Scripts from most Will Ferrell movies probably run with a directive that demands the actor rely on petulant silliness and his suburban dad-ish vibe to rake in the laughs, a schtick that has landed him successes like “Anchorman” and “Step Brothers.”
A scene from one such movie — “Semi-Pro” (oh, don’t bother watching it) — shows Ferrell wrestling a bear in a setting that mirrors the underground wrestling event from Tobey Maguire’s first outing as Spider-Man.
The only damage the human might have inflicted was surely of the verbal kind; Dewey the Bear swiftly whoops his ass and proceeds to escape the cage, running off somewhere into a darkened crowd. Ferrell asks the audience to remain calm, only to have a dramatic turnaround as soon as a roar echoes through the stadium. “Everybody panic!” he screams in his distinct neurotic-old-lady voice.
You don’t panic in the face of a bear, of course. But taken with a touch of whimsy, “everybody panic” seems like phrasing appropriate enough when looking to instill public alertness: Epidemiologists, behavioral scientists, and psychologists recall that more robust Covid-19 messaging might have significantly lowered the toll of the pandemic — messaging that perhaps successfully communicated fear of the infection, or better yet, of its potential societal consequences.
What we got instead was the demonstration of lax preparation and a broken mechanism. And even if that storm has been weathered, health institutions don’t have the luxury of relaxing; as things stand, Covid-19 wasn’t a once-in-a-lifetime tragedy. A statistical analysis predicts that the probability of a coronavirus-level pandemic is about 2 percent in any given year, with outbreaks of a lesser degree sprinkled throughout.
About 20 years ago, medical historians Elizabeth Fee and Theodore Brown commented on the periodic rediscovery of deficiencies in the American public health system.
“We continue to mobilize episodically in response to particular threats,” they wrote, “and then let our interest lapse when the immediate crisis seems to be over.”
Since the 20th century, infectious diseases have killed more people than wars and famines combined, yet resources allotted to combating these outbreaks have paled in comparison to those assigned to security. Nuclear arsenals may boast superficial strength, but they don’t threaten invaders of the microscopic kind.
Humans don’t live in a bubble; as the global population grows — along with the interplay of a myriad of other factors — future pandemics become more likely. Yet we find ourselves in this cycle of panic and neglect, where resources are focused on the containment of infections rather than preventing them in the first place. Just see how we fared against the most recent one despite having multiple pandemics worth of experience and even a Pandemic Playbook in our hands.
What is the rational response of the masses, then, if not irrational panic-stricken reclusiveness?
Background
Interest in two specific diseases has mushroomed over the past months — and for understandable reasons:
(1) Bird flu
Back in April, the Texas Department of State Health Services announced that a worker on a dairy farm had tested positive for the highly pathogenic avian influenza A (H5N1) virus, apparently infected after being exposed to cattle — likely the first instance of cow-to-human transmission of the virus.
As of Sept. 3, the U.S. Department of Agriculture reports that 196 dairy cow herds in 14 states have confirmed cases of avian influenza.
There have also been 14 reported cases in humans since 2022, where all except one were caused by exposure to infected cattle or poultry, though reports suggest that several more sick farm workers might be going undetected. Doctors are currently looking closely into the fourteenth case, which might be the first instance of human-to-human transmission of the virus.
(2) Mpox
First detected in humans in 1970 in the Dominican Republic of Congo, mpox has been spreading for years in Central and West Africa, where two strains of the virus are considered endemic: clade I (which causes more severe illness) in Central Africa, and clade II in West Africa. But clade I has started spreading into nearby regions of Burundi, Kenya, Rwanda, and Uganda — even in Sweden, stoking an international emergency.
This international spread has triggered the Africa CDC and the World Health Organization to designate it a Public Health Emergency of International Concern (PHEIC). “Today, we declare this PHECS to mobilize our institutions, our collective will, and our resources to act—swiftly and decisively,” said Africa CDC Director General Dr. Jean Kaseya in a press release.
