Health personnel in protective suits supervise a massive test in Seoul on March 22. Lee Jin-man / A
P Infectious epidemics have accompanied humans for as long as they exist, as archaeological research shows . But you don't have to go back thousands of years. So far this century, humanity has faced SARS in 2003, flu pandemics between 2009 and 2010, MERS in 2012, Ebola from 2014 and today. Before or after having overcome the covid, a new virus will once again find its way to jump from its host and infect people and mobility will again spread it and put humanity to the test. What pathogen will cause it? We are prepared? Advances in medicine, capable of shortening the deadlines for the development of vaccines in years, allow us to think that we are more prepared, but reality shows that a specific treatment has not yet been found for those who become infected and that the health and social systems they are not enough to prevent and deal with a situation such as that generated by the coronavirus, despite the fact that it had been announced . The history of pandemics leads to doubt that society underlines and learns this page so as not to repeat the mistakes when turning it. The anthropologist Alberto del Campo affirms that "in a few generations there is a natural forgetfulness to continue." But scientists warn that not learning from this pandemic is a luxury that humanity cannot afford.
“The pandemic is more traumatic for Mediterranean cultures. It pisses us off not being able to go out and touch each other ”
Eduardo Martínez Manzanares, Professor of Microbiology at the University of Malaga, affirms that infectious diseases that can become pandemic are inherent to the coexistence of man with animals that act as reservoirs and explains: The mutational capacity of pathogens makes it possible for microorganisms to develop virulence factors and jump species. Then they find a virus with new abilities and an immune system that is not prepared. ”
With these conditions, he believes that the pathogen that will generate the next pandemic will be the one that is more resistant and has the most virulence (the ability of a microorganism to produce a disease), with a lethality that does not make you lose your options for survival. In this sense, Joel O. Wertheim, from the Department of Infectious Diseases and Global Public Health at the University of San Diego, states when reviewing the covid: “Pandemic surveillance was not prepared for a virus like SARS-CoV-2. We were looking for the next SARS or MERS, something that will kill people at a high rate, but looking back, we see how a highly communicable virus with a modest death rate can also put the world in check. ”
virus Guillermo López Lluch, professor of cell biology at Pablo de Olavide University (UPO), adds two more conditions: "A global pandemic requires a microorganism that spreads easily and is highly mobile." "A virus has more capacity than a bacterium," he adds.
In this sense, both coincide with what the John Hopkins University pandemic expert wrote three years ago without his warning serving to prevent covid: "The greatest threat The probable natural level (global catastrophic biohazard) that humans face is from an RNA virus transmitted through the respiratory tract, so this class of microbes should be a priority for prevention. ”
The origin can be anywhereGuillermo López Lluch, professor of cell biology at the Pablo de Olavide University
"The origin can be anywhere," adds López Lluch. “With climate change, vectors are multiplying, as shown by the latest outbreaks of the Nile virus or other infectious diseases.”
Martínez Manzanares adds the risk involved in “exposing the population and animals that should not be together”: “Favoring that pathogens can jump to humans is traumatic.
In this sense, the microbiologist supports the opinion of María Neira , director of Public Health and Environment of the World Health Organization (WHO), who warns of the dangerous relationship between viruses and human pressures on the environment : “By replacing the forest with intensive and polluting agriculture, the animals that live in those places where man had not entered undergo profound transformations. We interact with species with which we were not in contact and that can transmit diseases to us ”. Martínez Manzanares adds: "These are situations that, naturally, would not occur."
According to these two experts, the first preventive measure against the risk of next pandemics is to reduce the relationship between reservoirs and people: avoid the usurpation of natural spaces – "Cholera arose from the occupation of Indian mangroves by the English to plant rice", recalls the Malaga microbiologist – and avoid the sale or contact of live animals that can harbor pathogens.
Are we prepared?
A From considering the jumps from viruses to people inevitable, science comes into play. For López Lluch, "the key is to identify the pathogen as quickly as possible." "Now we have better tools to determine a disease and sequence the genome," he adds. On January 11 of last year, a few days after the existence of the new coronavirus that causes covid (SARS-CoV-2) had been identified, scientists published its genetic makeup. And new variants are regularly disclosed.
