Coronavirus rapidly fitting the category of dreaded ‘Disease X’, a serious pandemic which could kill 80 million
For two years, scientists have been on high alert for ‘Disease X’, a novel pathogen for which there is no cure or vaccine yet. And as the new coronavirus continues to spread, could this be it?
According to Dr Marion Koopmans, advisor for the World Health Organisation (WHO), the outbreak is rapidly becoming the first true pandemic challenge that fits the Disease X category. The WHO says that Disease X represents the “knowledge that a serious international epidemic could be caused by a pathogen currently unknown” to cause human disease.
In a video, WHO says that currently there is no disease called Disease X and explains that the term is a concept. It is a placeholder name adopted for a completely new disease (or one that is known, but not enough) that suddenly emerges, is very severe, spreading everywhere. It has the potential to give rise to a severe epidemic for which there is not enough or no medical counter-measures (drugs, vaccines).
"Whether it will be contained or not, this outbreak is rapidly becoming the first true pandemic challenge that fits the Disease X category, listed to the WHO’s priority list of diseases for which we need to prepare in our current globalized society," says Dr Koopmans, head of the Viroscience department of the Erasmus MC Rotterdam.
Dr Koopmans opinions have been published in Cell as part of a report -- 'The Novel Coronavirus Outbreak: What We Know and What We Don’t'. It includes the voices or opinions of other experts as well.
Dr Koopmans focuses on the global population-level impact of rapidly spreading zoonotic virus infections, with special emphasis on food-borne transmission, says the WHO biography.
She has been active as an advisor for the WHO on foodborne diseases and emerging disease outbreaks and has served as a member of the WHO emergency committee on MERS -- which advises the Director-General on public health emergencies and the Food and Agricultural organization committees on MERS and Ebola.
“As head of the virology reference laboratory of the national public health laboratory, a position she held from 2001 to 2014, she has been responsible for emerging disease preparedness, and coordination of the national laboratory response to such disease outbreaks, including SARS, pandemic influenza H1N1 2009, avian influenza and MERS. Building from those experiences, she developed an academic emerging disease preparedness research agenda at Erasmus MC as head of the Department of Viroscience,” reads the biography.
The report comes even as the outbreak has spread to the Middle East and Europe, with South Korea, Iran, and Italy seeing a massive rise in the number of new infections in a week. Globally, the total number of cases has crossed 80,000, and 2,699 people have died. In China alone, 77,658 have been sickened and there have been 2,663 deaths.
Dr Koopmans says that initial resemblances with the Severe Acute Respiratory Syndrome (SARS) outbreak in terms of its origin, the disease associated with infection and the ability to spread are clear. But since 2003, global air travel has increased more than tenfold and the efforts needed to try to contain the epidemic are daunting.
She accuses scientists and public health experts of wasting time. "There have been great advances since 2003, with the coordinated efforts of WHO and funders focusing on the priority threats. But unfortunately, as in past outbreaks, key knowledge gaps and medical counter-measures need to be assessed on the fly and scientists and public health experts alike are wasting precious time writing grant applications to do what we long know needs to be done, but which is not part of routine investment in science and (global) public health preparedness," she says.
In the report, Dr Koopmans further says that only time will tell whether the "consolidated efforts" of the Chinese authorities and the international public health and research community will succeed. "But we also need to understand how we make this model of preparedness future-proof," she adds.
Disease X is part of WHO’s R&D Blueprint
For its R&D Blueprint for action to prevent epidemics -- the WHO has developed a special tool for determining which diseases and pathogens to prioritize for research and development in public health emergency contexts.
The blueprint is a global strategy and preparedness plan that allows the rapid activation of R&D activities during epidemics. It aims to fast-track the availability of effective tests, vaccines, and medicines that can be used to save lives and avert large-scale crises.
"This tool seeks to identify those diseases that pose a public health risk because of their epidemic potential and for which there are no, or insufficient, countermeasures. The diseases identified through this process are the focus of the work of R&D Blueprint," says WHO.
The first list of prioritized diseases was released in December 2015. The list was reviewed in January 2017 and a second time in 2018.
It currently includes Crimean-Congo hemorrhagic fever (CCHF), Ebola virus disease and Marburg virus disease, Lassa fever, Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS, Nipah and henipaviral diseases, Rift Valley fever (RVF), Zika, and Disease X.
"The R&D Blueprint explicitly seeks to enable cross-cutting R&D preparedness that is also relevant for an unknown “Disease X” as far as possible," says the WHO.
As part of WHO’s response to the COVID-19 outbreak, the R&D blueprint has been activated to accelerate diagnostics, vaccines, and therapeutics.
Deadly global pathogen could kill 80 million, WHO had warned in 2019
Interestingly, last year, in its first report of the Global Preparedness Monitoring Board (GPMB), which focused on epidemics and pandemics WHO had said that the world is at acute risk for “devastating regional or global disease epidemics or pandemics” that would not only cause loss of life but upend economies and create social chaos.
The 1918 global influenza pandemic sickened one-third of the world population and killed as many as 50 million people - 2.8% of the total population. The experts said if a similar contagion occurred today with a population four times larger and travel times anywhere in the world less than 36 hours, 50-80 million people could die. In addition to tragic levels of mortality, such a pandemic could cause panic, destabilize national security and seriously impact the global economy and trade.
"There is a very real threat of a rapidly moving, highly lethal pandemic of a respiratory pathogen killing 50 to 80 million people. A global pandemic on that scale would be catastrophic, creating widespread havoc, instability, and insecurity. The world is not prepared," the report had warned.