The first thing to get out of the way is that neither has spread past a threshold that would gain them pandemic status, but concern is obvious. Individual reports of their pandemic potential — that of avian influenza in particular — represent a growing sense of alarm among public health scientists.
At this point, the evidence is clear: The Covid-19 pandemic can be traced back to a bat. Whether spillover happened because someone ate an infected bat, was exposed to a bat’s bodily fluid, or came in contact with some intermediary-infected animal, we are unlikely to be able to determine.
But one of the main lessons from how the pandemic unfolded is how integral a role systemic testing of exposed animals and humans plays in preventing a global outbreak, a lesson we often hastily unlearn.
A story
In August 1999, a cluster of cases of encephalitis surfaced among New Yorkers. The CDC reported it as an outbreak of human arboviral encephalitis caused by the Saint Louis encephalitis virus.
Around the same time, Tracey McNamara, chief pathologist at the Bronx Zoo, noticed something distressing — crows seemed to be falling dead from the sky near the zoo grounds. “This is a bird that can live on road kill,” a veterinarian told the New York Times, “so the amount you have dying now, you have to wonder if they’re being poisoned. We just can’t put a finger on it.”
Then came the casualties among captive bird species: three Chilean flamingos, a guanay cormorant, and a bald eagle. County health departments across New York had been reporting an alarming uptick in the number of dead birds since early summer. Between August and December, more than 17,000 dead birds would be reported.
McNamara suspected the human and avian cases to be connected, but the CDC repeatedly ignored her concerns because they “don’t do flamingos.”
Concluding that this was some disease unknown to veterinary medicine — contrary to what the CDC believed — McNamara would perform her own biopsies. What she found was brain inflammation of a degree that she had never seen in 18 years of animal postmortems.
She eventually convinced the CDC to analyze the genetic materials of the viruses, which they verified to be the West Nile virus, known to infect birds as well as people in parts of Africa, Europe, and Asia.
How the West Nile virus arrived in New York remains unknown. In 1937, a woman in the West Nile district of Uganda came to a hospital with a mysterious fever, and doctors isolated the then-unseen virus from her blood. Over the next few decades, scientists found the same virus in many patients in the Near East, Asia, and Australia, along with the finding that the virus could infect birds as well.
Experts extrapolated that the virus could’ve been transmitted to some migratory bird that brought it across the ocean. In the years since, West Nile has become the most common mosquito-borne illness in North America, spreading vivaciously through the monsoon months.
Trespassing and spillovers
The main takeaway from the West Nile story: Animals, be it pets, wildlife, or livestock, can all serve as early warning signs of an emergent biological threat to humans. Maybe the WN virus could’ve been nipped in the bud had it been detected early in birds. Similarly, spotting signs of disease in bats or an intermediary like pangolins may have warned officials of an approaching pandemic.
Most animal pathogens are not readily transmitted to humans; for an animal pathogen to transmit easily among humans, multiple variables must align. And even if that happens, the virus needs to be capable of generating an infection, which makes the risk of a pandemic look pretty slim.
Yet over 70 percent of the infectious diseases that have emerged in the 21st century — including HIV, Ebola, and coronavirus — leaped to humans from wildlife. What’s more, these “spillover” events have been increasing at an estimated rate of 5 percent annually.
Why has this happened?
Nearly ten thousand years ago, when hunter-gatherers transitioned to farming, they began establishing permanent settlements and domesticating animals. This shift significantly raised the chances of zoonotic spillover, with infections spreading more easily within densely populated and interconnected human communities.
Just look at historic mass extinctions; none have been caused by a maliciously spreading virus or a fungus that turns animals into mindless cannibals. It’s typically been an asteroid, dramatic changes in climate, or intense volcanic activity that eradicates (almost) all life. However, the main cause of widespread deaths began to change with the advent of the agricultural revolution.
Researchers almost unanimously agree that one event serves as the catalyst for these spillovers: Deforestation.
In Africa, there’s been a 63 percent rise in the number of zoonotic outbreaks in the last decade, the WHO says. On a seemingly unrelated (but totally related) note, deforestation in Africa has been conducted at a pace almost double that of the world’s average, with 4 million hectares of forests cut down each year.
