The next pandemic could make COVID look like a cakewalk, one expert warned Tuesday at Fortunes Brainstorm Health conference in Marina del Rey, Calif.
COVID was a very bad pandemic, with more than 1.1 million deaths in the U.S. alone so far, Dr. Robert Wachter, chair of the Department of Medicine at the University of Californias School of Medicine in San Francisco, noted. Wachterthe author of 300 articles and six books, including a New York Times best-sellerbecame popular on Twitter during the pandemic.
COVID wasnt the beast it could have been in terms of mortality, he argued. The virus generally killed under 5% of the people it infected, and, depending on which country you resided in, often much less. Fellow coronaviruses SARS and MERS, on the other hand, were much less transmissible but more deadly, with case fatality rates around 10% and 34%, respectively.
When it comes to the next pandemic, Watchter said he is quite worried, and that it could be worse than COVID.
Theres nothing in the book of life that says you couldnt have a virus thats as infectious as this one but far more lethal, he noted.
COVID could evolve
Wachter isnt the only expert to raise the possibility of an equally transmissible but more lethal pandemic pathogen. COVIDs ability to infect more efficiently has sky-rocketed since 2019, soaring from near the bottom of the list of contagious diseases to near the top.
Its possible that ultra-transmissible Omicron evolves to become more deadly, experts warnthough theres no telling just how likely this scenario is, or when the transition might occur, if it ever does.
Whats to say that were not going to eventually see a COVID that has both? Dr. Michael Osterholm, director of the University of Minnesotas Center for Infectious Disease Research and Policy (CIDRAP), told Fortune last fall. He was speaking of transmissibilitywhich Omicron has in spadesand the lethality of SARS, MERS, or worse.
If COVID evolution were to take a turn for the worst, powers that be would need to decide whether it constituted a new pandemic and warranted a new name entirelyperhaps SARS-CoV-3or if it was simply an extension of the current pandemic, which is still ongoing, according to the World Health Organization.
Since Omicron burst onto the scene nearly a year and a half ago, evolution, while speedy, hasnt resulted in any major changes in how the virus presents, though each new major variant tends to chip away a little more at immunity and/or become a bit more transmissible, Wachter said. But a new variant could come out tomorrow. It could laugh at your prior immunity.
The chances of such a scenario are likely less than 20%, Wachter and colleagues estimate. The largely survivable but less-than-harmonious coexistence with the virus were experiencing now will likely be unchanged three years from now, he added.
Other viral threats are possible
The next pandemic pathogen may not be a coronavirus at all. Experts are eyeing a variety of strains of bird flu, given increasing transmission to and among mammals, and several recent human cases in disparate parts of the world.
Theres always the possibility of something entirely new. Among the list of the WHOs priority pathogens that have the potential to cause outbreaks and pandemics is Disease X, which represents an unknown threat.
That list also includes Crimean-Congo hemorrhagic fever; the Ebola and Marburg viruses; Lassa fever; coronaviruses SARS, MERS, and COVID-19; henipaviruses, and Rift Valley fever. The list was last updated in 2019, and a revised list should be released this year, according to the WHO.
