James A. Marcum
Waco, Texas, United States
|Computer generated representation of COVID-19 virions (SARS-CoV-2) under electron microscope. Image by Felipe Esquivel Reed. Via Wikimedia CC BY-SA 4.0|
The history of medicine reveals that epidemics and pandemics have plagued humanity throughout the centuries.1 Examples include the Antonine plague (165-180 A.D.), the Justinian plague (541-542 A.D.), the Black Death (1347-1351 A.D.), pandemics such as the Spanish flu (1918-1919) and the Asian flu (1957-1958), and now the COVID-19 pandemic.
Edward Winslow2 made a very astute observation about what we have learned from the 1918-1919 Spanish flu pandemic. We have learned that the Spanish flu was a zoonotic disease, caused by what became known as the H1N1 virus. We now also know that many epidemics and pandemics share a common zoonotic origin. For example, the animal reservoir for the influenza A virus is generally avian and can infect wild, domestic, and farm animals, as well as humans; and the influenza A virus subtype H1N1 virus was responsible for the 2009-2010 Swine flu.3 COVID-19 is also a zoonotic disease, with bats implicated as the reservoir for the β-coronavirus—SARS-CoV-2—causing the disease. The origin of the virus is thought to be a wet market in Wuhan, China.4
Given the zoonotic origins for these pandemics, including COVID-19, how can we prevent future zoonotic pandemics? Several strategies have been proposed in both the lay and professional literature. One important strategy would be to develop template protocols for the rapid production of vaccines and other countermeasures to zoonotic outbreaks.5 Although this is an important strategy, issues arise concerning the efficacy of expedited vaccines and countermeasures; and moreover, this strategy is more reactive than proactive. Other proposed strategies, however, are more proactive. For example, one strategy would be to increase surveillance of wildlife populations for high-risk pathogens and of the people who come into contact with them, as well as improving biosecurity of wildlife trade and wet markets.6 Another strategy goes so far as to advocate banning wildlife trade and closing wet markets to prevent future zoonotic pandemics.7
Besides wildlife trade, other strategies target animal agriculture. The problem here is the close confinement of farm animals and the squalor in which they live. As Michael Greger points out, “the slum conditions on factory farms are breeding grounds for disease.”8 Moreover, Michael Osterholm9 acknowledges the problems associated with animal agriculture and zoonotic diseases, and he promotes the One Health initiative of the U.S. Centers for Disease Control and Prevention. An additional very real fear, besides novel pathogens, is that the high levels of antibiotics used in animal agriculture could result in antibody resistant pathogens.10
|Transmission electron microscopic image of an isolate from the first U.S. case of COVID-19. The spherical extracellular viral particles contain cross-sections through the viral genome, seen as black dots. Image by CDC/ Cynthia S. Goldsmith and A. Tamin. Via CDC. Public Domain.|
Finally, in a New York Times Opinion article as part of the newspaper’s “The Stone” series, David Benatar11 offers an interesting twist to a strategy for preventing future pandemics. He begins by placing the blame for the COVID-19 pandemic squarely on our cruelty towards wild and farm animals, especially the conditions under which animals are caged or penned. We have failed to realize that such conditions are the source of zoonotic pathogens. In other words, to maximize profits animals are kept under conditions that are ripe for breeding novel pathogens that can infect human hosts. As he concludes, “the coronavirus pandemic is a result of our gross mistreatment of animals.”
Benatar’s strategy for preventing future pandemics is to treat animals more humanely, unlike the inhumane treatment associated with wet markets and animal agriculture. As he insists, “Real prevention requires taking steps to minimize the chances of the virus or other infectious agents emerging in the first place. It would require a more intelligent and compassionate appraisal of our treatment of nonhuman animals, and concomitant action.”12 Benatar’s strategy has certainly sparked debate. For example, Richard Raymond13 exonerates animal agriculture from any culpability for COVID-19 and even questions the pandemic’s zoonotic origin. But Benatar’s point is that to prevent future zoonotic pandemics we must change our behavior towards animals from one of aggressive exploitation and abuse to one of humanitarian management and husbandry, whether by regulating or banning wildlife trade, improving the living conditions associated with animal agriculture, or by eating less meat and more plant-based foods or even laboratory-cultured meat.14
Benatar’s strategy and other similar strategies face several serious obstacles. Wildlife trade and animal agriculture have an immense impact on our global economy. For example, in 2019 $4.3 billion of legal wildlife trade was imported into the U.S. alone.15 Given this economic impact, it is unlikely that reducing or even eliminating these industries is a realistic goal. Another obstacle is the human attitude that we are superior to nonhuman animals and can use them to our ends, such as for food and clothing. This attitude has been labeled speciesism16 and addressing it is the focus of many animal rights and welfare advocacy groups such as People for the Ethical Treatment of Animals or PETA. The final obstacle is that we have not learned the historical lessons for proactively preventing pandemics. As Howard Markel wrote earlier this year in Wired, “when comparing the ever-changing story of Covid-19 to pandemics past, I feel like quoting Yogi Berra: It’s ‘déjà vu all over again,’ albeit a nightmarish blend of several déjàs vu into one.”17 To prevent the déjà vu experience, we need to understand why we fail to act at social and political levels and simply forget the lessons of past epidemics and pandemics.
