Modernizing and expanding outbreak science to support better decision making during public health crises: lessons for COVID-19 and beyond

Abstract

A global catastrophic biological risk (GCBR) constitutes a sudden, widespread disaster beyond the control of governments and the private sector. Several microbial characteristics, including efficient human-to-human transmission, a significant case fatality rate, lack of effective countermeasures, a largely immunologically naïve population, immune evasion mechanisms, and respiratory spread, heighten the risk of a GCBR. Although any microbe could theoretically evolve into a GCBR-level threat, RNA viruses, with their high mutability and lack of broad-spectrum antivirals, pose the greatest danger. Current efforts to catalog viral species, while scientifically valuable, may not translate directly into improved pandemic preparedness. A more effective approach involves enhanced surveillance of respiratory RNA viruses, coupled with aggressive diagnostic testing of infectious disease syndromes in strategic locations. This, combined with increased vaccine and antiviral research specifically targeting RNA respiratory viruses and clinical research to optimize treatment protocols, would strengthen pandemic preparedness. Human factors, such as infrastructure limitations and flawed decision-making, can exacerbate outbreaks and elevate pathogens to GCBR status. – AI-generated abstract.