Imagine an exercise in which several possible scenarios are simulated in order to estimate the probability that a certain scenario will happen. Now imagine that what is being simulated are combinations of several factors that could result in a pandemic. This exercise was carried out and the results published in November 2023.
The study estimates that there is a 4.2% chance that a new pandemic will occur next year, causing the deaths of 10 million people or more. Considering the next five years, the chance increases to 19%. Considering the next 10 years, the chance increases to 35%.
If the scenario were a pandemic that caused one million deaths or more, the chance of it happening is 6.3% in one year, 28% in five years and 48% in ten years.
There is already a consensus that a new pandemic will happen, even though it cannot be said which pathogen will cause it. Most likely, however, the same will occur this century.
The Covid-19 pandemic has made clear the lack of preparation of most countries. There are three crucial activities that need to be structured to face epidemics and pandemics.
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First, prevention, whose vigilance is the key piece. This includes genomic surveillance to identify circulating pathogens and strains, surveillance of fever cases of unknown origin, and animal surveillance, as the vast majority of pandemics have been caused by zoonoses. A critical function of surveillance is to produce an alert system that allows the healthcare system to adapt to increased demand for services in a timely manner.
Second, preparation, that is, what must happen so that there is a rapid response to emergencies, be they an outbreak, epidemic or pandemic. Good preparation implies the rapid detection of outbreaks and their causative agent, the rapid acquisition of inputs, the ability to subsidize the response (through the analysis of data collected by surveillance) and the structure for developing rapid tests and vaccines.
Third, the response, which includes containment (stopping transmission), suppression (minimizing transmission) and mitigation (adopting social and public health measures in addition to treatment). If, on the one hand, containment is not always viable (depending on the pathogen), on the other hand, effective containment and suppression require an effective warning system.
In Brazil, if the lessons of the Covid pandemic served as a lesson, there should be a discussion about the need to create a body, linked to the Ministry of Health, but with independent governance (like Anvisa), responsible for coordinating health care efforts. prevention, preparedness, and response to public health emergencies (e.g., the U.S. and European Centers for Disease Control and Prevention).
Such a body would be innovative in Brazil, although part of the effort would be to structure networks whose nodes already exist, such as laboratories, universities and research centers. It would make the SUS (Unified Health System) stronger and the system more resilient to emergencies. It would be the way to face future emergencies in a completely opposite way to what was seen during the Covid pandemic, when municipalities faced the pandemic, without any preparation, articulation or coordination with other areas.
Brazil has the means, technical training, and part of the infrastructure to create a disease control and prevention center, responsible for preventing, preparing for, and responding to public health emergencies.
After more than 700,000 deaths from Covid-19, and with the real risk of a new emergency occurring in the not-distant future, strengthening the capacity to respond to emergencies is a priority task.
