The Future of Global Health Pandemics, According to a Microbiologist

Even though the COVID-19 pandemic is still far from over, you might already be wondering if more crises are to come. Here's what a coronavirus expert has to say about the future state of global health.

What a Microbiologist Wants You to Know About the Post-COVID Future
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Will the coronavirus continue to mutate? Could there be another pandemic in our future? In an effort to offer some clarity (and control) over what's to come, Shape spoke with microbiologist Stanley Perlman, M.D., a professor of microbiology and immunology at the University of Iowa who has studied coronaviruses for more than 38 years. Here, he shares information and advice that everyone needs to hear.

Shape: Were you surprised when the virus, technically known as SARS-CoV-2, hit last year?

Dr. Perlman: "No, I wasn't surprised. But what was unexpected is how transmissible it is. Coronaviruses haven't done that before. The virus also has some unique manifestations. For instance, take the people with COVID-19 who lose their sense of smell. We're studying that phenomenon in mice and trying to understand how it works and what we can do to minimize it. Sense of smell is a big deal because if you lose it, you lose the joy of eating. So far we've been studying the nose, but we're branching out to see if it involves the brain as well.

"These effects — loss of smell, lung disease, and long-term complications in the brain or the heart — are very unusual. We haven't seen them before in virus infections. Of course, no one ever looked so hard. This virus is being studied with such passion and detail, so we're learning a lot."

Shape: You've speculated that it was circulating among us long before 2020. What makes you think so?

Dr. Perlman: "We believe this virus came from bats. When viruses cross species, they usually need to change to adapt. In 2003, when the SARS virus crossed from animals into humans, we watched it evolve to infect people more easily. None of that occurred with SARS-CoV-2, at least initially. That seems to indicate that the virus was already well adapted to humans and had been circulating in the population for a while." (BTW, this is why new COVID-19 strains are spreading more quickly.)

Shape: We're seeing a lot of new mutations now. Why?

Dr. Perlman: "The goal of the virus is to make more viruses. The best way to do that is to transmit more effectively from person to person. If it doesn't transmit well, the virus will die off because it won't have enough susceptible hosts. The virus discovered that it would thrive better if it mutated."

Shape: Are we likely to face more viruses like this in the future?

Dr. Perlman: "Yes. The one thing that's been clear for the last 15 years is that people have been infringing on wildlife habitats. We see that all the time with endangered species and some of the viral infections that result. This experience went one step further. We infringed on a habitat, or something similar. So a virus that normally would never come near humans instead reached us and evolved to easily infect us."

"I don't think this would have occurred if bats stayed in their caves and people stayed out of those caves — or if they didn't collect the wild animals that are near bats. The only thing that's predictable is that there are going to be repeated episodes like this." (

Shape: How can we protect ourselves?

Dr. Perlman: "What's remarkable is that there has been a huge reduction in the number of flu cases during this time. We've learned that if you wear a mask and wash your hands, it will help prevent the flu, COVID-19, and possibly other viruses too. On a broader level, if we have better preparation — in terms of testing and tracing and more ventilators and protective gear, those things will help a lot."

Shape: What's the most important thing you want us to know about the virus?

Dr. Perlman: "That it has to be respected. The virus's ability to spread among people and to mutate has to be taken seriously. The infection has to be recognized for what it is: a huge danger to older people and people with comorbidities. When you understand that, you'll do things like wear a mask when you go the store without even thinking about it. That will definitely cut down on transmission and protect the people around you. And it will protect you too. But you have to believe it's an important thing to do."

Shape: Do you think we should look at COVID-19 as a wake-up call?

Dr. Perlman: "We could have said that after SARS and after the Zika virus epidemic in 2015. This isn't a wake-up call — it's more like a wake-up bang in the head."

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