Discussing Pandemics & Outbreak Culture

Scientists have known for decades that a pandemic is looming, and that it likely would be an airborne disease that would spread rapidly. While it is difficult to predict for certain the name of the pathogen, it is not surprising to see that the spread of COVID-19 is near identical to what has been predicted. An outbreak of an infectious disease in any part of the world is extraordinarily challenging for many reasons, not the least of which is that pathogens do not adhere to manmade borders. They also make no distinction of race, religion, ethnicity, or national origin. With increased urbanization and other major environmental changes, we, collectively, as a human race are all susceptible to the virus.

While it's challenging for scientists to predict the exact origin of where an epidemic—or even pandemic, in this case—would emerge, the region in China where COVID-19 originated is an urban area, densely populated, and easy to travel to and from. This makes it a prime spot for the quick and easy spread of a highly contagious disease.

We know for certain that we are yet again in the midst of experiencing what Dr. Pardis Sabeti and I have termed as outbreak culture. Outbreak culture is the mindset that emerges as an outbreak begins to take hold in a region, or even around the world. Outbreak culture can manifest in actions based on fear, an instinct to protect oneself or others, or the desire to capitalize during a crisis. Outbreak culture has been experienced during every major disease outbreak in the past, and this one is no different.

It is difficult to predict the outcome of this current outbreak, but we still have the power to change its course.

One main consideration at this point is to protect our protectors. Our front line health workers are at great risk for infection. Our health care system does not have the capacity to handle the influx of projected cases. Delivery and effective and universal use of diagnostic testing and personal protective equipment (PPE) should be prioritized. As citizens, we can practice good hygiene and social distancing to protect the vulnerable and prevent overwhelming our health workers and our healthcare system.

Countries around the world—including the U.S.—have repeatedly chosen response over readiness, although we know the long-term economic and life-saving benefits of being prepared. COVID-19 is yet another hard-learned lesson that we are in need of a shift in our outbreak culture.

Unfortunately, COVID-19 will not be the last fast-spreading outbreak of a pathogen that we experience. Evidence suggests we could see at least three more major outbreaks within this century. Our book, Outbreak Culture: The Ebola Crisis and the Next Epidemic, highlights key principles to modify the way the global community should regard and prepare for epidemics.

The award-winning genetic researcher who helped tame the Ebola epidemic pairs up with a prize-winning journalist to tell the story of what happened and what would have to change to prevent the next outbreak from spiraling out of control.

At the height of the Ebola outbreak in West Africa, as thousands succumbed to the horrors of the disease, a prominent physician working in Sierra Leone, Sheikh Humarr Khan, became infected with the virus and died. As Pardis Sabeti and Lara Salahi show, much more could have been done within the medical community and among international actors not only to protect this renowned infectious disease expert but also to safeguard the well-being of his patients and others affected by this devastating disease.

Outbreak Culture examines each phase of the epidemic—the largest and deadliest Ebola outbreak to date—and identifies the factors that kept key information from reaching physicians and complicated the response to the crisis. Drawing insights from clinical workers, data collectors, organizational experts, and public health researchers, Sabeti and Salahi expose a fractured system that failed to share knowledge of the virus and ensure containment.

Secrecy, competition, and poor coordination plague nearly every major epidemic. Conducted with fearless scrutiny and unassailable expertise, this postmortem of the Ebola crisis seeks to change the culture of international responders, which has left us acutely unprepared for the next major outbreak.