Five years on from the onset of the COVID-19 pandemic and its subsequent lockdowns and disruption across the globe, The Weekly’s Genevieve Gannon explores what could the next pandemic be, and asks: are we ready for it?
In the spring of 2021, as NSW residents sheltered inside during the second lockdown, the isolation orders coincided with the wettest November on record. As people rushed in and out of supermarkets, clutching loo rolls and umbrellas, the state’s lakes, ponds, and rivers swelled. By the time the state emerged in early 2022, the world was humming with life, including mosquitos, which had hatched in huge numbers under perfect breeding conditions.
Meanwhile, doctors were puzzling over a mysterious new infection. Four patients with vomiting, fever, confusion and severe headaches had been admitted to a hospital in Albury, NSW, on the Murray River. The patients returned negative results for Murray Valley encephalitis (MVEV), Kunjin virus and dengue fever – the most likely culprits. Then, a health alert provided a clue: A tropical mosquito-borne disease, Japanese encephalitis (JE), had been detected in some NSW pigs. The Albury patients were tested and the results came back positive. It was a disquieting “eureka” moment. Japanese encephalitis had only been contracted in mainland Australia once before.
An unexpected outbreak
“We don’t know the full story,” says Professor Brett Sutton, the CSIRO’s Director of Health and Biosecurity. “But it may have been driven by the incredible rainfall we got in south-eastern Australia … and waterbird migrations from northern Australia … bringing potentially, the virus.”
Cases soon appeared in Victoria, South Australia and Queensland. In March 2022, JE was declared a Communicable Disease Incident of National Significance, and a free vaccination was offered to eligible Australians. By December, the containment measures had worked and the number of cases had dropped to zero.
This “outbreak within an outbreak’ shows how climate change spreads disease-causing pathogens, and the challenges health and policy leaders face to arm our population against what’s coming next.
What are the emerging threats?
“The next pandemic was a given,” Peter Doherty Institute Director Professor Sharon Lewin says, reflecting back on scientific opinion pre-COVID. The Institute’s scientists were the first outside China to grow the SARS-CoV-2 virus and share it with the world. Now Professor Lewin is helping to direct research towards protecting against future pandemics.
The world missed an opportunity to amass an anti-COVID arsenal at the start of the century. Severe Acute Respiratory Syndrome (SARS-1) emerged in 2003 and spread to 29 countries, necessitating urgent research programs that were quietly shuttered when the threat appeared to have passed. But it was because of the initial vaccine developed for SARS-1 that scientists did have “a few things in the cupboard,” Professor Lewin explains, when COVID-19 arose. “Now, the global thinking is, we want that leg-up in many other viruses that may one day be a problem.”
The World Health Organization (WHO) maintains a list of priority pathogens. COVID, MERS, SARS, Zika virus and Lassa fever are on the WHO hitlist, along with less transmissible viruses. Australian scientists work on them all.
“Viruses evolve quickly … if they mutate and adapt, they can become better at human-to-human transmission,” Professor Lewin says.
What is disease X?
The Nipah virus, for example, has appeared only in small outbreaks in Bangladesh and India but it’s on the list in case it mutates. Presently, we have nothing to fight it if it does. “It’s a nasty virus. It’s got a very high mortality rate,” Professor Lewin explains. “If it suddenly became better at human-to-human transmission then we’d really have to worry about it.”
There are also unforeseen, novel pathogens to be considered. “We’re focused on the likely ones but we always have to be ready for what we call ‘Disease X’,” Professor Lewin says. “Disease X is something we could never imagine.
“I don’t want to terrify people that we’re going to get some crazy new infectious disease,” she continues, but she doesn’t want a failure of imagination to be our downfall. HIV, for example, was an unforeseen pandemic. “No one ever thought about a sexually transmitted virus that becomes part of your own DNA.”
In addition to WHO’s priority pathogens, each Australian state and territory has its own list of notifiable diseases. Professor Sutton names dengue fever, Chikungunya and Zika. “We can’t be complacent … Pandemics have, over the last century or so, occurred every 20 or 25 years,” he says.
Are we prepared?
The CSIRO report, Strengthening Australia’s Pandemic Preparedness, warns that disease outbreaks are increasing in frequency and severity. Scientists are identifying new viruses with two novel viruses on average appearing in humans each year, and outbreaks can rapidly spread across the globe. Influenza remains an ever-present threat. “Sometimes you get a shift in a flu strain the world’s never seen before and that’s a pandemic strain,” Professor Lewin explains. “The chance of that is low, but it’s possible.”
Despite the challenges, Professor Lewin is optimistic about Australia’s capabilities. COVID stimulated spending in science and on new initiatives, including the Cumming Global Centre for Pandemic Therapeutics, which focuses on better pandemic drugs.
“All of this will make us stronger next time,” Professor Lewin says.
This article originally appeared in the March 2025 issue of The Australian Women’s Weekly. Pick up the current on-sale issue at your local newsagents or subscribe so you never miss an issue.
