Disease X or Zombie Apocalypse: what will end the world?

There is possibility that we may have to deal with multiple pathogen pandemics simultaneously

Recently, I have been bombarded by questions from friends and colleagues asking me about a “new” virus that is apparently more dangerous than the Covid-19 virus (SARS-CoV-2). Yesterday while I was driving, the host of a morning radio show also warned about a new virus that is spreading fast and making the WHO worried about the next pandemic, as the Disease X pandemic will be even deadlier. Contrary to many radio hosts, this one is well educated, well read, and makes sense in her morning talks. That got me worried, as my friends and colleagues who were calling me are also highly educated, including many medical doctors.

So, what is Disease X? How dangerous is this new virus? How fast may it spread? Why is WHO worried about it? Well, let me quickly burst your bubble. Disease X is not a real disease. It’s a hypothetical name given to a future pandemic-causing pathogen. Yes, we don’t know what the next pandemic-causing pathogen will be, but we need to prepare for it. Think about your school days spent learning algebra. You were always supposed to find the value of X. X is normally a placeholder for an unknown quantity or variable. Similarly, WHO started using Disease X in 2018 to warn the world of an imminent pandemic. But no one paid attention until we were hit by a massive pandemic in 2020. However, when WHO used the same term again in the Global Economic Forum meeting, everyone paid attention, and it became a headline across the world.

The world is now inhabited by “educated and learned” people who only read headlines and then forward those headlines through their social media accounts. This created panic when this news went viral. Unfortunately, no one bothered to actually read the news they were forwarding, including the radio host, who just shared the headline and not the context of the news.

In 2011, to shake people into action for pandemic preparedness, Dr Ali S Khan, who was then a Rear Admiral and Director of Preparedness at the US-CDC, published “Preparedness 101: Zombie Apocalypse” on the US-CDC website. Though it was educational entertainment, its real purpose was to give a face to the next pandemic preparedness. It was successful in making people talk about the need to prepare for the pandemic. But like today, many just focused on the headline and did not understand or read what the objective was or what was being taught there.

We know the next pandemic will happen. There is a possibility that we may have to deal with multiple pathogen pandemics simultaneously. The next pathogen, or Disease X, could be even deadlier and more infectious than Covid-19. These are not projections being made in thin air, but with our population explosion, increased connectivity, climate challenge and other social factors, we are at the tipping point. Unfortunately, even after more than seven million deaths and trillions of dollars in losses, the world is still not paying any meaningful attention to its preparedness for the next pandemic. In that situation, public health professionals and organisations are struggling to keep decision-makers’ attention on the subject.

Maybe our friend and colleague, Dr Ali Khan was not far off in predicting a world with a virus damaging our nervous systems and brains. The Zika virus has clearly been associated with microcephaly (small head size) in childhood and severe neurologic complications in adults, such as Guillain-Barré syndrome, etc. Long Covid has multiple neurological complications, including brain fog, anxiety and depression. Mental health issues after Covid-19 are still being studied, and in some surveys, increased alcohol and drug use is being identified as a coping mechanism by many patients.

The question is not what pathogen will start the next pandemic, but the real problem is that our governments are still not preparing to protect us. They will spend billions of dollars on weapons but not even pennies to protect you from the next pathogen. So now we should start talking and asking our political leaders what their plans are for the next pandemic. Year 2024 is a global election year, and if we start asking this question to all leaders, we may make a difference.

Published in The Express Tribune, January 27^th, 2024.

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