PANDEMICS – How likely are we to see a Major Pandemic?

Today we are talking with Jason Tetro, The Germ Guy, to find out how likely we are to see a major pandemic in the near future, and how to protect yourself should one strike.

Can you tell us a little bit about yourself and your experience with pandemics.

I am a microbiologist with over 25 years of experience in various areas of microbiology and human health research.  I am currently the coordinator for two research centres at the University of Ottawa, the Emerging Pathogens Research Centre (EPRC) and the Centre for Research on Environmental Microbiology (CREM).  I’m also known as the “Germ Guy” and a promoter of global health and hygiene.

At uOttawa, our work focuses on the nature of pathogens both in the environment and in the host, their evolution, their spread and how best to prevent and control them.  With respect to pandemics, we have published peer-reviewed articles on the evolution of SARS (the pandemic that never was) and the infamous H5N1, more specifically, why it may never end up causing a pandemic.  I’ve also co-authored a chapter on the environmental survival of SARS and how to effectively control its spread.

How likely are we to see a major pandemic in the near future?

By its definition, a pandemic is major however in the context here, I believe that the world is becoming increasingly more likely to see a major event.  It’s a process that is highly predictable.

It starts with migration of agriculture and urban environments into more rural and remote areas, increasing the likelihood that a potential pandemic strain of a pathogen will come into contact with humans increases.  Then, thanks to the rise in densification of both animal and human populations, these pathogens can spread in a localized environment and evolve to cause greater problems.  Finally, with travel from the localized area, the pathogen can then move worldwide.  This fact is particularly important when one thinks that almost 100 years ago, when we had the 1918 pandemic, it could take months to circumnavigate the globe.  Today, it can be accomplished in a day.  Moreover, with more individuals traveling than ever before (some 1.4 billion air travelers per year), the opportunity for a pandemic strain to spread is greater than it has ever been.

What are the biggest threats that you see on the horizon?

The majority of pandemics have been due to the evolution of an animal pathogen to a human pathogen.  So, the real threat that faces humanity is the continued sharing of spaces between animals who carry these viruses, such as chickens and pigs, and humans.  In the case of several near-pandemic pathogens, like H5N1 influenza and the H1N1 pandemic, cases were almost always associated with close contact with a carrier animal.  Then, through a process of evolution, the pathogen can ‘adapt’ to the human host and then be able to spread without the need of an animal.  The H5N1 has yet to accomplish this adaptation whereas the H1N1 successfully made the transition and led to the pandemic.

If a major pandemic does hit what will it look like?

I guess if one looks back over the last decade, there are two possible streams for a pandemic.

The first, represented by H1N1, may lead to a high number of infections with a slightly higher or equal rate of mortalities.  Normally, influenza has a mortality rate of about 0.1% .  The mortality from the H1N1 pandemic virus was similar, if not lower.  By the time the pandemic was over, there was some impact on the global scale but for the most part, the world was able to move forward.

The second, represented by SARS, would be much worse.  With a mortality upwards of 15-20%, the virus would not only spread like wildfire, but also kills in high numbers.  In affected regions, which included Toronto here in Canada, hospital intensive care units would be filled to capacity and many of them would be essentially locked down.  Away from the health impact, travel to these cities would plummet and economies would suffer for years afterwards.  As a result of a rapid global effort, SARS was effectively stopped before it could go global, however, the impact could be extrapolated to give an idea of what might happen in the event of a pandemic following this path.

Can you give us some realistic contagion timelines?

To be honest, no.  While it’s easy for Hollywood to come up with potential timelines for a pandemic, the reality is that several factors have to be taken into consideration before making a guess as to the speed that a pandemic might travel.  These factors include:

1. The ability of the strain to infect,
2. How lethal the strain is to humans,
3. The ability of the strain to spread,
4. How easy it is to kill the strain,
5. The likelihood that people will listen to warnings and advisories in order to prevent a pandemic from taking hold.

For example, almost everyone believes that Ebola virus would make a great pandemic.  It infects rapidly and it quite lethal.  However, it’s fairly easy to kill and it’s not easy to pick up the virus unless you are relatively close to an infected individual.  Also, because it’s so lethal, when infection is found, people tend to ‘run for the hills’ and would easily take to any recommendations to prevent spread.  So, in that sense, it’s not a particularly good candidate for a pandemic and it’s timeline would be rather short.

As we saw with the H1N1 pandemic, the virus infected with relative ease although it wasn’t quite lethal.  It spread between humans effectively although it was simple to kill.  The real reason the pandemic took hold was that people simply didn’t listen to the warnings and advisories and acted as if nothing was wrong.  It wasn’t until a few key deaths occurred in October of 2009 that suddenly the world took notice.  By that point, the virus had spread worldwide and simply had to peter out, which took at least another 10 months.

So, I guess the simplest way to estimate a timeline is a comparison between the lethality of the virus and the ability of humans to react to the news of the virus.  I’m sure that there’s a ‘happy medium’ that could lead to the worst case scenario, significant lethality and a lack of attention leading to a sustained timeline, but I haven’t seen anything that could qualify…yet.

Is there anything that people can do to prepare?

The Scouts motto is “Be prepared,” and thankfully, it will be easy to follow when it comes to a pandemic.  For starters, if you live in a developed country, there’s little chance that the pandemic will start on your street.  It will happen in a developing country or one that has low standards for animal and human health and hygiene.  If the pathogen starts to spread like a pandemic, it’ll be in the news.  So, try to pay attention to the news.  If there are any signs that a pandemic is coming, start to find out how your national, state (or provincial) and local authorities are reacting.  Advisories will come long before the virus and instructions on how to best protect yourself will be provided in an easy to follow format.

How can the average person increase their chances of survival.

In the unlikely chance that a pandemic does happen to occur in your local area, there are some rather simple rules to follow.

1. Social distancing is key – if someone appears to be infected, stay at least 6 feet away from them and do what you can to prevent any kind of close contact.
2. Stay hygienic – handwashing is obviously critical and a simple hand sanitizer will kill pretty much any pandemic pathogen if it has between 62 and 75% ethanol and is used for about 30 seconds.  Personal hygiene is also important if only to show others that you are not infected and thus not a target for social distancing.
3. Be aware of your condition – if you start to feel sick for whatever reasons, consult some form of medical advice, whether it be through a physician, nurse, friend, or colleague.  But, as we have learned, the central locations for a pandemic will inevitably be hospitals; they should be avoided unless there is a real concern.

Our next article in the series features Cyber-Terrorism expert, Damon Petraglia, and looks at how a major pandemic could affect our infrastructure, and how hostile nations could exploit the situation by launching a cyber attack.