If you asked most Americans, they'd probably tell you that one global pandemic in a lifetime is one more than they wanted. They'd rather not think about the next one.
But for Center for Infectious Disease Research and Policy (CIDRAP) Director Michael Osterholm, PhD, MPH, the mistakes that were made during the emergency phase of the COVID-19 pandemic, and the lessons learned, provide an opportunity to explore how a future pandemic caused by an even deadlier virus than SARS-CoV-2 could play out.
In The Big One: How We Must Prepare for Future Deadly Pandemics, Osterholm and his co-author and longtime collaborator Mark Olshaker weave together two threads. One is an assessment of how the COVID-19 pandemic was handled by the US government and public health agencies like the Centers for Disease Control and Prevention and the World Health Organization.
Osterholm says it's the culmination of a project that began early on in the pandemic, when he and Olshaker recognized that many mistakes were being made and they authored several op-eds that were critical of the federal response.
"At that point, we realized we really needed to write a book about this pandemic when it finally ends, and what lessons should be learned," he says in an upcoming episode of the Osterholm Update podcast.
Along the way, Osterholm and Olshaker address many of the most prominent controversies that have come to dominate the national discussion about the pandemic, from lockdowns and school closures to communications failures and the debates over masking and vaccine mandates. The aim was not just to highlight the mistakes or place blame, but to understand the lessons that can be drawn from those mistakes and then applied to the next pandemic.
"Some of the problems we collectively encountered were structural, and not quick or easy to solve," Osterholm and Olshaker write. "But they all have to be addressed if we are to have a chance of triumphing in the microbe wars."
'A great mystery story'
The next pandemic is the focus of the other strand of the book, a "thought experiment" developed by Osterholm and Olshaker that traces the path of a hypothetical virus that originates in Somalia, soon jumps to a nearby refugee camp in Kenya, and then spreads like wildfire around the globe. The virus, eventually labeled SARS-CoV-3, combines the infectiousness of SARS-CoV-2 with the lethality of the original SARS virus (which caused a global outbreak in 2003) and Middle East respiratory syndrome (MERS) virus.
"What would happen if you had a virus that had the capacity to infect like COVID, but the ability to kill like MERS or SARS?" asks Osterholm, who is also a Regents Professor and the McKnight Presidential Endowed Chair in Public Health at the University of Minnesota. "And believe it or not, we have now found viruses—in bats in caves in China—that have that construct. So this is not just science fiction; we actually know these viruses exist."
The scenario describes the impact of the virus as it spreads and causes havoc around the globe, but it also delves into the response from US and global officials, the public reaction, and the role of the media. For many readers, it might feel like being transported back to early 2020.
What would happen if you had a virus that had the capacity to infect like COVID, but the ability to kill like MERS or SARS?
Olshaker says they wanted to create a "nightmare scenario" that was realistic, scientifically plausible, not over-the-top, and gripping. He compares it to the true crime books he's co-authored.
"What we have here is great mystery story, which is what public health really is, as well as high technological drama," he says.
The Big One: How We Must Prepare for Future Deadly Pandemics is out today. To hear more from Osterholm and Olshaker, tune in to the August 4 episode of the Osterholm Update on the CIDRAP website.
