In a research letter published by Nature in the last week of June, Kevin J. Olival and his team at the EcoHealth Alliance, a New York based global environmental health nonprofit organization, have announced the results of their latest study on “Host and viral traits predict zoonotic spillover from mammals”. Researchers investigated whether it is possible to predict human pandemics of viral origin by focusing on “by phylogenetic relatedness to humans, host taxonomy and human population within a species range”. Their findings suggest that “both the total number of viruses that infect a given species and the proportion likely to be zoonotic are predictable”, consequently “providing a novel framework to assess if a newly discovered mammalian virus could infect people”. The study size was remarkable. Researchers investigated 54 mammalian species (in this preliminary study they focused only on mammalians), say 14% all mammalian species, and identified 586 different viruses. Among these viruses, 263 (44,8%) were shared by animals and humans, including 188 zoonotic viruses, which were transmitted from animals to humans in the past; 73 viruses, previously considered “specific” to humans, were instead found in animals, so providing the evidence of “inverted” zoonosis, say, transmissions from humans to animals. Overall this study demonstrated the ongoing infective cycle between humans and animals, which strongly supports the notion of “one health”.
Surprisingly enough, the results of this study have been immediately reported and amplified by world leading media, including The Economist, Time, Wired, Science Magazine, International Business Times, Wall Street Journal, Spiegel, BBC News, CNN News. It is rare to see such an interest for a news which could seem, at a first glance, of interest only for biologists and epidemiologists. Why so many media were “thrilled” by this study? The Economist provides a possible answer, “maps”. The research team was as smart as to distillate their results into very catching graphics, “heat maps showing places where the actual and predicted number of zoonotic viruses least resemble one another, and which therefore have the highest risk of springing a nasty surprise on the world”. Brief, “having maps like these – continues The Economist - is important because they can help researchers choose the most fruitful places to conduct studies into zoonotic transmission and (…) increase the chance that the next SARS or AIDS might be spotted, almost before it has emerged”. This is then the first lesson to be learned, in the information society – like in the illiterate medieval Europe – images are much more effective than words if one aims to reach a wider audience. In the medieval Europe, where most people could not read, the Church, which included most educated people of that epoch, sponsored artists to educate the mass by images. We should then thank illiteracy for the windows of the Chartres Cathedral and Giotto’s paintings. Although one can hardly recognize today Giottos, effective tools for communicating scientific discoveries are welcome.
Yet, there is probably a deeper reason why this news has had such an impact on media, something novel happened recently, deeply changing the nature of epidemics and pandemics. Once, epidemics and pandemics were considered non-insurable risks. The Insuranceopedia defines non-insurable risk “a risk an insurance company deems too hazardous or financially impractical to take”, which is a right definition but still insufficient. A more precise definition is provided by the Financial Time Lexicon, “A risk for which an insurance company will not provide cover because it cannot calculate the chance of it happening”. More precisely, a non-insurable risk is a risk whose odds of coming to be cannot be calculated, and therefore the insurance company cannot work out a premium that must be paid. Typical non-insurable risks are political, reputational, and regulatory risks, whose odds are unpredictable because they depend too much on human contingency and randomness; also “acts of God”, the legal formula used in the English–speaking countries to indicate natural disasters, are non-insurable. For insurance purposes, acts of God are events that cannot be foreseen, avoided, or anyway prevented. Today, however, some acts of God are considered insurable (e.g., flood, earthquake, volcanic eruptions, and so) either because they turned out being the consequence of human intervention (e.g. environmental disasters) and consequently preventable, or because their chance of occurrence can be inferred from statistics of similar past events. Epidemics and pandemics have been always considered totally unpredictable and unpreventable, consequently uninsurable. Given that the definition of risk entails that 1) the odds of a negative event can be calculated; and 2) the negative event may be avoided through preemptive action, epidemics and pandemics should be considered – rigorously speaking - dangers, threats, but not risks. This holds true till to 2014.
In 2014, the Munich Reinsurance Company (Münchener Rück), a world’s leading reinsurance company, started a strategic partnership with Metabiota, a San Francisco-based global company that “has pioneered the use of near-real-time data collection and comprehensive risk analytics for epidemics”. In 2015, in the midst of MERS epidemics, Munich Re, on the basis of data provided by Metabiota, accepted to reinsure the Korean government, which wanted to offer a full insurance coverage to all international travelers and tourists. This decision contributed to prevent massive travel cancelations and consequent economic loss. In May 2016, the World Bank in collaboration with the World Health Organization initiated the Pandemic Emergency Financing Facility (PEF), a global insurance scheme for epidemics and pandemics risks, offered to 77 low income countries. The PEF covers most zoonotic viruses involved in potential pandemics, including new Orthomyxoviruses (new influenza pandemic virus A), Coronaviruses (SARS, MERS), Filoviruses (Ebola, Marburg) and other zoonotic diseases (Crimean Congo, Rift Valley and Lassa fever). PEF financing is triggered when the infection reaches a certain level of contagion, calculated on the basis of WHO data on the number of deaths, the speed of the disease spread and whether the disease crosses international borders. Munich Re, