Professor of Medicine, Yong Loo Lin School of Medicine, NUS

Senior Consultant, Infectious Diseases, NUHS

Disease X: The Next Pandemic and lessons from COVID-19

The COVID-19 pandemic is unprecedented not in terms of mortality (the “Spanish flu” or “Black Death” were far worse) but rather in terms of the disruption it caused to life in almost every corner of the globe. There were some positive outcomes of the pandemic including new concepts of work for many, the rapid rollout of self testing, scaling up of molecular diagnostics globally, large scale clinical trials of repurposed drugs (including veterinary products such as nirmatrelvir) and rapid rollout of global vaccines (although it would have been nice if they could have ended the pandemic by stopping transmission like all other historically licensed vaccines). However, there were a number of negatives including the uncovering of inequality both globally and locally in many countries, the stresses on healthcare workers and families and the polarisation of scientific debate with major journals and regulatory agencies often raising more questions than answers. There are many unanswered questions that remain concerning the origins of the virus (in particular the intermediate animal), the modes of transmission, the reasons why children are not so badly affected and many others. These will unfortunately come back to haunt us as we prepare for the inevitable next pandemic.