Rivers’ and George’s proposal was read by the right people. Five days after President Joe Biden’s inauguration, the new administration committed to creating a National Center for Epidemic Forecasting and Outbreak Analytics. In March, they designated $500 million in funding for it as part of the American Rescue Plan Act.
Here’s where the coming US agency and the hoped-for international effort dovetail: Their successes will hinge on data: more abundant data, more granular data, just more. In the mid-20th century, the inaccuracy of weather forecasting was the butt of late-night TV jokes. What made it a reliable endeavor was deploying data-collection devices—satellites, Doppler radar, weather balloons, automated surface-observing systems—and achieving the supercomputer processing power and graphical systems to understand and represent the results.
The data-collection devices that could help us scan the horizon for pandemics already exist. (You might be reading this on one.) Mobility data, purchase records, search terms, the words you use in tweets—all represent information that can fuel predictive tools. Public health doesn’t yet do a good job of accessing that data, collating it, and analyzing it. The channels for getting to it haven’t been carved out even in rich countries. In the Global South, the problem is worse.
“There’s so much heterogeneity in the underlying capabilities of various countries and places,” Rivers says. Obtaining that data to help a country ring alarm bells, let alone contribute to global forecasting, “might even be a matter of moving from paper reporting to digital reporting,” she adds. “It’s hard to see how you can skip to the end and have an advanced radar system without first attending to those basic pieces, when each of those pieces in each jurisdiction is a big undertaking.”
Take test results, for instance. It would be desirable to plug in the results of any diagnostic tests done during health care visits, to sort out whether a wave of respiratory infections is being caused by a common virus or a new strain. But so many people lack access to health care that diagnostic data might have limited predictive power. On the other hand, most people use sewage systems—where they exist—and wastewater sampling can detect pathogens without intruding on individual privacy or forcing the construction of interoperable record systems.
Animal data is another gap. Structures already exist for reporting cases of human disease and wildlife and livestock diseases, but they are separate, run by different United Nations agencies. Reports in one system won’t ring an alarm bell in another—an oversight, since so many emerging diseases are zoonotic, beginning in animals and then leaping to humans.
That revelation two weeks ago that a coronavirus carried by cats and dogs had been found in old throat swabs from people proves the point. It came to light belatedly, because of an academic project. These detections did not get reported through a notification system, and there is no indication that anyone has set up anything new to track the virus. “We don’t have systems now that could go keep an eye on canine coronaviruses,” Carlson says. “We know that this is a virus that can recombine in such a way that it can transmit to humans. We’ve seen it do it, in a really limited way. We know that is a potential threat to health security. But there is no global monitoring.”
The final question a pandemic radar will face is this: Who benefits? The colonialist model of resource extraction—take a commodity from the Global South, use it to benefit the Global North—has tripped up disease surveillance before. In 2007, in the midst of worldwide concern over the spread of H5N1 avian flu, Indonesia stopped sending viruses collected within its borders into the WHO’s flu surveillance network. The WHO scolded the nation, saying it was endangering the world. The government of Indonesia—which, at the time, had experienced more bird flu deaths than any other country—responded that this was its only possible leverage against inequity. If affluent countries used Indonesian viruses to develop a bird-flu vaccine, Indonesia wanted guaranteed, inexpensive access—to not have to compete to buy a product that would not have existed without its help.