But in order to sequence and identify the pathogen, one must first be aware that it has arisen, that it generates a new disease, that it is necessary to apply measures and that it cannot be hidden. Li Wenliang, the ophthalmologist who along with seven other doctors was the first to raise the alarm about the new coronavirus in December 2019 and who died of covid weeks later, was accused of "spreading rumors" and held in the police station until he signed a false repentance.
SARS-CoV-2 circulated undetected for at least two months before the first human cases of covid were described in Wuhan.
Using molecular dating tools and epidemiological simulations, researchers at the University of California San Diego School of Medicine, with colleagues from the University of Arizona and Illumina, have determined in a study published in Science that SARS-CoV-2 circulated undetected for at least two months before the first human cases of covid were described in Wuhan (China)
To avoid errors in diagnoses, Raimundo Real, scientist from the Department of Animal Biology at the University of Malaga (UMA), has drawn up a map of the potential expansion of virus vectors such as Zika (mosquitoes) so that, among other objectives, it serves as an alert tool for health authorities , which act by administrative divisions that do not correspond to the danger zones and for which, by not taking into account that they are in a risk area, they can let the first symptoms go unnoticed and co nfund with those of other ailments
López Lluch, as a member of the UPO Department of Physiology, Anatomy and Cell Biology , considers that the basic strategy, after the preventive one (avoid contact with the animals that serve as reservoirs), It is to strengthen the systems for the identification of pathogens and new infectious diseases, to have prepared health systems with sufficient resources and to act with the utmost urgency in the event of any notification, even if it does not result in a situation as serious as the current one. "I'd rather they make a mistake than hide it," he assures.
In order to maintain these strategies, it is essential to invest in two interconnected areas: science and health. The first is essential to recognize the emergence of a new pathogen and develop both vaccines and treatments. The second, to establish prevention and intervention strategies. In this sense, Martínez Manzanares is pessimistic: “ The investigation is very neglected . Public and private investment is far below what corresponds to countries like ours. It's ridiculous. And the only way to get out of a crisis is with new ideas ”.
Some promising young researchers have abandoned their careers to serve drinks on the weekend because they earn more. And those are not recovered Eduardo Martínez Manzanares, Professor of Microbiology at the University of Malaga
To argue his description of the situation, the microbiologist gives an example: “In Spain, having 30 years of research, with articles published in top-level journals [a scale of the relevance of scientific work], means earning 300 gross euros more per month ”. Economic compensation, as he clarifies, is only an indicator of the lack of recognition of science and the absence of incentives, not just monetary. In this sense, the microbiologist laments: “Some young and promising researchers have abandoned their careers to serve drinks at the weekend because they earn more. And those are not recovered ".
The scientist warns that these circumstances are fundamental in the face of the danger of a new pandemic:" With the covid we have made a mistake and it is not nonsense. A virus is not only dangerous because of its transmission capacity but also because of the lack of preparation. And this is historical ”
Isolation and vaccines
The doctor and professor of History of Science at the University of Castilla-La Mancha María Isabel Porras , who has analyzed the social response to other health crises, warns that one of the keys to covid and in the next epidemics is the "positive role of isolation measures, perimeter closures and limitation of population movement, to reduce the number of cases and alleviate the overload of the battered public health systems, thinned by years of neoliberal policies" .
In this sense, it points out that one of the lessons to be learned for future episodes is how to mitigate the effects of these measures among workers and in the low-income population that, according to it, “must choose between isolating themselves — not without difficulty due to the conditions of their housing— and go to work to survive. "
also considers that the vaccine development strategy must be rethought:" as they are not marching properly. Production and distribution have become a powerful business, a way to achieve or maintain the political and economic hegemony of the countries ”. And he concludes: “The main lessons that we should draw would be the need to temporarily suspend the patents of effective and safe vaccines to facilitate their manufacture, diffusion and application to the world population, and not forget the other more general inequalities to also address them and facilitate a recovery after the pandemic. Let us not lose again the opportunity to change the course of a pandemic and its consequences, as we have done at various times in the past year. ”
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