Five years after COVID-19 lockdowns, BU experts find some glimmers of hope, but say new US policies could put the world at greater risk of a coronavirus-like outbreak
Photo via iStock/AmArtPhotography
Pandemics
Five years after COVID-19 lockdowns, BU experts find some glimmers of hope, but say new US policies could put the world at greater risk of a coronavirus-like outbreak
COVID-19 shut down the world, killed more than seven million people, and triggered a major economic recession. Many assumed the coronavirus pandemic’s destructive toll would spur global action to prevent such a disaster from ever happening again. But as the world marks five years after the declaration of a pandemic, just how prepared are we for another outbreak?
“In some ways better, in some ways worse,” says Boston University infectious diseases expert Nahid Bhadelia. She heads the University’s Center on Emerging Infectious Diseases (CEID) and served as senior policy advisor for global COVID response on the White House COVID-19 Response Team.
Counting in the world’s favor: we’ve done this before and we have a lot of new tools—from vaccines to monitoring technology—to deploy. But, says Bhadelia, vaccine hesitancy and health misinformation are growing problems, climate change increases the risk of another outbreak, and stubborn health disparities put us all in greater danger. According to the global epidemic preparedness coalition CEPI, the chances of another pandemic happening in our lifetimes is about 38 percent.
And then there’s the new elephant that’s entered the room: President Donald Trump’s overhaul of international collaboration, healthcare administration, and scientific support—not to mention his appointment of a noted vaccine skeptic as secretary of health and human services.
“Politics are affecting our pandemic preparedness,” says Bhadelia, citing efforts to shake up research funding, shutter the US Agency for International Development (USAID), and reform the collection and accessibility of federal health data. She says restrictions around health disparities data, in particular, are “beyond abnormal.”
The Brink spoke with Bhadelia, a BU Chobanian & Avedisian School of Medicine associate professor of medicine, and other BU experts to measure the world’s readiness for another outbreak. They shared reasons for concern and hope—and recommendations for what policymakers and individuals can do to reduce the risk of disaster.
5 Reasons to Be Optimistic
1. Major Progress on Developing Vaccines
Photo: A person getting a vaccine at an immunization clinic
The mRNA technology used in COVID shots could help scientists quickly build vaccines against new and emerging infectious diseases. Photo by Jackie Ricciardi
Vaccines usually take years to develop, decades even, but the COVID shot was making it into arms within a year. And it used an approach—mRNA, which helps train our bodies to fire up immune responses—that hadn’t been approved for use in the United States before. (The breakthrough mRNA technology that led to the COVID vaccines was codeveloped by a BU alum, Drew Weissman (CAMED’87, GRS’87, Hon.’23), who shared the 2023 Nobel Prize in Physiology or Medicine for the work.) With the mRNA platform in place and proven, it could rapidly be turned against other diseases in future. Researchers at BU have also developed a new RNA vaccine with the potential to be more effective than existing shots, while scientists are working on mRNA vaccines for other viruses, including influenza. “The threat of a new pandemic a lot of times boils down to an unknown disease that we don’t know how to handle,” says Bhadelia. “But having a tool like that [mRNA] could help build vaccines pretty quickly.”
2. We’re Better Prepared to Act Fast
When the coronavirus first started its march around the world, most countries were unprepared and slow to react, with little agreement on how to respond. If—or when—the next pandemic lands, things should be different. Bhadelia says most international health organizations have coalesced around the “goal of a 100-day mission,” deploying expertise, equipment, resources, and vaccines as promptly as possible. She says that’s already been shown to be effective in the response to two virus outbreaks in Africa: Marburg in Rwanda and Ebola in Uganda. “Timelines have shrunk. That’s a reflection of a common language of what’s needed and more experience with international collaboration.”
3. International Collaboration Has Improved (with a Big USA Asterisk)
After fighting COVID-19, governments and cross-border organizations gained valuable experience in sharing surveillance data and coordinating and deploying countermeasures. There’s plenty of room for improvement, according to Bhadelia, but the world is in much better shape than it was in 2019. Rather, it was in better shape: Bhadelia says that the Trump administration’s moves to withdraw from the World Health Organization and dismantle USAID, as well as cut much health and virus research funding, could be devastating. “We’re not at the table where a lot of data gets exchanged—that’s a step back,” she says. Plus, it may also mean robbing the world of US expertise and technical assistance when trouble strikes. “It’s not just something we’re giving, we’re gaining something out of it: trust, information about our own security and how we ready ourselves.”
