowledge of the origination of the pandemic need to be forthcoming with their data rather than play politics.
Selling of wild caught animals should not be permitted in food markets. These markets need to be overseen by local governments and subject to strict biosecurity, sanitation and hygiene practices. The origin of all animals in local markets must be known so there is supply chain management. Sick animals or animals from unknown origins should never enter markets.
Following these procedures will reduce the origination of zoonotic infections in live animal markets as have occurred with influenza and coronavirus pandemics. Isolation and identification of viruses from wild caught and live animal markets must be continued to avert future pandemics but undertaken only by highly trained individuals in adequate containment facilities, which have been certified by the government. It is axiomatic that scientists never be permitted to genetically engineer viruses from wild caught animals to infect human cell cultures.
We are indeed fortunate that the U.S. has world-class scientists with vision, courage and perception who are capable of marshalling resources to resolve both emerging public health emergencies and ongoing erosive conditions.
It is therefore incumbent that these scientists are given increased latitude and funding to continue their endeavors with their charge to develop life-changing discoveries through sound science according to the standard operating procedures mandated by the FDA and public health officials.
Scientific discoveries from national and internationally known agencies, including the FDA, CDC and NIH, should be translated to laymen’s understanding and disseminated at the grassroots level by respected state and local public health officials, so that the general public can more easily understand and accept them as factual.
Educating the populace on pandemics and the importance of maintaining public health for the good of mankind should start in school-age children. Americans have gladly ceded their civil rights for anti-terrorism and travel safety, but many won’t budge to prevent the spread of a pandemic.
Although governmental mitigation mandates are productive in stopping the spread of a pandemic, they may result in political blowback, disruptive protests and the spread of conspiracy theories, which are more commonly accepted as fact in less educated and misinformed individuals. It is more productive to encourage vaccination rates using positive incentives and attempting to counter the malicious, mischievous and misplaced misinformation spread on websites and fringe media.
There needs to be positive role models in sports, politics, business, entertainment and religion to recognize their specific responsibility to encourage mitigations, including maintaining proper sanitation, hygiene practices, masking, social distancing and vaccination.
If unsubstantiated comments from political pundits and fraudulent doctors, who have their own agendas and lack knowledge of infectious diseases, are allowed to be disseminated on social media as was done with Covid-19, we are destined to repeat mistakes that will lead us on the road to another serious pandemic.
Joseph Giambrone is a professor emeritus in Auburn University’s Department of Poultry Science with a joint appointment in the Department of Pathobiology in the College of Veterinary Medicine.