Michael Osterholm, PhD, founding director of the University of Minnesota’s Center for Infectious Disease Research and Policy, will deliver the keynote address, “The Big One: Are we ready for the next global health crisis?,” as part of the launch of McGill University’s new Pandemic and Emergency Readiness Lab (PERL) on February 3. He spoke to Health e-News ahead of the launch about his new pandemic book and what he wishes governments would do to improve our readiness for the next ‘big one.’
In your book, The Big One: How We Must Prepare for Future Deadly Pandemics, you depict a potential next pandemic involving a rapidly spreading virus like COVID-19 with the high mortality of SARS and MERS. How ready are we for such a scenario?
We’re largely not prepared for any future pandemic. We still have major challenges with vaccines and one of the major mRNA technology companies announced last week they’re no longer going to invest in vaccine work because of the lack of support from governments. We also have not done anything really to repair or improve upon our healthcare capacity in terms of the number of beds, the number of healthcare workers, those wearing N95 respirators, etc. So, in many ways, we’re actually more at risk of having a devastating impact with a future pandemic than we were even in 2020. And that is an unfortunate mistake.
What should we be doing to get ready for “the big one”?
We need to have a 9-11-like report. That report did not pull any punches – it went through in great detail and described the shortcomings or the lack of preparedness in that situation. And it was done in a nonpartisan way, jointly sponsored by both Democrats and Republicans, and nobody pointed fingers. I long for the day in this country when we could do the same thing, where without blame, we totally review what happened, what didn’t happen, what could have happened, what should have happened, and then come up with a plan for the future. From my perspective, we still have that opportunity, but I’m afraid the window is closing as we get further and further away from the actual pandemic itself.
Looking back, what could have been done better to mitigate the impacts of the pandemic?
In the very earliest days of the pandemic, I urged that we take a step back and not do any kind of lockdown because, in fact, this would likely last three or more years. There’s no way that we could do a lockdown of any kind of efficiency during that entire time. I suggested keeping our hospitals as available as possible. To do that, we needed to reduce transmission in the community. I’d suggested that hospitals keep a daily tab of their bed count and publish that. And when hospitals get to a certain level, such as 85 to 90% full, then you come out with what we call ‘snow days.’ Schools and businesses close temporarily, and you can drive that number back down again so you’re not dealing with a hospital that has 140% capacity. You reduce the impact of the pandemic, while also limiting the impact on society as a whole.
Last year, Canada lost its measles-free status due to outbreaks fuelled by low vaccination rates. The US recently rolled back its childhood vaccine schedules. Can initiatives like PERL help us get back on track?
First of all, we have to understand we never really were on track. We surely were not in as bad shape as we are now, but going into the pandemic, we were not prepared. At this point, we have to help people understand that future pandemics are not optional. They will occur. And they could be much more devastating than what we have already experienced. When you add those latter two points together, it screams we need to be better prepared.
Frankly, oftentimes academic centres are in the best position to continue to put forward that message. Governments are not having much to say, and the private sector, unless it is being charged with coming up with new products or new ways of approaching old products, is not likely going to have much to say.
This interview has been edited for length and clarity.
PERL Launch Event: Health Crises in an Era of Autocracy, Disinformation, and Shifting Geopolitical Risks, February 3. Please note: the in-person event is now at capacity, but you are invited to tune in to the livestream on YouTube.
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PERL Launch: In conversation with award-winning health reporter André Picard