4. Artificial Intelligence Could Help Spot and Track Incoming Threats
In the past five years, artificial intelligence (AI) breakthroughs have come at lightning pace—and the technology could have a significant impact on our ability to monitor and respond to viruses, says Yannis Paschalidis, director of the BU Rafik B. Hariri Institute for Computing and Computational Science & Engineering. In collaboration with Bhadelia, he’s studied the ability of AI to detect disease and speed up drug discovery. “An exciting direction we’re pursuing is developing methods that optimize epidemic control,” says Paschalidis, a College of Engineering distinguished professor of electrical and computer engineering. During COVID-19, “control measures were applied uniformly, in both large, dense cities and rural areas. That is not necessary, and we can optimize such measures on geography, age groups, and individual health characteristics.” He and Bhadelia are also working on an AI-powered global surveillance platform—Biothreats Emergence, Analysis and Communications Network (BEACON), which they hope to launch this year—to monitor and analyze infectious diseases threats.
We think about pandemic preparedness as a matter for scientists and doctors, and it’s not. It’s a much bigger problem, it touches all of society.
Nahid Bhadelia
5. We’ve Learned a Lot—Including That Prevention and Response Takes Experts from Many Fields
Preventing or combating a virus outbreak can’t be done by doctors and medical experts alone. COVID-19 brought into sharp relief the roles that everyone from engineers to climate experts could play in advancing new technologies, improving care, or anticipating future threats. Bhadelia gives the example of the computer and data researchers she’s collaborating with to build outbreak early-warning systems. “We think about pandemic preparedness as a matter for scientists and doctors, and it’s not,” she says. “It’s a much bigger problem, it touches all of society.” At CEID, faculty come from a range of disciplines, including communications, Earth and environment, engineering, law, sociology, social work, and global studies, as well as health fields.
5 Reasons to Be Pessimistic
1. America Is Withdrawing from the World and Shifting Its Science Priorities
Photo: Protestors holding signs outside of USAID shuttering, one says "Thank you USAID Workers"
Supporters cheer fired US Agency for International Development (USAID) workers. BU infectious diseases expert Nahid Bhadelia says President Trump’s moves to dismantle the agency could make it much harder for the world to deal with future outbreaks. Photo via AP/Jose Luis Magana
Among President Trump’s early second-term initiatives were attempts to halt much health and science research, strip down USAID and health-centered agencies, and appoint a vaccine critic as health secretary. While his supporters cheer the administration’s focus on cutting federal spending, reducing America’s global engagements, and shaking up the status quo, many health experts like Bhadelia are extremely worried. Swingeing job and funding cuts at health and science agencies mean a massive loss of experience—at home and abroad. For example, she says, ending or scaling back USAID’s work will incapacitate the global health programs—“the resources on the ground that can help quickly identify a disease, diagnose and isolate patients”—that can stop a virus from spreading. CEID core faculty member Brooke Nichols, a BU associate professor of global health, has found that the end of USAID tuberculosis programs alone could lead to 2.2 million new deaths over the next five years. “If infectious diseases [research and investment] is on break, I don’t know how you’re going to manage a new outbreak,” says Bhadelia.
2. And the Federal Government Could Make It Harder for States to Be Ready
Changes at the federal level may also hamstring states’ pandemic prevention and response, according to Bhadelia. She fears the Trump administration’s severe staffing and budgetary cuts at agencies like the Centers for Disease Control and Prevention (CDC) will “mean horrific things for pandemic preparedness and identifying new biological threats.” States rely heavily on funding from the CDC. She also says that political pressure may delay—or even thwart—the declaration of a public health emergency should another virus overwhelm the country. “We could be very far behind in responding to new threats,” says Bhadelia. “Public health emergency powers aren’t just a piece of paper—they allow greater federal involvement in states in terms of gathering data, they free up more money and resources that can be mobilized.”
