Is the next big pandemic already here? This is what the experts say

Even if SARS-CoV-2 turns out to be acutely seasonal, winter will make weathering a second wave extremely challenging. 

Every year, Americans endure an admixture of influenza and common cold strains between the months of September and February. Alone the two bear the potential to overwhelm health systems without the help of a new mutated pathogen.

Still, it’s too early for experts to anticipate the effect COVID-19 will have on these cycles, saying nothing of the recent outbreaks appearing across the country.

“The real risk is that we’re going to have two circulating respiratory pathogens at the same time,” said Dr. Robert Redfield, Director of Centers for Disease Control and Prevention (CDC) during a TIME 100 Talks discussion. “We know flu by itself can cause substantial morbidity and mortality and hospital utilization, especially for elderly people and those who have underlying health conditions. With the new coronavirus wreaking devastation in these groups and others, “this could be really a very, very difficult situation.”

For better or worse, coronavirus vaccines are on the fast track. 

However, if flu vaccines are any indication, it might take some delicate rhetoric to ensure most people take them. 

“Historically, less than half of Americans get flu vaccines,” Redfield continued. “This is the year that I’m asking the American public to seriously reconsider, because that decision may make available a hospital bed for somebody else that really needs it for COVID.”

Meanwhile, new findings published in the Proceedings of the National Academy of Science posit that pigs in China are becoming infected with a strain of influenza that has the potential to jump to humans with greater frequency. 

“We just do not know a pandemic is going to occur until the damn thing occurs,” commented Robert Webster, an influenza investigator, in Science Magazine. “Will this one do it? God knows.”

The research was conducted by a team led by Liu Jinhua from the China Agricultural University (CAU).

Together, they analyzed 30,000 nasal swabs taken from pigs at slaughterhouses in ten different Chinese provinces, and another 1000 swabs from pigs being treated for respiratory symptoms at a veterinary teaching hospital. 

The swabs revealed 179 separate swine influenza viruses, the vast majority of which were G4 or one of five other G strains from a lineage that resembled avian strains recorded in Eurasia.

The authors focused in on an influenza virus the nicknamed G4 because it’s a blend of three strains: one similar to strains found in European and Asian birds, the H1N1 strain that staffed the 2009 pandemic, and a North American H1N1 that has genes from avian, human, and pig influenza viruses. Humans have zero immunity to avian influenza viruses.

From the report: 

“G4 virus has shown a sharp increase since 2016, and is the predominant genotype in circulation in pigs detected across at least 10 provinces,”

Reassortment is the process by which a virus strain swaps genes. If the G4 variant mutates into a human translation, we could be looking at another devastating pandemic. Thankfully, most of the academics who have reacted to the new study, concede the importance of the analysis, while maintaining confidence that we won’t be blindsided by another pandemic anytime soon-so long as the right surveillance precautions are in place.

“The likelihood that this particular variant is going to cause a pandemic is low,” says Martha Nelson, an evolutionary biologist at the U.S. National Institutes of Health’s Fogarty International Center.” We need to be vigilant about other infectious disease threats even as COVID is going on because viruses have no interest in whether we’re already having another pandemic,”