I warned of viral pandemics like COVID in 1998 and 2015 (books), and in…

My 2015 warning: (The Future of Almost Everything, published by Profile Books)

Humankind is very vulnerable to viral attack because we have very few, and relatively feeble, antiviral therapies.

There is not a single antiviral today that is as effective as penicillin when first discovered. Antiviral research is 50 years behind antibiotics. 

Spanish flu in 1918‒19 spread across the world in months, on foot, horses, donkeys, trains and ships, killing over 30 million people, out of a world population of 2 billion. 

If a similar highly infectious and lethal pandemic begins tomorrow, it is likely to spread on international flights in days and weeks, not months, with no time for vaccine development or global distribution, and could kill 100 million people within a year. 

That is why the World Health Organisation keeps warning governments about these threats.

Extract from The Future of Almost Everything - first edition in 2015; 2nd edition in 2019.

VIRAL PANDEMICS – MAJOR HEALTH RISK

Every year we see new mutant viruses, and as populations grow, mutations develop and spread faster. Mutation is particularly likely when viruses from animals infect humans, or when people are treated with antivirals.

There is not a single antiviral today that is as effective as penicillin when first discovered. Antiviral research is 50 years behind antibiotics. Our only really effective weapon is vaccination. Hepatitis C virus is just one threat, carried by 3% of the entire world, including 4 million in America and 215,000 in the UK. Hepatitis B and C kill over a million a year.

AIDS will be a global menace for decades

AIDS has killed over 40 million people with a further 35 million infected, mainly in Africa, and will continue to be a global health threat in 2040. HIV mutated as it jumped from animals to humans decades ago, and is a warning of other mutants to come, against which we will have no immunity, vaccines or treatments.

I have been deeply involved with AIDS work since 1988, when the international AIDS agency ACET started in our family home, as a result of my NHS work with people dying of cancer in London, during which I discovered people with AIDS who were dying in great physical and emotional distress. Today ACET has prevention and care projects in 18 nations, mainly in the poorest parts of the world.

Back in 1987, I said that developing a vaccine against HIV would be very difficult, because the virus keeps changing its outer surface, and escapes every vaccine trick we know. I predicted back then that it would be at least 15 years before a vaccine would be developed, and today there is still no likelihood of an effective, widely available vaccine by 2035.

Treatments have improved, as well as availability, and AIDS is becoming a chronic illness. But there is still no cure, treatments are toxic and are taken for life. We are discovering rare genes that provide partial or complete HIV protection, and which will lead us to gene-linked therapies.

Even if a cure is discovered tomorrow, it will take over 12 years for clinical trials to prove safety, and at least 25 years more to bring HIV under control. TB, for example, became curable in 1944, yet we still have the world’s largest pandemic today.

The good news is that prevention works, with falling or stable infection rates in many nations like Uganda where up to 30% of all sexually active men and women were infected at one time. However, complacency will be a constant challenge, in many nations among different parts of the community.

Spanish flu, SARS, bird flu, swine flu

Another mutant virus on the scale of HIV was the Spanish flu epidemic of 1918‒19, which spread across the world in months, on foot, horses, donkeys, trains and ships, eventually killing over 30 million people, out of a world population of 2 billion.

From swine flu to ebola

The genetic code of the Spanish flu virus is almost identical to that of swine flu.

Therefore it was worrying when swine flu reappeared in Mexico in 2009. It spread globally in weeks and caused 14,000 deaths, despite mass-mobilisation of health resources, bans on travel, and almost instant lock-down of parts of Mexico. (2020 note: 24% of the world was infected by H1N1 from 2009-2010 - including 50% of children.)

SARS also appeared without warning in 2003. Over 8,600 people were infected with the virus within a few weeks, despite huge containment efforts, and 860 died.

And 1% of carriers were so infectious that even touching a light switch 24 hours after they had done so could have been enough to kill you.

SARS was only stopped by aggressive contact tracing and quarantine, in China, Canada and other nations.

The outcome would have been very different if a single ‘super-spreader’ had travelled across Africa in a crowded plane, seeding clusters of infection in remote rural areas.

The 2014‒15 ebola outbreak killed and orphaned many thousands, paralysed West African economies, stopped farming, closed markets, and caused widespread hunger and deaths from other treatable diseases, with constant threats of more outbreaks from infected animals in the bush.

How much more evidence do we need? Mutant viruses will be a major future threat, and we will see far greater investment into antiviral therapies, rapid vaccine development and epidemic monitoring as a result.