A new study published April 28th in Nature indicated that we’ll see additional pandemics spring up in the coming years. Put mildly: that’s incredibly bad news considering we have only a basic understanding of Covid-19’s long-term effects on our health.
Rapid and effective research is the only way to stave off massive loss of human life over the next 50 years. Fortunately, there are three things we can do right now to give researchers the tools and support they’ll need in the near future.
First, the impending doom
“Over the next 50 years, climate change will drive thousands of viruses to jump from one species of mammal to another …[and] increase the risk that one will jump into humans and cause a new pandemic.”
That’s from Carl Zimmer’s New York Times report on “Climate change increases cross-species viral transmission risk,” the troubling new study recently published in the journal Nature. The authors, including Georgetown global change biologist Dr. Colin Carlson, used computer modeling to simulate how global climate change could incite more pandemics over the coming half-century. Their findings indicate that as rising temperatures drive animal populations into cooler regions, species of wildlife will intermix in new ways and transfer viruses more rapidly.
The authors speculate that as many as 10,000 virus species are currently contained within wild mammal populations and have the capacity to jump to humans. As inter-species contact increases, new viruses will take hold in human populations and spark outbreaks. “We’re in a world that’s 1.2 degrees warmer [than preindustrial levels], and there is no backpedaling. We have to prepare for more pandemics because of it,” Dr. Carlson explained to Ed Yong of The Atlantic.
We still don’t know why Covid-19 affects the whole body
Meanwhile, our Covid-19 fight is nowhere near over and our understanding of the virus’ long-term impact is still incomplete. “It affects all organ systems,” explained Devang Sanghavi, in a Q&A for the AMA series,“What Doctors Wish Patients Knew.” Dr. Sanghavi, who serves as vice chairman of clinical practice and critical care at Mayo Clinic, noted that Long Covid can dramatically affect the cardiovascular system and lead to lung damage. Sensory symptoms include loss of taste and smell, and cognitive functions can be severely impacted. Kidney injuries are also prevalent, as are gastrointestinal symptoms and bowel issues.
All of these conditions can result from this single virus, yet we know relatively little about how or why multiple systems are affected, often in the same person. Due to overall risks, costs, and the time required to facilitate clinical trials, whole-body studies are difficult to conduct. Instead, researchers are left to examine these impacts on an organ-by-organ basis, frequently requiring a lengthy, expensive clinical trial for each. So what can be done to accelerate our research systems?
Solution one: Support private party research
Private party research offers some help. Patients suffering from Long Covid have begun collaborating and forming citizen science initiatives. Organizations like Long Covid Support and Survivor Corps drive citizen-led research studies and share data with researchers and accelerate the discovery process.
Speed is the goal. Clinical trials launched by the NIH have been slow to return value back to enrolled patients — or even enroll patients at all. As STAT’s Rachel Cohrs recently reported, an enormous National Institutes of Health study “…had only enrolled 3% of its recruitment goal as of March 18 , more than a year after the agency received $1.2 billion for the effort.” Criticism from patients and experts spurred the Biden administration to ramp up its efforts, but the NIH still must recruit over 37,000 more participants for the study.
Good science is good science, whether it’s funded through government agencies or a combination of public and private donations. If the data are peer-reviewed and the methods deemed sound, the results will be actionable across the entire medical community. The more hands we have working on solutions – whether public, private, academic, or governmental – the better off we’ll be.
Solution two: Rethinking the whole-body study
Inside both public and private organizations can generate, researchers are often constrained by conventional thinking about human research. In fact, some traditional approaches — like clinical trials — can actually place humans in harm’s way while slowing things down. For us to move quickly (and safely), researchers need to rethink the way they conduct their studies.
Labs must adopt innovations that enable whole-body research at scale. The truth is that this technology finally does exist, and is already being used in new studies. Sourced ethically from accredited, US-based whole-body donation programs, matched sets of specimens can now contain samples from multiple organs and several bio-fluids; each set collected from an individual donor with the potential to scale into the thousands.
These sets essentially provide biological documentation of each deceased donor’s personal fight against a disease. Researchers who are more accustomed to running more focused studies – centered on individual organs or systems – must learn to think more broadly. If their research can be done just as effectively using cadaverous tissues, then this matched-set process could potentially shave years off of research around Covid and any new pandemics that emerge.
Solution three: Surveillance
Wastewater testing is a very effective way to monitor the evolution, infection, and outbreak of existing and novel pathogens.
New York City has been surveilling its wastewater since the early days of the pandemic. Researchers continue to deploy this tactic to keep a close eye on mutations and possible variants. Scientists and public officials are still discovering ways to implement these findings.
Some smaller communities have stepped up as well. Earlier this year, Rochester Institute of Technology (RIT) shared that it was monitoring wastewater across its campus to see where testing might be needed. Other campuses have been doing the same and in September 2020, the CDC launched the National Wastewater Surveillance System (NWSS) in an effort to coordinate and track the virus in wastewater samples collected across the country.
Despite this effort, we’re unable to get a comprehensive picture of the state of health in the US. Wastewater testing and reporting is not mandated and can be expensive to implement. In fact, only 12 states were participating as of mid-March and data was incomplete for those that were.
Ultimately, local and national governments are the only authorities charged with the non-commercial objective of preventing disease outbreak. It’s up to the public and the scientific community to put pressure on representatives to provide resources for this testing. After all, if researchers don’t have access to what’s coming down the pike (pipe), the therapies they’re developing will be made obsolete before they’re even approved.
Planning for “when,” not “if”
More pandemics are coming our way and we remain vulnerable: we’ve only just begun to understand the virus behind the current outbreak.
Dire as that sounds, I’m optimistic that we can face down these threats if we start now; giving our research teams the tools, processes, and resources they’ll need. It’s up to everyone – especially those of us in the scientific community – to push and collaborate and advocate for these advancements. Our future literally depends on it.
Photo Credit: RLT_Images, Getty Images