Pandemic Prevention: Surveillance Has a Higher Return on Investment Than Vaccines
If you’ve got money to spend on pandemic preparation, put it into better global surveillance, not better vaccines. Surveillance is our radar for novel pandemic-potential pathogens (‘PPPs’). The better our radar, the sooner we find the PPP, the smaller the outbreak will be at the time, and the quicker, easier, and cheaper it will be to eliminate it. Vaccines, in contrast, are one of our last lines of defence. If we are to protect ourselves from PPPs in the long-run, we’ll need stop them long before we need to resort to global vaccination.
This would surprise me. Surveillance is a very expensive ongoing cost, and the actions you should take upon detecting a new microbe which could potentially be a pathogen are unclear. Have you got a more detailed version of why you think this?
1 Do you have any estimates for that? The cost of annual surveillance is surely a pittance compared to the cost of a Covid-19 pandemic every 20-30 years. We have an insurance industry for this reason. One would also expect the cost of that surveillance to fall over time, and the quality of the info it provides to improve too.
2 The cost of developing, trialling, manufacturing, and distributing 8bn doses of an unproven vaccine to every corner of the world every time a novel PPP is discovered (!!) would surely be more than the annual surveillance costs. It also offers worse health outcomes. Plus vaccines are our last line of defence. If we aim to defend ourselves there, then it is only a question of time before we lose. Global vaccination is, to be frank, an insane approach to pandemic risk management. This, thankfully, is starting to be understood by some prominent epidemiologists:
“the actions you should take upon detecting a new microbe which could potentially be a pathogen are unclear”
First you alert the world to the fact that there is an unidentified / novel pathogen circulating. Then you implement your national pandemic prevention plans. Remember, this is not a scientific matter. Making decisions in uncertain environments is risk management, not science. Real world planning, preparation, resource management, and tactical decision-making in uncertain environments are required to protect humanity from pandemics, but they are not scientific skills. They are not taught to, or by, scientists, so the methods of science are of little value in a crisis. A scientist can tell you what a hurricane is, whereas a risk manager can tell you what to do about it. That’s the key difference. But, that’s also a major hurdle that we’ll need to overcome, as scientists are very influential but also VERY unwilling to recognise the inadequacies of their methods.
“Have you got a more detailed version of why you think this?”
Speed. If an outbreak is growing at 3x per week, then every week saved in finding the outbreak cuts it in size by a factor of 3. The smaller the outbreak when we find it, the more local it will be, and the quicker, cheaper, and easier it will be to contain and eliminate it. Covid had at least a 10-week head start on us, and then we sat around for another month or two before we did anything substantial. The outbreak had increased by many orders of magnitude before we even got started with our responses. With better surveillance we could have picked it up in November 2019, it would have been 1⁄10,000th the size when we responded, and the outbreak would have been over by spring 2020 with little disturbance outside of China and a few cities in the EU/USA. Surveillance is speed, and speed is our greatest leverage over PPPs.
Pandemic Prevention: Surveillance Has a Higher Return on Investment Than Vaccines
If you’ve got money to spend on pandemic preparation, put it into better global surveillance, not better vaccines. Surveillance is our radar for novel pandemic-potential pathogens (‘PPPs’). The better our radar, the sooner we find the PPP, the smaller the outbreak will be at the time, and the quicker, easier, and cheaper it will be to eliminate it. Vaccines, in contrast, are one of our last lines of defence. If we are to protect ourselves from PPPs in the long-run, we’ll need stop them long before we need to resort to global vaccination.
This would surprise me. Surveillance is a very expensive ongoing cost, and the actions you should take upon detecting a new microbe which could potentially be a pathogen are unclear. Have you got a more detailed version of why you think this?
“Surveillance is a very expensive ongoing cost”
1 Do you have any estimates for that? The cost of annual surveillance is surely a pittance compared to the cost of a Covid-19 pandemic every 20-30 years. We have an insurance industry for this reason. One would also expect the cost of that surveillance to fall over time, and the quality of the info it provides to improve too.
2 The cost of developing, trialling, manufacturing, and distributing 8bn doses of an unproven vaccine to every corner of the world every time a novel PPP is discovered (!!) would surely be more than the annual surveillance costs. It also offers worse health outcomes. Plus vaccines are our last line of defence. If we aim to defend ourselves there, then it is only a question of time before we lose. Global vaccination is, to be frank, an insane approach to pandemic risk management. This, thankfully, is starting to be understood by some prominent epidemiologists:
https://www.oecd-forum.org/posts/entering-the-age-of-pandemics-we-need-to-invest-in-pandemic-preparedness-even-while-covid-19-continues
“the actions you should take upon detecting a new microbe which could potentially be a pathogen are unclear”
First you alert the world to the fact that there is an unidentified / novel pathogen circulating. Then you implement your national pandemic prevention plans. Remember, this is not a scientific matter. Making decisions in uncertain environments is risk management, not science. Real world planning, preparation, resource management, and tactical decision-making in uncertain environments are required to protect humanity from pandemics, but they are not scientific skills. They are not taught to, or by, scientists, so the methods of science are of little value in a crisis. A scientist can tell you what a hurricane is, whereas a risk manager can tell you what to do about it. That’s the key difference. But, that’s also a major hurdle that we’ll need to overcome, as scientists are very influential but also VERY unwilling to recognise the inadequacies of their methods.
“Have you got a more detailed version of why you think this?”
Speed. If an outbreak is growing at 3x per week, then every week saved in finding the outbreak cuts it in size by a factor of 3. The smaller the outbreak when we find it, the more local it will be, and the quicker, cheaper, and easier it will be to contain and eliminate it. Covid had at least a 10-week head start on us, and then we sat around for another month or two before we did anything substantial. The outbreak had increased by many orders of magnitude before we even got started with our responses. With better surveillance we could have picked it up in November 2019, it would have been 1⁄10,000th the size when we responded, and the outbreak would have been over by spring 2020 with little disturbance outside of China and a few cities in the EU/USA. Surveillance is speed, and speed is our greatest leverage over PPPs.