America Should Prepare for a Double Pandemic

Having failed to lead the best-prepared nation in the world against one pandemic, Donald Trump has made it more vulnerable to another. He has, for example, frayed international bonds further by trying to pull the U.S. out of the World Health Organization. Whether he has the legal authority to do so is still unclear, but even if the threat is empty, “some of the effects will be immediate,” says Loyce Pace, the president of the Global Health Council. U.S. officials and experts will start disengaging from international institutions, and that might encourage other nations to follow suit.

This won’t just harm the WHO at the time when it is most needed, but will also further diminish America’s already damaged international standing. A country that has badly mishandled its own outbreak, that has bought up the world’s stock of important drugs, and that has petulantly withdrawn from global alliances is less likely to receive warnings or support if a new crisis emerges.

There is an optimistic scenario if a second virus begins to spread: The new pathogen finds it harder to move around an alert world, is rapidly detected wherever it arrives, and fizzles out because cautious citizens have their guard up.

As long as people stay vigilant against the current pandemic—keeping their distance, wearing masks, avoiding indoor crowds—they should theoretically be guarded against a second respiratory virus. It used to be common for measles and pertussis to interfere with each other, so that if one spiked, the other would subside. That might be because kids who got one disease would stay home, reducing their risk of the other. “It’s nothing to do with a vaccine or the immune system,” says Sarah Cobey, an immunologist at the University of Chicago. “It’s just people being careful.”  

The same tests that are being used to diagnose COVID-19 could also be tweaked to cover the new pathogen. One company is already developing a fast “multiplex” test that could look for four respiratory viruses—the new coronavirus, two types of flu, and respiratory syncytial virus (RSV)—in a single nasal swab. And if the new pathogen is a flu strain, existing vaccines could be tweaked to protect against it. That would still take several months, but the existence of a seasonal flu vaccine offers an invaluable head start.  

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This future is easier to imagine in countries like South Korea, New Zealand, and Germany, which have successfully controlled COVID-19. It seems less likely in nations like the U.S., Brazil, Russia, and India, which are stretched and struggling.

In such places, COVID-19 would effectively cloak the spread of any new respiratory virus with similar symptoms, which “could have a chance to take off before we realized it had,” Cameron said. A new virus would also be harder to spot because “all the resources we would normally use to detect potential viruses of concern have been redirected for COVID-19,” says Lauren Sauer, who works on disaster preparedness at Johns Hopkins Medicine. She means everything from physical equipment like swabs and storage tubes, to health-care workers who administer and process tests, to public-health experts who analyze the data or conduct contact tracing. These are either running out or burning out. A second respiratory virus would further tax the same resources that the U.S. has already failed to adequately marshal for COVID-19.