Lab technicians analyse Novel oronavirus test kit samples to identify new cases at a disease prevention and control centre in Nanyang, Henan province, China, this month. Xinhua

In a twist of fate, even as China battles with COVID-19, it has also seen the re-emergence of another disease, the bird flu epidemic also known as H5N1, with more than 17,000 chickens culled as of the beginning of February.

Yet, this sequence of events may only be the tip of the iceberg, if one considers the findings of the Economist Intelligence Unit’s (EIU) assessment of global health capacities, released five months ago.

In October 2019, the EIU Global Health Security Index indicated that “[no] single country in the world is fully prepared to handle an epidemic or pandemic”. Granted, a 100 percent preparedness level may be hard to achieve. What is surprising, however, is how far countries are from the ideal state: the global average score is 40 out of 100, and even among the richest, high-income countries, the average score is 51.9. Worse still, this comes 15 years since the World Health Organization (WHO) released its International Health Regulations in 2005, one of the references for the EIU’s index. It recommended “strengthen[ing] national disease surveillance, prevention, control and response systems… [and] public health security in travel and transport”.

No one can say that the global community had not been forewarned. As early as March 2019, scholars from the Wuhan Institute of Virology and the Chinese Academy of Sciences had already published a document, presciently. They warned: “It is highly likely that future SARS- or MERS-like Coronavirus outbreaks will originate from bats and there is an increased probability that this will occur in China.”

What those Wuhan scholars did not anticipate then, though, was that while COVID-19 would not be nearly as deadly as Severe Acute Respiratory Syndrome (SARS), it would instead be many times more contagious, closer in fact to the swine influenza, H1N1. The trait of being highly contagious but less (yet still) lethal, has been interpreted previously as the virus’ own evolutionary mechanism to adapt and raise its own probability of survival. Indeed, if COVID-19 had killed off its first victims immediately, then, after migrating from animals to man, it would have been less likely to travel abroad too and situate itself in more than 29 countries and a cruise ship, Diamond Princess. We do not yet know how its lethal properties may worsen in the long run because there are still multiple pending cases.

This trend of evolution of viruses is making disease diagnosis more time-consuming, almost impossible for any single country, with the global community paying the higher costs of delays in findings. For instance, it took three weeks to confirm COVID-19’s human-to-human transmission (Jan 21), since the time when the Chinese government reported its “mystery pneumonia-like disease” (Dec 31).

The exponential spread of the virus within China (with spill-overs abroad), could have been significantly slowed had earlier action been taken. Yet one cannot blame China because its investment in infectious disease-testing and monitoring far outstrips other countries, at $1.94 billion, approximately triple that of the next biggest investor, Japan ($640 million), as reflected in the EIU’s recent web briefing on COVID-19. Other countries today are thus more likely than not to have been caught off-guard had they faced the same plight. In spite of this, China still saw a preponderance of false-negatives such that its testing accuracy was only at 30-50 percent. Moreover, it took three days to generate tests results in Beijing and only seven hospitals were equipped with some genome sequencing capacity for virus diagnosis, the EIU revealed.

WHO data shows that COVID-19’s spread is slowing, having reached the highest number of daily new, laboratory-confirmed cases (approximately 4,000) on Feb 5; by Feb 16 this number had decreased to close to 1,000.

Nonetheless, three key lessons can be gleaned from this experience thus far, if countries are to avoid the same plight. First, early research efforts are needed in preparing for future disease outbreaks, long before wartime conditions occur. In fact, doing so can shift global action from fire-fighting to prevention. Global collaboration, seen today, should have begun with this, rather than in responding to the virus after it became an international phenomenon. Second, input from the academic and scientific community need to be given more weight. It is one thing to have faced COVID-19, but it is quite something else to have faced it even after warnings had been given in the previous first quarter in 2019. Third, as the types of novel forms of diseases have multiplied over time, with each branch of the organism giving birth to sub-branches of different levels of contagion and lethality, potentially hitting multiple countries at the same time, it is imperative that an equally vigilant and networked approach is taken by the international community. A networked approach to preparing for novel diseases in future would be akin to holding three types of lenses at the same time: wide-lenses to see the full range of diseases as they occur, a microscope to investigate each one of them and binoculars to foresee how these viruses are transforming far into the future.

This is embodied in the Global (genome) Microbial Identifier (GMI) initiative advocated by scientists in 2011. The GMI is a “global system to aggregate, share, mine and translate genomic data for microorganisms in real-time”. This could provide “wide-lenses” through real-time information sharing among scientists, governments and the private sector.

Jose Montesclaros is Associate Research Fellow at the Centre for Non-Traditional Security Studies, S. Rajaratnam School of International Studies, Nanyang Technological University, Singapore. This first appeared in RSIS Commentary.