Building a global knowledge base for future threats

A rapid and effective pandemic response hinges on understanding how a pathogen behaves and spreads through populations – and what actions will help stop the contagion. That knowledge buys critical time to contain its spread and allocate resources where they are most needed. 

We have the knowledge to be better prepared for the next pandemic, but it is scattered through the scientific literature, World Health Organisation (WHO) reports, and other documents. 

There have, for example, been 40 documented outbreaks of Ebola in central Africa, 17 of which have been in the Democratic Republic of the Congo. And yet when the 2014 West African Ebola epidemic began, we had to collate that information about the virus and previous outbreaks while trying to analyse the epidemiology of the outbreak.  

The information already existed, but not in an easy-to-access standardised format. 

For almost a decade, researchers from the Pathogen Epidemiology Review Group at Imperial College London have been developing a database called epireview that compiles known information about dangerous viruses, so that researchers can analyse outbreaks and support authorities to understand what is happening on the ground in real time. 

Since 2019, the group has worked to populate the database with information about nine pathogens, which the WHO has identified as most likely to cause a future epidemic or pandemic. These pathogens include Zika, SARS, Lassa Fever, Ebola virus disease, Marburg virus disease, and others. 

The team identified the parameters that researchers and authorities want to know at the beginning of a disease outbreak, such as the severity of the disease and transmissibility of the virus, the duration of time before symptoms appear, and how long people are usually hospitalised for. They also included information about potential existing immunity in populations and contextual information such as population demographics. This data is standardised and easily extracted. 

When the ongoing Ebola outbreak, caused by the Bundibugyo virus, was declared, we drew on the database and were able to provide epidemiological information and estimates to health authorities within hours instead of a week. 

The next global biosecurity threat could come from an existing pathogen, but it could also be something new. Yet, it is likely to be related to viruses or other microorganisms that have caused disease in the past.  

For example, the SARS-CoV-2 virus was novel, but it was closely related to pathogens that have been closely studied, specifically Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome. 

When the COVID-19 pandemic struck, we were able to analyse its epidemiology because there was extensive literature available on coronaviruses, which described their natural history parameters. That helped us in our initial assessment of the COVID-19 pandemic and is a recurring need that I’ve seen in every epidemic I’ve been involved in. 

Unfortunately, analytics infrastructure – such as disease literature databases and software packages to perform epidemiological analyses – often falls between research and response funding. To date, researchers within the Pathogen Epidemiology Review Group have been populating epireview alongside their own research, with no dedicated funding. 

If we want to be prepared for the next pandemic, all biosecurity stakeholders need to come together to evaluate the pathogens that are most likely to cause an epidemic or pandemic, not just the viruses. And then they need to fund preparedness infrastructure, so that when the warning signals of an outbreak begin to emerge, we can respond as quickly as possible and save lives.