When I mentioned that I didn’t think that Ebola virus would become a pandemic–though it’s certainly horrible for those who have it–that’s because the next big thing will likely catch us unawares. We’ll have to spend time figuring out what it is and how to deal with it. That will allow the threat to spread, give it time to take hold. If enough people become carriers before we truly know what hit us, that’s when we see mass suffering on a global scale. For all the terror of Ebola, it’s already “announced” itself.

One exchange from “How to Survive the Next Plague,” Joanna Rothkopf’s Salon interview with epidemiologist Dr. Stephen Morse:

“Salon:

Moving into the theoretical future, what kinds of emerging viruses could we see? How well are we prepared to handle a virus that comes as a surprise?

Dr. Stephen Morse:

It’s always easier to prepare for the known, especially when you have warning from somebody else experiencing it and suffering through it. People always ask me which emerging viruses do I worry the most about, and I always say the ones we haven’t found yet, because we’re least prepared for that. If they show infectious signs, like a seizure or severe flu-like illness — these all start like flu-like illnesses and sort of rapidly get worse — hopefully in North American and Western Europe we would all have the awareness to take the appropriate infection control precautions and, as we do with Ebola, treat the patient symptomatically, give them the best supportive treatment until hopefully they get better or whatever.

Obviously we would be trying to identify the virus in the laboratory. There are some more generic ways to do that now with sequencing, and there are some broad-based techniques that will identify even some viruses of known families but which are themselves unknown. But as for the precautions, I think they would generally be fairly similar. These are fairly generic and that’s the good news: that people are careful and take basically similar precautions as they would for SARS or Ebola and try to find out what the patient has.

I have no idea, truthfully. We’ve never successfully predicted any emerging infection or pandemic before it happens — that is, before it actually started to appear in humans. And even with influenza, every prediction we’ve made about the next influenza pandemic has been wrong. So I’m always very cautious about making predictions, but I think many of the generic things you do at the beginning would be useful.

As for the public health systems? I think certainly that’s an area that is stretched pretty thin. New York City is excellent and they work very hard. Even they would tell you that they’re understaffed and many other places have even less. One of the issues in Africa, of course, is the lack of real public health infrastructure in many countries. Not much information sharing across those borders, although the people and the microbes cross the borders quite regularly.”