This article was produced in partnership with The Sick Times, a journalist-founded website chronicling the Long COVID crisis.
When a pandemic begins, so does the blame game. Early days of COVID-19 pointed fingers at wild meat markets and debunked lab leak conspiracies, and that crystallized a long-running narrative that outbreaks are generally humans’ fault; roll the dice enough times with wildlife and you’re bound to land on a plague.
Problem is, generalizing that narrative may be misleading, if not just wrong and racist, according to Colin Carlson, a global change biologist who studies pandemics and climate at Yale University. “We all have this story in our heads of a remote community where people cut down forests and then mysteriously start getting sick,” he said. “We get things wrong because of this narrative.”
A new paper from Carlson and his colleagues aims to change that script, and argues that doing so could save lives. The “insidious” misconception, according to Carlson, is a belief that there is more cause and effect than there actually is.
“A pandemic could just happen because we live on a biodiverse planet — we are constantly in contact with animals and pathogens,” Carlson said. COVID-19 still circulates, bird flu emerging from U.S. farms is at the door, and other outbreaks are becoming more frequent as the planetary driving forces run unchecked. It’s time to prepare. And despite next to zero hope of federal protective policies, there are still actions available at the local, worker, and scientific level.
What drives outbreaks
To better understand what drives outbreaks, Carlson’s team analyzed every pandemic since the start of the 20th century. In total, they counted 10. Some were viral (such as COVID-19) and some, like cholera, were bacterial. Eight killed over one million people around the world. The team categorized all of these modern outbreaks as results of four planetary drivers: agriculture, changes in human land use, climate change, and wildlife use.
For example, influenza circulates more easily thanks to livestock and contact with wild birds. Mosquito-borne disease transmission climbs with global warming. Lyme disease has increased in recent years because human developments upset the balance of animal species in nearby forests, causing a boom in small rodents that play host to the parasite.
“We can look at the trends of climate and biodiversity and say, ‘Uh oh… ‘line go up. If there's one thing this paper is about, it's ‘line go up.’” – Colin Carlson
Land, agriculture, climate, and wildlife all affect biodiversity and the frequency with which diseases emerge. The drivers also amplify each other, like how agriculture and deforestation fuel more climate change.
Some of these connections might seem obvious or even inevitable. That’s the point. We’d contact fewer pandemic threats by not pushing human civilization into wild lands and depending less on poultry, pork, and beef. Such solutions challenge the fundamental structure of society.
As a result, pandemics will be more frequent in the next 100 years than they were in the last. All the factors contributing to pandemics are worsening with time. “We can look at the trends of climate and biodiversity and say, ‘Uh oh… ‘line go up,’” Carlson said. “If there's one thing this paper is about, it's ‘line go up.’”
According to Carlson, this analysis affirms that the next pandemic will likely be familiar. Don’t expect a long-lost zombie virus to awaken from thawed permafrost and sweep the globe, nor even Ebola. “The pandemic threats of the future look like more flu, more coronaviruses,” he said, or pox and retroviruses similar to HIV.
Familiar threats are no less daunting. COVID-19 still kills people (17,000 to 30,000 estimated since last October, according to the Centers for Disease Control and Prevention (CDC)) and continues to disable Americans at a high rate. Over 20 million Americans currently have Long COVID, while a Nature paper estimates the disease affects more than 400 million people globally. (2003’s SARS-Cov-1 may have been similarly disabling.)
These pathogens can lead to life-altering health afflictions, such as myalgic encephalomyelitis , dysautonomia, and mast-cell activation syndrome in a society that offers shamefully little support. “Our country seems to be uniquely bad at navigating pandemics,” Carlson said.
And here is where Carlson hopes to change how we think about pandemics — preparing to respond to the inevitable.
Toward better preparedness
What does better preparedness look like? Diagnostic tests ready on day one. Universal healthcare (perhaps at state or local levels). Vaccine innovations and new drugs against the families of viruses that pose pandemic threats. In its final days, the Biden administration’s Department of Health and Human Services awarded $590 million to mRNA biotech company Moderna to fast-track bird flu vaccines.
