Epidemiologists have been warning of a coronavirus outbreak for years and say that another pandemic will happen again

• Epidemiologists have been warning of a coronavirus outbreak for years and say that another pandemic will happen again.
• However, the speed and severity of the next outbreak does not have to be as detrimental as the one we're experiencing now.
• Scientists have the tools in place to predict and identify harmful viruses. They just need the world to listen more closely next time.
• Visit Business Insider's homepage for more stories.

For most people, the ongoing coronavirus pandemic appeared out of nowhere. But scientists who have spent their lives studying emerging diseases and epidemiology anticipate moments like this.

"If you look at the coronavirus literature, there were scientists who knew this could happen since at least 2015, maybe even earlier," said Tara Smith, an epidemiologist at Kent State University.

Those same experts say it is not a question of whether another pandemic will sweep the world but of when. Does this mean much of the world will be under a shelter-in-place order and in danger of exceeding hospital capacity again?

"I would like to think we would learn some valuable lessons from this and I'm hopeful that this does not repeat itself," said Meghan May, a microbiologist at the University of New England.

Identifying the root source

The coronaviruses that have most severely impacted humans, SARS and MERS - a coronavirus with a 35 percent fatality rate - are contracted through cross-species contact where humans contract the virus from another species.

For example, livestock contact has led to cross-species transfers of viruses like the H1N1 swine flu that led to the 2009 pandemic. Evidence also shows that MERS is likely to spread to humans through close contact with camels.

Steven Osofsky, a wildlife health expert at Cornell University, pointed out that the trade, consumption, and mixture of wildlife from markets worldwide can facilitate disease spillover through contact with humans.

"This is a viral lottery," he said, describing how all sorts of wildlife normally separated by continents are brought together at markets in Asia. "If you're a virus and you survive by spreading, you couldn't create a more perfect system for aiding and abetting the next pandemic."

To reduce the risk of future outbreaks, Osofsky recommended a policy to shutter these wildlife "wet markets." But while this could prevent some viral spillover into humans, an investigation shows the issue of shutting down these lucrative markets is both culturally and economically fraught. More research is needed to know if this is a viable solution to help prevent another global pandemic.

In the meantime, it's likely that the "risk of introducing novel coronaviruses into naive human and animal populations remains high," according to a review of emerging coronaviruses published in 2013.

How viruses take hold

Just because humans and animals end up in close proximity does not mean that they will necessarily share viruses.

May, who researches how viruses manage to infect human cells in the first place, pointed out that we are often in contact with animals like dogs and cats, but this doesn't always make us ill. A virus has to have a matching "key" that fits the "lock" of the human cell to get inside, she said.

May uses her research to try to anticipate the characteristics of an emerging disease, like this novel coronavirus. "We look at unknown viruses from animals that we've never seen before in humans that seem like they have those potential traits that could allow them to bind onto human cells and cause disease."

For example, one scientific article from early 2016 points out that coronaviruses isolated from bats pose a "significant threat" to humans and are capable of direct transmission.

Lessons for the future

The evidence that a novel coronavirus was circulating through the human population was noted by scientists as early as the final days of 2019.

May, like other infectious disease researchers, spotted a Dec. 30 post on a specialist medical listserve called ProMED that described a severe pneumonia cluster of "unknown cause" in Wuhan. On Jan. 1, she posted an argument on Facebook describing why she thought that this pneumonia was likely caused by a novel coronavirus.

The writing was on the wall and preparation for this outbreak could have begun earlier, said Smith who regularly conducts "tabletop exercises" with colleagues, where they plan and prepare an effective public health response to an imaginary pandemic.

Smith added that there's no reason the world cannot be better prepared for an outbreak or pandemic, no matter the type of pathogen. "We're seeing shortages of PPE and shortages of ventilators. These are things we have been warning about for 20 years or more," she said.

She said South Korea learned their lessons from a MERS outbreak in 2015 and were better prepared with diagnostic testing and case tracking this time around.

"We [the United States] need the ability to be nimble, which I think we do not have right now. So hopefully that will be a lesson learned from this."

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