Why the Next Pandemic Will Spread Faster Than COVID — and What We're Not Ready For

Epidemiologists warn the next pandemic pathogen could spread faster than COVID-19 did. Here is the specific surveillance gaps, the WHO's preparedness framework, and what has — and hasn't — been fixed.

The COVID-19 pandemic demonstrated both the specific vulnerability of global societies to novel pathogen spread and the extraordinary scientific capability that can be mobilised in response. The honest assessment of pandemic preparedness improvements since 2020 is: significant progress in specific areas, inadequate progress in the areas that matter most for early detection and containment.

What has improved: vaccine manufacturing capacity has dramatically expanded, and the mRNA platform demonstrated that vaccine development from pathogen sequence to initial doses can be accomplished in weeks rather than years. Genomic surveillance — real-time sequencing of pathogens to track variant emergence — has been institutionalised in the major economies and partially built out in lower-income countries where it was previously absent. International Health Regulations compliance has improved in several key surveillance metrics.

What has not improved adequately: the detection gap remains the most dangerous vulnerability. Most pandemic pathogen emergence occurs at the human-animal interface in regions with limited healthcare infrastructure and limited surveillance capacity. The specific jurisdictions where novel pathogens are most likely to emerge — rural China, Southeast Asia, sub-Saharan Africa — have seen some surveillance improvement but remain inadequately covered. The average time from a new pathogen's emergence to its international detection and reporting has been several weeks to months across documented historical spillover events. COVID-19 had circulated for weeks before the cluster in Wuhan was recognised as unusual.

The WHO's Pandemic Agreement negotiations — attempting to create binding international commitments for pathogen sharing, surveillance cooperation, and equitable access to pandemic countermeasures — have been proceeding but remain contested, with wealthy countries reluctant to commit to the technology transfer and benefit-sharing provisions that lower-income countries require as the price of surveillance cooperation.

For 'Disease X' — the WHO's placeholder name for the unknown pathogen that will cause the next pandemic — the specific characteristics that epidemiologists consider most dangerous are: airborne transmission (maximising spread in indoor settings); presymptomatic or asymptomatic infectiousness (spreading before detection); and higher case fatality ratio than COVID-19 while maintaining sufficient transmission to achieve global spread.