SEATTLE — The World Health Organization declared COVID-19 a pandemic on March 11, 2020, after more than 118,000 cases in 114 countries and 4,291 deaths were confirmed.
It's been nearly three years since that declaration and even longer since the Centers for Disease Control (CDC) reported the first laboratory-confirmed case of the 2019 Novel Coronavirus in the U.S. from samples taken on Jan. 18 in Washington state. On that same day, the CDC activated its Emergency Operations Center (EOC) to respond to the emerging outbreak.
Confirmed and unreported positive COVID-19 cases are still occurring three years later but the risk of severe illness has diminished due in part to vaccinations.
According to the latest data reported as of March 1, nearly 70% of the world population has received at least one dose of a COVID-19 vaccine. 28% of people in low-income countries have received at least one dose. More than 759,000 doses are administered daily.
The next pandemic is 'inevitable'
“I'm an optimist and I wish I could tell you that it's not going to happen soon, but it's more than likely that we're going to have another epidemic that becomes a pandemic," said Linda Venczel, director of epidemic and preparedness response program at PATH in Seattle.
Venczel is an epidemiologist and a microbiologist.
The PATH team includes scientists, health professionals, business leaders, engineers, advocates, and experts from dozens of other specialties. It works in more than 70 countries to create "sustainable solutions that improve health and well-being for all."
"My prediction is, we're going to see this as more common occurrence moving forward," Venczel said. "But we do have the know-how and we do have the tools to be able to prevent things from becoming as bad as they were with the COVID-19 outbreak."
Venczel said it is possible for the United States and other countries to be better prepared for the next outbreak or pandemic. Preparedness depends on a number of factors including strengthening labs and contact tracing.
“Making sure that there is the right funding, the right stockpiles of vaccines and diagnostics available," Venczel said. "If you don't have that, then you're kind of running blind on what the actual situation is.”
Emerging viruses
PATH and the Washington State University Paul G. Allen School for Global Animal Health have been closely tracking and further researching viruses with the most potential cause of an outbreak.
Several are on a lengthy list of viruses the WHO has reported as "emerging viruses."
A few of the viruses include Nipah, Ebola and Crimean-Congo hemorrhagic fever. All three are spread to humans from animals or insects.
“We're doing a study now of the different viruses that are passed along by bats and other animals and we're just touching the surface of how many viruses are carried by bats and they migrate all over the world," Venczel said.
Climate change is another factor impacting virus outbreaks, according to Venczel.
"With climate change, there's a lot of people that are going and looking for food in areas they didn't before," Venczel said.
The team at WSU Paul G. Allen School for Global Health Care agrees that people are intermingling with wildlife more than ever.
“We're really rapidly expanding into the natural world around us and as we do that, we come into contact more and more frequently with wildlife that we never really would have had a chance to come into contact with before," said Michael Letko, WSU assistant professor in the Laboratory of Functional Viromics.
Letko and the team at WSU have been working on a two-year study showing how viruses related to SARS look and how they can grow in culture.
According to the study - several coronaviruses have been transmitted from animals to people. Twenty years of virus discovery studies have uncovered thousands of new coronavirus sequences in nature.
Most of the animal-derived sarbecoviruses have never been isolated in culture due to cell incompatibilities and a poor understanding of the in vitro requirements for their propagation.
The team's work led to the successful isolation of more sarbecoviruses than previous approaches and from field samples that had been collected over a 10-year longitudinal study.
“The first step that we would need if we would want to develop a vaccine for these types of viruses," Letko said.
Nipah virus
Nipah virus (NiV) is a zoonotic virus. It is primarily bat-borne and is also known to cause illness in pigs and people.
NiV was first discovered in 1999 following an outbreak of the disease in pigs and people in Malaysia and Singapore. According to the CDC, this outbreak resulted in nearly 300 human cases and more than 100 deaths. More than one million pigs were killed to help control the outbreak, causing a substantial economic impact.
Ebola
Ebola Virus Disease (EVD) is a rare and deadly disease in people and nonhuman primates, according to the CDC. The viruses that cause EVD are located mainly in sub-Saharan Africa. People can get EVD through direct contact with an infected animal - bat or nonhuman primate - or a sick or dead person infected with Ebola virus.
In December 2019 the U.S. Food and Drug Administration (FDA) approved the Ebola vaccine known as "Ervebo." This is the first FDA-approved vaccine for Ebola.
This vaccine is given as a single dose vaccine and has been found to be safe and protective against Zaire ebolavirus, which has caused the largest and most deadly Ebola outbreaks to date.
Crimean-Congo hemorrhagic fever
Crimean-Congo hemorrhagic fever (CCHF) is caused by infection with a tick-borne virus (Nairovirus) in the family Bunyaviridae. The disease was first characterized in Crimea in 1944 and given the name Crimean hemorrhagic fever, according to the CDC. It was later recognized in 1969 as the cause of illness in the Congo, thus resulting in the current name of the disease.
Insect repellants containing DEET are the most effective in warding off ticks. Wearing gloves and other protective clothing is recommended. The CDC said individuals should avoid contact with the blood and body fluids of livestock or humans who show symptoms of infection.
According to the CDC, "an inactivated, mouse-brain derived vaccine against CCHF has been developed and is used on a small scale in Eastern Europe." However, there is no safe and effective vaccine currently available for human use. The CDC said further research is needed to develop these potential vaccines as well as determine the efficacy of different treatment options including ribavirin and other antiviral drugs.
Working with world partners
Working closely with communities in Sub-Saharan Africa and Southeast Asia – PATH said it aims to put the best outbreak prevention resources in countries that need them most.
This includes places that were most vulnerable at the start of the COVID-19 pandemic.
“If you look at the Ebola outbreaks that have occurred in DRC [Democratic Republic of the Congo], they become smaller and smaller over time because now we have a vaccine that we have developed and we've also had very good rapport with the community," said Venczel, director of epidemic and preparedness response program at PATH in Seattle
While working in its global hubs to increase vaccine education and contact tracing methods, PATH discovered a way to meet a dire need in Africa - bleach for cleaning hospitals and disinfecting water.
PATH's team designed and created a new portable machine designed to turn water and salt into bleach. One of many new tools to fight the spread of a virus.