Covid-19: UK government failed to act on warnings about pandemic but got lucky with vaccine. The next major outbreak could be fungal, not viral – Professor Harry Burns

In 2019, the UK government was warned about the need to prepare for the health, social and economic consequences of a pandemic virus.

The 2019 National Security Risk Assessment highlighted the need to stockpile essential equipment such as PPE, establish public health procedures for testing and tracing contacts, and preparing hospitals for an increase in demand.

It even mentioned to possibility of a coronavirus pandemic. Planning was not implemented, and we were slow to get to grips with the emergency.

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The government has announced an inquiry into the handling of Covid-19. It will, I imagine, consider plans for minimising the impact of inevitable future pandemics.

However, it would be better if the international community took action to prevent them. Pandemics occur as a result of transmission of organisms from an animal host to humans.

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Many organisms can infect humans but do not spread between humans. Malaria is one such infection. Some organisms, such as Ebola, can spread from animals to humans but do not infect large numbers. Other viruses make the transition from animal to human and, thereafter, spread extensively in humans.

There is no clear understanding of the reasons that some viruses become widely infectious while many do not. What is clear, however, is that close contact between humans and animals is central to the process.

The swift development of a Covid vaccine was fortunate, but the next pandemic organism could be a fungus, rather than a bacterium or a virus, warns Professor Harry Burns (Picture: Michael Gillen)

As we increase our interactions with animals by destroying their habitats, hunting, wet markets, and domesticating them, the probability of cross-species infection increases significantly.

The Sars outbreak probably came from bats associated with the wet markets of China. The H1N1 influenza pandemic probably emerged from swine in the US. The hunting of chimpanzees led to the simian immunodeficiency virus spreading to humans, resulting in the HIV outbreak.

The next pandemic will be caused by close contact with animals and efforts to minimise such contacts could do much to prevent these outbreaks.

Instead, the conventional approach has been to wait and see what happens. The global death toll of Covid-19 shows how disastrous the wait-and-see strategy is.

The availability of a vaccine much earlier than originally anticipated has been fortunate and it seems to be effective in reducing the impact of the virus. What if the next pandemic organism is not a bacterium or virus susceptible to antibiotics or vaccine? What if it is a fungus?

Athlete's foot is probably the most widely known fungal infection. However, a recent article in Scientific American suggests that 1.6 million people are killed every year by these organisms and 300 million people are infected by them.

Fungi which are inhaled and infect the lungs are especially serious. Patients with underlying problems with their immune system are particularly at risk of fungal infection and the number of effective antifungal drugs are far fewer than the number of antibiotics available to treat bacterial infections.

The Americans are suggesting climate change is causing fungal disease to spread more widely across North America, therefore these infections seem likely to become commoner.

The government's inquiry is likely to come up with a predictable list of things to do when the next pandemic occurs. They may even act on those recommendations. Perhaps a better strategy would be to preserve animal habitats and limit contact with them in various ways. Prevention would undoubtedly be better than cure.

Sir Harry Burns is a professor at Strathclyde University

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