Governments should invest in national stockpiles of PPE, electronic infrastructure for contact tracing, and reagents for rapid serologic and PCR testing as ’no regret moves’ to prepare for future pandemics. This allows for immediate, large-scale testing and mitigation efforts.
Establish a large national stockpile of immune-modulating drugs, as many infectious diseases involve an overactive immune response, making this a crucial therapeutic preparedness measure. This strategy is more general than specific antivirals, which may be virus-specific.
Adopt a sophisticated, phased therapeutic strategy for infectious diseases: early treatment should focus on antivirals and immune amplifiers, while later stages, characterized by hyperactivated immune responses, should utilize immune modulators and respiratory support. This approach tailors treatment to disease progression.
Invest in developing biomarkers to identify different stages of disease and predict progression, enabling personalized and modulated therapy. This is an ideal application for machine learning, combining biomarker data with epidemiological factors to guide treatment decisions.
Implement serial testing (e.g., every couple of days) to monitor patient markers and feed data into machine learning models. This approach could identify individuals at risk of severe disease, allowing for timely and targeted interventions like antivirals or immune activators.
Prioritize research into the durability of immune responses to viruses, particularly how long immunity protects against severe disease versus preventing viral shedding and transmissibility. This knowledge is crucial for vaccine strategies and public health planning, as it impacts societal protection.
To understand immunity waning and transmissibility, conduct human challenge studies where volunteers are infected with a common cold coronavirus, and then reinfected later to measure cold symptoms and the extent of viral shedding. This helps determine if reduced shedding is sufficient to prevent spread.
Recognize that some viruses, like SARS-CoV-2, may never be eradicated, necessitating a societal shift in mindset and planning towards long-term coexistence rather than elimination. This involves understanding how to manage the virus if it becomes a common cold.
Thoroughly evaluate the risk-benefit profile of vaccines, especially for new viruses, considering that some vaccines (e.g., RSV) are harder to develop safely. This requires a careful cost-benefit analysis before widespread implementation, as risks can vary.
Public health strategies must proactively address and understand public willingness to be vaccinated, as vaccine acceptance is a critical factor in achieving widespread immunity. This is an important consideration for the success of any vaccination campaign.
To truly understand viruses and their impact, educate yourself thoroughly on the immune system, including innate, adaptive, humoral (B cells, antibodies), and cellular (T cells) components. This foundational knowledge is essential for comprehending viral dynamics.
Listen to the David Watkins podcast before this one to get a foundational understanding of immunology, which will help in understanding the coronavirus discussion. This sequential listening provides necessary context for complex topics.
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