How clearing a forest may result in zoonotic spillovers is easily visualized. Imagine two different lakes in a forest, one serving as the drinking grounds for lions and the other for deer. Both species are likely to carry different pathogens, ones they have developed an immunity against. But get rid of one of these two lakes, and you force the animals to socialize (ignore the part where the lions slaughter the deer for dinner), allowing said pathogens to hop over, change hosts, and reassort in the process. Now imagine confining hundreds or even thousands of species spread over a vast jungle into a significantly smaller domain — it’s a viral bonanza.
About the next pandemic
Viruses are ubiquitous components of the global ecosystem; the most abundant biological entities on Earth — there are about 10 million of them in a drop of seawater. Regularly moving between interacting species that typically have no associated disease, they exist to threaten. The inconvenient truth implied here is that a pandemic is essentially inevitable.
Viruses already circulating in humans are unlikely to cause a pandemic due to preexisting herd immunities. It is therefore much more likely that the next pandemic will be one transmitted from its animal reservoir to humans.
So, which virus is it going to be?
The Global Virome Project estimates that of some 1.6 million viral species estimated to skulk in the world’s mammalian and avian wildlife, up to half (650,000 to 840,000) can spill over into humans. With such large numbers in play, just one virus can’t be singled out. However, we can make some educated guesses.
Most of the past pandemics have been connected to five viral families: Coronaviridae, Paramyxoviridae, Filoviridae, Flaviviridae, and Orthomyxoviridae — families that include well-known killers like SARS, Nipah virus, Ebola, dengue, and the flu viruses. While these priority pathogens may represent just a small portion of the viral population, they serve as a good enough short-list to start.
When a survey asked infectious disease experts to rank pathogens in order of their pandemic potential, the majority considered influenza as the pathogen of highest pandemic risk at 57 percent. Other highly ranked pathogens include disease X (21 percent ranked this number one and 14 percent second), Sars-CoV-2, CCHF virus, and Ebola virus.
But pandemics are, by nature, events triggered by flukes.“No matter what the origin story of COVID-19, a single virus, infecting a single individual in Wuhan, China, jumbled the lives of billions of people—for years,” political scientist Brian Klaas writes. “One fluke can change everything, everywhere, all at once.”
Predicting which exact species will hop over, when it does so, and what its pathology in humans will be like is stupendously complex even with the reams of genetic data we have collected. The virus can jump from its reservoir species to another animal; it may jump to a human; or maybe it infects a human, reassorts by interaction with other viruses, reinfects another animal species, but has turned into something significantly more lethal through the journey.
The focus, therefore, should instead be on monitoring areas where animals and people intermingle: Virus hunting at the hot spots.
The disease detectives
By carefully monitoring where a zoonotic disease is known to exist, epidemiologists can use variables to predict the likelihood of that pathogen becoming more prevalent, maybe endemic, to that region.
So what do such predictive models require? Professional “disease detectives,” as we’ve learned.
The field of animal health has long been detached from human health, but the coronavirus outbreak served as an eye-opener: Infectious disease experts aside, veterinarians, zoologists, farmers, and ranchers have a vital role to play in preventing the next pandemic. Not only do they bring knowledge about animals and animal diseases to the table, but they’re often the ones dealing with the initial cluster of cases.
When it comes to dealing with pandemics, the ideas put forward by key institutions have been focused almost exclusively on dealing with one once it has been sparked; the idea of better understanding the human-animal-environment interface is often an afterthought. But this first step is the simplest, most cost-effective, and frankly one that screams common sense: Fixing the broken relationship with nature.
“Preventing pandemics at the source is the most equitable way to benefit all of humanity,” a group of scientists wrote. Diminishing the interface where dangerous viruses jump over can, if not prevent all pandemics, at least narrow down the list of biological threats to a degree that allows the world to fight back, not back into a corner and wait for the storm to subside.
(Featured Image: Unsplash/Boston Public Library)