By Pardis Sabeti, professor at Harvard University and Harvard School of Public Health, institute member of the Broad Institute; and Nathan Yozwiak, Director of Viral Genomics at Ring Therapeutics, Inc.
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As 2018 has come to a close, the memory of the remarkable crisis of the 1918-19 influenza pandemic looms large over public health practitioners. On this centennial anniversary, we must ask: Are our tools, systems, and collective mindset prepared for the next pandemic?
First, the good news. This past century’s collective commitment to America’s science engine — its “Miracle Machine” — has resulted in unprecedented growth in our understanding of infectious disease. We now have an arsenal of new tools to detect, treat, and prevent influenza and a multitude of other pathogens. Rapid flu diagnostics can return results as quickly as pregnancy tests, antivirals such as oseltamivir (Tamiflu) offer a treatment option to patients diagnosed early, antibiotics can ward off secondary bacterial infections, and the pipeline for designing and producing a seasonal vaccine protects millions each year. A coordinated network of labs test more than 1 million specimens each year for influenza, and over 2,800 outpatient centers gather data on influenza symptoms.
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We need a firm commitment from the international community to the science to develop new diagnostic tests for all infectious diseases anywhere in the world. Even in the most advanced hospitals, the vast majority of infections remain undiagnosed, and patients and clinics are often disconnected from what may be going on around them. The recent Ebola and Zika outbreaks circulated for months under our radar before they were properly tracked.
We need new therapies (such as the experimental drug favipirivir), and multidrug combinations need to be developed and approved for flu, because highly mutable viruses like flu can develop resistance. The flu vaccine pipeline, while a time-tested and well-oiled machine, still takes six to eight months for production, and too often the vaccine misses the mark due to changes that occur in the virus in nature and during egg-based manufacturing. Many researchers are pursuing the holy grail of flu prevention: a universal vaccine that will protect against many flu types for many years and alleviate the need for annual shots.
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