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As the world faces another possible pandemic, experts ask how can we find outbreaks faster?

On the eve of 2020, a new strain of coronavirus named SARS-CoV-2 was reported from Wuhan, China. By the end of February, the number of confirmed cases of infection, called COVID-19, surpassed 80,000, the infection spread to 30 other countries, and the outbreak was declared a global health emergency. Within two months, COVID-19 had claimed nearly 3,000 lives, with many more at risk.

Mark Smolinski envisions a world without pandemics, a world with faster detection of outbreaks and fewer fatalities. He says, “This really is a wake-up call and outbreaks such as this that spread from animals to humans will continue to occur. My motto is, ‘Don’t be scared, get prepared.’”

For the past 25 years, Smolinski has worked to improve disease prevention and control across the globe. As president of Ending Pandemics, Mark and his team work to improve infectious disease surveillance. In short, they help countries find outbreaks faster.

Like the age old adage, “What gets measured, gets done,” Ending Pandemics developed a framework for measuring timeliness of outbreak detection and response, along with a set of other key milestones.

Ending Pandemics piloted such timeliness metrics in 28 countries to test the feasibility of measurement. Ending Pandemics then hosted a sector-spanning, international program with Salzburg Global Seminar in 2018, to refine these metrics and identify mechanisms to aid their widespread implementation.

Smolinski says, “Much to our surprise, this diverse group of people representing many sectors and countries came to agreement on standard milestone definitions.” The World Health Organization and other agencies have since adopted the timeliness metrics for measuring the impact of an outbreak on human health.

But pandemics affect more than just people. Often diseases start in animals and transfer to humans, and the health of animals and humans both impact the health of the environment – and vice versa. Greater recognition of this relationship led to the call for “One Health” timeliness metrics.

Expanding on their earlier work on human outbreak timelines metrics, Ending Pandemics led a diverse group of experts that spanned the One Health spectrum at a second program with Salzburg Global in 2019. The consensus between the experts gathered was again expeditious as they drafted a set of One Health timeliness metrics. Smolinski credits the Salzburg program for the speedy breakthrough. “To be able to come away with completely satisfactory results in the end really speaks to the process and the preparation that goes into [the program],” he says.

This more complete set of timeliness metrics are still designed around “milestones”: the dates when an outbreak is predicted, detected, verified and responded to, when the authorities are notified, and when a multisectoral investigation is launched, lab tests conducted, control measures implemented and the public informed.

Smolinski says, “The metrics are a set of indicators against which we can measure progress. We have build them into how we monitor our work. We’re helping countries figure out how to build them into their automated disease surveillance systems for continuous improvement.

“We hope that these simple set of metrics, in the end, will allow countries to regularly calculate them as performance measures. They’re so common sense. The reality that they’re not systematically collected is a challenge we can easily overcome.”

Ending Pandemics continues to provide scientific, technical, and financial support to find outbreaks faster in emerging disease hotspots. The spread of COVID-19 has shown the world is still not ready to prevent pandemics, according to Smolinski, as still plenty of challenges remain.

“What motivates me is the fact that the challenges continue to exist, that the opportunities with new technology, data sharing, and artificial intelligence are just so exciting that I’m convinced we can find outbreaks faster and contain them at their source.”