Why we need to build a virus early warning system

The pandemic seems to be ending; it isn’t. The vaccine breakthroughs are key, but coronavirus variants, the nature of asymptomatic carriage and transmission, and difficulty in getting enough people vaccinated mean COVID-19 isn’t really going away and herd immunity may be out of reach. This virus, like all viruses, will mutate. Add in global and domestic travel, and we have a recipe for another pandemic. Yet, we have a chance right now to prevent that, by using what we have learned to build a Virus Early Warning System (Virus EWS).

We have the beginnings of this system; now we must keep it, expand it and fund it. Accounting for the loss of life and loved ones is impossible. Nonetheless one estimate has COVID-19 costing the U.S. $16.2 trillion a year — about 2.5 times more than the $6.4 trillion wars after 9/11 have cost. A current project allows researchers to share COVID data, but it needs a funded, on-going system to prevent it from becoming a flash in the pan. Federal dollars spent on a Virus EWS are dollars well spent. Pharmaceutical companies can also fund the work as a public-private partnership with universities. 

Three steps will allow us to detect not only coronavirus variants but flu and other diseases we want to keep under control so that we can return to healthy social lives. 

STEP 1: Leverage. We need to maintain and use the capacity to test for viruses developed during the pandemic.

A network of universities can be a key part of a Virus EWS. Universities such as my home institution, Georgia Tech, as well as U.C. Davis and other education centers developed and ramped up rapid saliva and waste water testing to detect outbreaks. Using saliva tests allows us to detect not only COVID-19 infection but a host of other respiratory diseases such as the flu. Yet, as vaccine rates go up, the temptation to dismantle this infrastructure is strong. That would be a mistake.

Public universities, especially, are present in all 50 states and are cross-sections of society. They reflect where we go and how we live. Students and faculty come from all over and travel often for conferences, sports, music, debate, spring break and other activities. Staff live in a range of communities surrounding campuses. With testing, we could detect and contain the start of new outbreaks much more easily.

Even if the COVID-19 virus becomes endemic, we need to attack it. Other endemic diseases like the flu are nasty, deadly and persistent. The flu mutates, and public health officials work hard to monitor the flu to catch variants and manage outbreaks. But the data they use comes from those who are already ill and see a doctor.

With COVID-19, however, people may have the virus and spread it without ever having symptoms. That means folks may never see a doctor and get tested. Ongoing surveillance testing allows us to defeat the challenges of mutation and asymptomatic transmission. 

STEP 2: Learn. Ongoing testing means more data from which we can learn and improve our public health.

Identifying new coronavirus variants is vital, but to date, the U.S. has lagged on this front. This task requires gathering samples, sequencing genetic codes and analyzing them with “high-end computer servers [run] by researchers with a specialized degree.” With university-based testing, professors and their students can continue research while also providing a public service. 

What’s more, saliva tests can be used to run a panel to detect multiple viruses — the coronavirus, flu and other respiratory diseases. Thus, testing could also increase our ability to identify and track flu variants.

The flu is an ongoing problem. Between 2010 and 2020, flu variants killed an average of more than 35,000 people every year in the United States. Some years, more 60,000 died. One firm estimates that the flu costs employers an average $15 billion annually and cost $21 billion in 2018.

Any edge against “normal” flu seasons would provide an immense benefit in developing flu vaccines, reducing millions of symptomatic illnesses and hospital visits, hundreds of thousands of hospitalizations and saving potentially billions of dollars

The flu can also create another pandemic. The 1918 flu killed an estimated 675,000 people in the U.S. and more than 50 million worldwide. The flu could again mutate into a deadly, pandemic variant, but ongoing testing could limit that possibility.

STEP 3: Live. With a Virus EWS we can limit the effects of viruses that attack the people we love. 

A Virus EWS means a jump start on seeing whether current COVID-19 vaccines are working against variants and whether we need boosters. Early detection means we could more quickly adapt vaccines and ramp up production, saving more lives. As Benjamin Franklin said 285 years ago, “An ounce of prevention is worth a pound of cure.”

We have our ounce of prevention in place now; we must build a Virus EWS to keep it. If we do that, we can avoid the suffering we all know too well and ensure that we can live and thrive the way we want.

Deven R. Desai is an associate professor of law and ethics and associate director of machine learning at the Georgia Institute of Technology.

Tags coronavirus Epidemiology Flu season Global health Influenza Influenza A virus subtype H1N1 Influenza vaccine Pandemics Virus

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