Pandemics do not arise suddenly: it begins with the outbreak of an infectious disease that turns into a local epidemic, which then spreads among its neighbors, and has the potential to become global. How to detect these first signs?
“For all disasters – whether they are famines, earthquakes or tsunamis – we need to be alerted as early as possible.” And pandemics are no exception.
This is the reflection of Andrew Natsios, professor at Texas A&M University and director of the Scowcroft Institute for International Affairs, in the United States, who maintains that just as a food crisis can be predicted by analyzing a series of variables, can also be estimated when an infectious disease outbreak has the potential to spiral out of control.
Creating an early warning method (called a Pandemic Early Warning System, PEWES) would serve to avoid what is produced, says the professor, who was also in charge of managing the United States Agency for International Development (USAID) between 2001 and 2006.
“A pandemic nor suddenly appears: it starts with an outbreak of a disease that then turns into a localized epidemic, then spreads to other countries and later turns into a pandemic that may have the potential to become global, ”he explains to BBC Mundo.
But how would this system work? What data would you base your prediction on? And are there no other early warning systems for pandemics?
Burials and crowds in hospitals
The system, explains the professor, would be similar to the Famine Early Warning Systems Network (FEWES), a successful model developed by USAID after the devastating 1985 famine in Ethiopia that left nearly a million dead.
Since its implementation, Natsios emphasizes, this program “has managed to predict all famines in the territories under his responsibility in the last 40, 50 years ”.
This system uses images satellite to assess what is happening on the ground, data on the grain and livestock trade, the climate, as well as reports from food experts, agricultural scientists and businessmen who enter information on the web when they notice that something is not right.
With this information, he produces free access maps of food insecure areas and analyzes of the problems that are brewing in the world.
In the event of a pandemic, reports from local health professionals in different regions of the globe they could contribute relevant information.
Isatellite images would allow key data to be obtained.
Aerial photos of mass burials, crematoriums working overtimeImages showing an increase in the size of groups gathering in front of clinics and hospitals are valuable material.
They are not necessarily indicators of an outbreak, but they do denote the presence of a problem that warrants investigation, for example.
August, not December
Another crucial tool is the monitoring of what happens on the internet and the topics that people are talking about.
Natsios refers to a recent study of the Harvard University which combined two pieces of information that led to an interesting conclusion.
“The researchers looked at satellite images of parking lots, clinics and hospitals in the zone of Wuhan, where the pandemic manifested itself on a large scale in China, and they noticed a great increase of people in those places in August of last year, “Natsios tells BBC Mundo.
The second data came from Facebook and Twitter, which revealed that since the beginning of August last year, people had started doing questions about a new disease, listing all the typical symptoms of COVID-19.
“Combining these two data, it is very likely that they have discovered that, in fact, the pandemic did not start in December but in August“Explains the professor.
Had we known, “even if we had not been able to send health aid teams (since China would never have allowed groups of the US, Europe or a UN contingent to enter) we could have alerted the Chinese authorities.”
Natsios does not believe that the Chinese government was aware of the situation at the time: he intuits that local officials did not want to send bad news to Beijing and therefore kept this information secret.
It is not that the data that Natsios mentions separately do not exist, “one can obtain them by buying them,” he explains.
But the idea is joinyou under a sameor roof, and put them in a report available to the public, NGOs and other organizations and institutions free.
The support teams they are the other leg of the alert system.
The idea, tells BBC Mundo Natsios, is to use USAID’s Emergency Response Teams structure to train professionals on the ground who can deal with a pandemic and send special teams of US aid to countries that allow it.
An early warning system is particularly useful for collect Data of countries with authoritarian governmentsUnwilling to disclose information, Natsios notes, although they are not the only ones reluctant to present unflattering information about themselves.
“No government really likes to give uncomfortable news. But in a democracy, there are civil organizations, professionals, study centers, congresses, parliaments and independent news media that can ask questions, “says Natsios, while autocracies lack these. control instances.
With an early warning system, information can be obtained by other means well in advance and the alarm sounded to take action or pressure some governments to take it.
Given the global scope of this project, it is logical to ask whether it would not be more appropriate for it to fall under the jurisdiction of an international organization, such as the UN, or any other institution that does not have a national affiliation.
It’s more, the UN already has a Global Outbreak Alert and Response Network (GOARN).
What is the use, then, of diversifying resources and efforts to create a parallel system?
“We can’t put all the ‘humanitarian eggs’ in one basket, because sometimes systems failNatsios says vehemently.
The problem with a system like the UN, is that because of the way it is organized, executive directors have right to veto, says the professor, and mentions the example of the Ebola outbreak detected by GOAR in 2014 in West Africa, of which an alert was not issued because the local official estimated that it would harm the regional economy.
“And sometimes our own system can also fail,” he admits. “So we have to have an overlay, a multiplicity of systems, in case of failures ”.
“Putting everything together in a single international system would be a terrible idea,” concludes Natsios.