The thing about outbreak response policies is that they look somewhat like prevention when executed well. Aside from vaccines, it looks like paid sick leave for everyone, especially people who work with wild animals, livestock, and labs surveilling disease outbreaks; government access to farms and protections for whistleblowers.
Factory farming drives disease outbreaks by intensely confining animals that have a greater tendency to become infected, combined with incentives for farmers to keep sick and vulnerable animals alive with drugs. Researchers have called this “the infectious disease trap” and it applies to pandemic pathogens, too, according to Carlson.
“The majority of biomass, the majority of animal biomass on this planet is not wildlife anymore — it's livestock,” Carlson said. While it is possible to reduce meat consumption, factory farming likely isn’t going anywhere anytime soon.
To this end, labor unions are an underrecognized avenue for pandemic preparedness. After COVID-19 decimated meatpacking plants in 2020, unions negotiated protections with employers that continue today. By union protections, meat workers should have access to personal protective equipment like boots, sleeves, masks, and goggles as fears of bird flu plague farms, plants, and “live hangs,” according to Mark Lauritsen, international VP and director of the United Food and Commercial Workers International Union’s Food Processing, Packing and Manufacturing division. (However, dairy workers have become infected by bird flu on farms where employers do not provide P.P.E., according to reporting by Amy Maxmen.)
Today, several major meatpacking companies offer up to 20 hours of paid sick leave — more than they did pre-COVID-19, thanks to union negotiations. Those negotiations provide 4 hours for every 400 hours worked in states without more required leave; the union “would like it to be more hours,” Lauritsen added.
While we may not stop the global forces behind the next pandemic, we may still weave a series of safety nets out of lessons from past ones.
But 20 hours is far from a generous shield. Flus and coronaviruses (including common colds) are contagious for about a week — longer for people with weakened immune systems — and can take weeks to recover from. And these protective policies don’t apply to workers in other industries, which have increasingly rolled back protections from sick leave to remote work. In December, the LA Times reported on overwork and burnout in a California lab surveilling bird flu.
Unions are a vehicle to enact some protections, but the country remains woefully unprepared.
Last year, the nonprofit Farmworker Justice released a report finding that dairy workers generally lack healthcare access, work atypical hours in isolated areas, face cultural barriers, and often fear asserting their rights including workers compensation. In November, the CDC reported testing 115 dairy farm workers for evidence of prior bird flu infection. Eight tested positive. Four remembered having symptoms. One knew the cows were infected.
Maddie Bender
Alexis Guild, a vice president at Farmworker Justice, emphasized the importance of community health messengers independent of the federal government for employees on the frontline of looming outbreaks. “Trusted community messengers were those who connected workers to vaccines,” Guild said.
While we may not stop the global forces behind the next pandemic, we may still weave a series of safety nets out of lessons from past ones. Carlson likens this frame-shift to recognizing that adapting to the effects of climate change is now as crucial as working to mitigate its causes. When kindling, sparks, and oxygen are all mounting right under your nose, you must prepare to contain inevitable flames.
But many institutions aren’t preparing. In fact, most are still ignoring the ongoing pandemic and speak about it in the past tense. On his first day in office, Donald Trump unlawfully withdrew the U.S. from the World Health Organization. The order explicitly halted U.S. negotiations on new international health regulations known as the pandemic treaty. His administration has since blocked vital CDC communications and stifled research funding indefinitely.
When kindling, sparks, and oxygen are all mounting right under your nose, you must prepare to contain inevitable flames.
“I think there's a lot of people who are very angry right now at the American government, and they see the same failures of the COVID response mirrored in our inability to mount a response to H5 [avian flu],” Carlson said.
The U.S. is still unwilling to prevent the continued spread of COVID-19 or support the millions of people with Long COVID — much less a looming bird flu outbreak. Pandemic preparedness and response must consider the long-term, mass disability that comes from widespread illness, the urgent need for biomedical innovation, and the inevitability of another catastrophe. Denial won’t prevent the crisis; accepting these hard truths could lessen it.
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