3. Vaccine Hesitancy Is Up, Trust in Science and Public Health Is Down
“There has been a steady decline in trust in science and health experts over the last few decades, which goes hand in hand with a decline in scientific literacy,” says Arunima Krishna, a BU College of Communication associate professor of mass communication, advertising, and public relations. Most Americans still have faith in science, but confidence took a hit during the pandemic, while vaccine skeptics like Joseph Ladapo (Florida’s surgeon general) and Robert F. Kennedy Jr. (the new US health secretary) are filling influential state and national health positions. Even in Massachusetts—a state renowned as a hub for science and health research and practice—vaccination rates are falling. Krishna is an expert on public perception of controversial social issues and a senior editor of the journal Health Communication. One part of her work, including with COM’s newly launched Graduate Certificate in Civic Science Communication, is helping scientists better communicate their expertise and findings to the public. During the COVID pandemic, she published a study testing ways of countering health misinformation using positive vaccine experience narratives. “The early days of the COVID-19 pandemic saw an informational vacuum,” says Krishna. “Such informational vacuums very quickly get filled by misinformation and disinformation, and working with communication experts can help prevent the creation of such vacuums.”
The early days of the COVID-19 pandemic saw an informational vacuum. Such informational vacuums very quickly get filled by misinformation and disinformation, and working with communication experts can help prevent the creation of such vacuums.
Arunima Krishna
4. Stubborn Health Disparities Put Us All at Risk
Not everyone suffered equally during the COVID-19 pandemic: in America alone, BU-led research revealed Black, Indigenous, Latinx, and other people of color were dying at disproportionately high rates compared with white people. And, as COVID showed, leave one group of people at risk and the danger increases for all—giving a virus greater opportunity to spread or mutate. But it seems a lesson the US and the world is struggling to take on board—with health inequities persisting along national, socioeconomic, educational, and racial and ethnic lines. That puts us at a disadvantage for future pandemic response, says Bhadelia. “And now we can’t even talk about it,” she adds, referencing President Trump’s push to end research on diversity, equity, and inclusion or work that supports what he calls “gender ideology,” as well as early restrictions his administration placed on access to federal data. She says that if researchers can’t collect or view information on who’s most at risk, virus surveillance programs would be decimated: “If we can’t talk about what puts some people at more risk than others, if researchers don’t have access to that data, how do we make better pandemic preparedness programs? It’s debilitating.”
5. Climate Change and Urban Development Push Pandemic Chances Higher
“We still constantly see new pathogens, such as Oropouche virus, that likely emerged due to changing environmental and land use,” says BU researcher Kayoko Shioda. Oropouche can be spread by mosquitoes. Photo via Unsplash/Erik Karits
More than 50 percent of infectious diseases that impact people have been aggravated by climate change, according to a 2022 study by University of Hawaiʻi at Mānoa researchers. As the planet heats up and human habitation infringes on more wild spaces, the chances of viruses leaping from animals to humans rises. “We still constantly see new pathogens, such as Oropouche virus, that likely emerged due to changing environmental and land use,” says Kayoko Shioda, a BU School of Public Health assistant professor of global health who’s also affiliated with CEID. Oropouche, which causes symptoms like fever and myalgia and has no vaccines or treatments, is spread by midges and mosquitoes. And because severe weather and contaminated foods and environments can also affect transmission, Shioda says some populations are especially susceptible to rogue enteric bacteria, which impact the intestinal tract. “Many low-income settings are especially vulnerable due to the lack of infrastructure and, therefore, there is a need to identify feasible and effective measures to enteric pathogens across seasons,” she says.
Feeling Overwhelmed? Here’s How Individuals Can Make a Difference
With pandemics requiring national and international responses, what difference can one person make?
On a practical health prevention level, there are some potent steps we can all take to reduce our chances of becoming sick, starting with getting vaccinated and staying aware of changing disease risks, so we know when to step up protection efforts. With bird flu swirling around, for example, have your kids wash their hands after playing in parks where birds congregate.
On a broader scale, Bhadelia encourages everyone to lessen their impact on the environment, to advocate for science, and to think carefully about where they get health information—verifying hot takes before sharing them. “Don’t inadvertently become a tool for spreading disinformation,” she says. “Seek out good sources, be a health champion, be a vaccine champion.” That may seem like a small thing, but the effect will multiply. “If you see misinformation or disinformation, call it out,” says Krishna. “Research shows that even if the individual spreading misinformation is not convinced, a third observer of the interaction may be prevented from accepting the premise of the misinformation message. This is called an observational correction.”
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