How Scientists Could Stop the Next Pandemic Before It Starts

On a cold morning in February 2018, a group of 30 microbiologists, zoologists and public-health experts from around the world met at the headquarters of the World Health Organization in Geneva. The group was established by the W.H.O. in 2015 to create a priority list of dangerous viruses — specifically, those for which no vaccines or drugs were already in development. The consensus, at least among those in the room, was that as populations and global travel continued to grow and development increasingly pushed into wild areas, it was almost inevitable that once-containable local outbreaks, like SARS or Ebola, could become global disasters.

“The meeting was in a big room, with all the tables arranged around the edge, facing each other,” one of the group’s members, Peter Daszak, recalled recently. “It was a very formal process. Each person was asked to present the case for including a particular disease on the list of top threats. And everything you say is being taken down, and checked factually, and recorded.”

Daszak, who directs the pandemic-prevention group EcoHealth Alliance and is also chairman of the Forum on Microbial Threats at the National Academies of Sciences, Engineering and Medicine, had been given the task of presenting on SARS, a lethal coronavirus that killed roughly 800 people after it emerged in 2002. (SARS stands for Severe Acute Respiratory Syndrome and is officially known as SARS-CoV-1.) “We’d done a lot of research on coronaviruses, so we knew they were a clear and present danger,” he told me. “High mortality, no drugs or vaccines in the pipeline, with new variants that could still be emerging.”

The discussion, he said, was intense. “Everyone else in the room knows the facts already — they’ve read all the research,” Daszak said. But for each pathogen, the speaker had to convince the room that it presented a significant threat — “that this disease really could take off, and that we should concentrate on it rather than on Lassa fever or something else. So, you argue the case, and then people vote. And sometimes it gets quite heated. I remember that monkey pox was an issue, because there are outbreaks, but there’s really nothing we can do about them. It was a really rigorous, really excellent debate — and then afterward, we went and had fondue.”

The final list — which did contain SARS and MERS, along with seven other respiratory, hemorrhagic or otherwise-lethal viruses — also included something the W.H.O. dubbed “Disease X”: a stand-in for all the unknown pathogens, or devastating variations on existing pathogens, that had yet to emerge. Daszak describes Covid-19, the disease caused by the virus SARS-CoV-2, as exactly the kind of threat that Disease X was meant to represent: a novel, highly infectious coronavirus, with a high mortality rate, and no existing treatment or prevention. “The problem isn’t that prevention was impossible,” Daszak told me. “It was very possible. But we didn’t do it. Governments thought it was too expensive. Pharmaceutical companies operate for profit.” And the W.H.O., for the most part, had neither the funding nor the power to enforce the large-scale global collaboration necessary to combat it.