In conclusion, we need to learn what the COVID-19 pandemic is now teaching us, and to implement realistic and reasonable strategies to prevent future zoonotic pandemics. Such strategies need to be motivated ethically by an attitude that we have a moral responsibility to prevent further harm to people and to the environment itself. It requires the political will not to forget the pain and suffering COVID-19 has caused tens of millions of people, and to enact robust policies to prevent future pandemics.
- Damir Huremović, “Brief History of Pandemics (Pandemics Throughout History),” in Psychiatry of Pandemics: A Mental Health Response to Infection Outbreak, ed. Damir Huremović (Cham, CH: Springer, 2019), 7-35.
- Edward Winslow, “Have We Learned Anything from 1918-1919 Influenza?,” Hektoen International: A Journal of Medical Humanities 12, no. 4 (2020), https://hekint.org/2020/06/01/have-we-learned-anything-from-1918-1919-influenza/?highlight=Covid.
- Derek Gatherer, “The 2009 H1N1 Influenza Outbreak in Its Historical Context,” Journal of Clinical Virology 45, no. 3 (2009): 174-178.
- Zi-Wei Ye, Shuofeng Yuan, Kit-San Yuen, Sin-Yee Fung, Chi-Ping Chan, and Dong-Yan Jin “Zoonotic Origins of Human Coronaviruses,” International Journal of Biological Sciences 16, no. 10 (2020): 1686-1697.
- Shmona Simpson, Michael C. Kaufmann, Vitaly Glozman, and Ajoy Chakrabarti. “Disease X: Accelerating the Development of Medical Countermeasures for the Next Pandemic,” The Lancet Infectious Diseases 20, no. 5 (2020): e108-e115.
- Peter Daszak, Kevin J. Olival, and Hongying Li. “A Strategy to Prevent Future Epidemics Similar to the 2019-nCoV Outbreak,” Biosafety and Health 2, no. 1 (2020): 6-8.
- A. Alonso Aguirre, Richard Catherina, Hailey Frye, and Louise Shelley. “Illicit Wildlife Trade, Wet Markets, and COVID‐19: Preventing Future Pandemics,” World Medical & Health Policy 12, no. 3 (2020): 256-265.
- Michael Greger, How to Survive a Pandemic (New York: Flatiron Books, 2020), 102.
- Michael Osterholm, “The Osterholm Update COVID-19,” August 11, 2020, https://www.youtube.com/watch?v=1LXro9ffc5M.
- Gowri M. Boovaragamoorthy, Murugadas Anbazhagan, Prakash Piruthiviraj, Arivalagan Pugazhendhi, Smita S. Kumar, Naif A. Al-Dhabi, Abdul-K. Mohammed Ghilan, Mariadhas V. Arasu, and Thamaraiselvi Kaliannan. “Clinically Important Microbial Diversity and Its Antibiotic Resistance Pattern Towards Various Drugs,” Journal of Infection and Public Health 12, no. 6 (2019): 783-788.
- David Benatar, “Our Cruel Treatment of Animals Led to the Coronavirus,” The New York Times, April 13, 2020, https://www.nytimes.com/2020/04/13/opinion/animal-cruelty-coronavirus.html.
- Richard Raymond, “Agricultural Practices Isn’t to Blame for Coronavirus Outbreak,” Des Moines Register, April 23, 2020, https://www.desmoinesregister.com/story/opinion/columnists/2020/04/23/animal-agriculture-and-coronavirus-cafos/3004538001/.
- Walter Willett, Johan Rockström, Brent Loken, Marco Springmann, Tim Lang, Sonja Vermeulen, Tara Garnett, David Tilman, and Fabrice Declerck. “The Lancet Commissions Food in the Anthropocene: The EAT–Lancet Commission on Healthy Diets from Sustainable Food Systems,” The Lancet 393, (2019): 447-492.
- Jonathan Kolby, “To Prevent the Next Pandemic, It’s the Legal Wildlife Trade We Should Worry About,” National Geographic, May 7, 2020, https://www.agricanto.org/uploads/5/2/6/3/52634281/to_prevent_the_next_pandemic_it%E2%80%99s_the_legal_wildlife_trade_we_should_worry_about.pdf.
- Oscar Horta, “What is Speciesism?,” Journal of Agricultural and Environmental Ethics 23, no. 3 (2010): 243-266.
- Howard Markel, “With Covid-19, Tech is Making History Repeat Itself,” Wired, March 3, 2020, https://www.wired.com/story/opinion-with-covid-19-tech-is-making-history-repeat-itself/.
JAMES A. MARCUM, PHD, is professor of philosophy at Baylor University. He earned doctorates in physiology from the University of Cincinnati Medical College and in philosophy from Boston College. He was a faculty member at Harvard Medical School as a molecular biologist for over a decade before joining Baylor’s philosophy department. His research interests include the philosophy and history of medicine and science. He has published eight books and examples of his articles appear in American Journal of Physiology, Journal of Biological Chemistry, Journal of Clinical Investigations, Journal of the History of Medicine, Synthese, and Theoretical Medicine and Bioethics.