What will the next pandemic look like – and are we ready?

A future pandemic as devastating as Covid is "a certainty", warned the UK's chief medical officer.

The NHS faced an "absolutely catastrophic situation" when the coronavirus first hit in 2020, Chris Whitty told the Covid-19 inquiry last week. But according to the first report from the public inquiry, published in July, reforms made since to better prepare for the next pandemic had "fail[ed] on a number of grounds".

"For as long as humans have been plagued by infectious diseases, the next pandemic has been a question of when rather than if," said the Financial Times. But in a densely populated and globalised world, "many risk factors are greater now than at any time in history". And the UK "does not have an up-to-date pandemic plan or strategy", said The Daily Telegraph.

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What did Whitty say?

"We have to assume a future pandemic on this scale will occur," said Whitty. In fact, it would be "foolish" not to.

Expanding the capacity of the health service would help it cope better in a future pandemic, he added. The UK has "a very low" intensive care unit capacity compared with "most of our peer nations". That is a "political choice".

Resolving NHS staff shortages is crucial because healthcare systems could not be "scaled up" in a future pandemic without a trained workforce. Without sufficient staffing "going into the emergency", you "should not have any illusions you're going to have it as you hit the peak", he said.

How will the next pandemic start?

Some forecast that there's a "one in four chance of another outbreak on the scale of Covid-19" in the next decade, said the BBC.

Last year an international survey asked infectious disease experts to rank pathogens based on their risk of sparking the next pandemic. Of 187 responses from experts in 57 countries, 79% ranked a flu virus among the likeliest causes.

"Each winter influenza appears," said Cologne University's Jon Salmanton-García, author of the study. In essence, these outbreaks are "little pandemics". They are "more or less controlled because the different strains that cause them are not virulent enough – but that will not necessarily be the case for ever".

About 21% believed the likely cause of the next pandemic would be an unknown virus, dubbed Disease X. This would "appear out of the blue" just as Covid-19 did in 2019, said The Guardian.

Disease X is "hypothetical" in that "it does not exist", said the Coalition for Epidemic Preparedness Innovations. While "no one can predict where or when" Disease X will emerge, "what is certain" is that "a future Disease X is out there" and it will "spill over from animals into people and begin to spread".

Concern is escalating over the spread of the H5NI strain of avian influenza, known as bird flu. Tens of millions of birds have died since the outbreak began in 2020, and the virus has spread to cattle in the US – and most worryingly, from infected animals to humans.

Are we ready?

The UK's last pandemic plan was published in 2011 and has "not been revised since", said The Telegraph. It also "proved ineffective for Covid-19", suffering from a number of strategic or "doctrinal flaws".

The UK "still has no special requirements for ports and airports" in a pandemic situation, and if a pandemic "hit tomorrow", we would "all but be starting again from scratch" on mass testing.

But there's a "bright spot" on vaccines. We have a "contract in place" for the supply of a vaccine against H5N1, "should the worst happen" and the virus makes the genetic leap to human-to-human transmission. We could have the first doses within 16 weeks of a pandemic being formally declared.

Globally, "there's a huge degree of engagement by countries" on the issue, Ashley Bloomfield, co-chair of a global negotiation to amend the World Health Organization's International Health Regulations, told the FT.

Having said that, international negotiations over the world's first pandemic treaty have been "painstaking", said the paper. But even if some of the provisions are "scaled back", the effort will hopefully "still lead to significant improvements on the previous pandemic response".

We are better prepared thanks to "technologies developed for vaccines, diagnostic tests and therapeutics", said Chatham House. Covid-19 "massively accelerated" that development.

Artificial intelligence may also "help to alleviate" the next outbreak, said the BBC. Researchers in the US are developing an AI-based "early warning system" that will "examine social media posts to help predict future pandemics".