Will we be prepared for "Disease X?" Misinformation could leave us vulnerable to a future pandemic

Pandemics have always been a major part of human history, they still dominate our present to some degree, and it would be prudent to prepare for them in the future to avoid the worst case scenario. In fact, that's what public health agencies have been doing for decades, but only in the wake of mass COVID-19 misinformation has routine surveillance of diseases become the fodder of conspiracy theories.

Two years before the COVID-19 pandemic, a committee from the World Health Organization gathered together to update a list of priority pathogens that could cause future pandemics. Initially, the list included names of viruses that are nearly household names —  Ebola, SARS-1 and MERS. All of these viruses can be quite deadly.

The idea was that by identifying these pathogens with major threat potential, the world could collaborate and be better prepared for a worst case scenario. It could respond more productively. But after assembling the list of pathogens the committee knew existed and could be problematic, they reconvened to add a disease that was yet to be discovered: Disease X. 

“The question was asked ‘What else?’ because there's always something else,” Dr. Michael Ryan, the executive director of WHO's Health Emergencies Programme, recently explained in a social media briefing this week. Prior to 2003, he said, nobody thought the coronavirus class of viruses would be such a major problem. It wasn’t a virus on peoples' radars that could cause a global pandemic in the year 2020. “There's always the sense of ‘Is there another virus family out there that could cause a problem?’

They needed a “Disease X,” he said.

“How will we react to that? How do we do primary research to deal with that?” Ryan said, adding that it’s important to think about how fast such a virus could be identified, characterized and if a generic vaccine could swiftly go into development. “We've been evolving that concept more and more.”

To be clear, Disease X is a hypothetical disease where the “X” is simply a placeholder. It can be thought of like war games, in which militaries perform exercises to prepare for a potential invasion. Disease X is a disease that could cause a pandemic, but isn’t necessarily obvious to public health officials and scientists around the world right now. While Disease X is not new, it’s been in the news lately as the World Health Organization recently took the opportunity at the World Economic Forum in Davos, Switzerland, to ask world leaders to consider the possibility of such a scenario.

It also comes at a time when world leaders are working on finalizing a draft for a global pandemic treaty, which could hypothetically be a cause of Disease X. But just as world leaders are preparing to have more in depth conversations about Disease X, misinformation has been circulating trying to make it seem as if world leaders are unhatching a sinister plot to wreak chaos on the world or install a world government. Unsurprisingly, there is zero evidence to support this conspiracy theory.

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By definition, a pandemic is a global disease outbreak. What makes it a pandemic are characteristics like how fast the disease spreads and how many deaths it causes. Just as natural disasters like hurricanes, tornadoes and tsunamis can’t be eradicated, neither can pandemics. They are an integral part of the history of civilization. From the Athenian plague to the Black Death to the Spanish flu pandemic, these significant outbreaks of diseases have had profound effects on societies and they aren’t going anywhere any time soon.

Dr. Rajendram Rajnarayanan, of the New York Institute of Technology campus in Jonesboro, Arkansas, told Salon it’s important to plan for the next pandemic, for a hypothetical Disease X, because the world is more connected than ever before. While disease outbreaks in early history were more localized, they have a greater potential to spread more rapidly today. 

“We have seen COVID-19, but that's not the end of it,” Rajnarayanan told Salon. “There’s something that's going to come later and that’s one of the reasons WHO wants to plan ahead, calling this hypothetical disease Disease X, says 'Hey, we have to plan ahead and look at the lessons learned.'”

One lesson Rajnarayanan said is the need for a centralized “command center” for communication. One that worldwide people can trust to deliver accurate and transparent information. He said it shouldn’t be the case that the world has to rely on information coming from the country where the disease originated.

Indeed, the lack of transparency from China contributed to a conspiracy theory that the virus emerged from a Chinese laboratory as a potential bioweapon. Scientists predominantly believe the virus occurred naturally in animals and spread to humans in an outbreak at a market in Wuhan, China, as there is stronger evidence to support this theory.

Yet variations of the so-called “lab leak” theory persist, despite evidence lacking to support the theory. Rajnarayanan said the world has seen how misinformation can lead to people arguing, and divide communities, which is why it’s important for the world to agree on a centralized communication authority.  

“If all the governments agreed that there is a single entity that's going to be transparent, that's going to provide us with authentic information that every one of us will be using, that will elevate us to a spot where we never had it during COVID-19,” he said. “Any misinformation could hurt.”

Dr. Amesh Adalja, an infectious disease and senior scholar at Johns Hopkins Center for Health Security, told Salon he’s concerned about the misinformation spreading and that it could prohibit the world from being prepared to face a hypothetical Disease X. 

“I think that the misinformation does make people reticent to engage in pandemic preparedness, because this has now become a very political issue and you have a lot of purveyors of misinformation that will use this as a way to score political points and prey on the ignorance of the general population,” Adalja said. “We have a major presidential candidate, RFK Jr., whose whole campaign is premised on this type of misinformation.”

Adalja added it’s “dangerous” to spread this information as health officials are just trying to not repeat the millions of deaths caused by COVID-19. In terms of lessons from COVID-19 that can be applied to Disease X, Adalja said one is that SARS-CoV-2 should not have come as a surprise since it came from a viral family, the coronavirus family, and had already shown it was efficient in infecting humans. He added that previous research for Middle East respiratory syndrome (MERS), which was also caused by a novel coronavirus, helped pave the way for COVID-19 vaccines.

“Speed and efficiency of the vaccine response was facilitated by prior work in that viral family,” Adalja said, adding that preparedness is key for the next pandemic. “In general, having the world take a coordinated approach to pandemic preparedness and being proactive is very important because these pandemics in general are going to spread.”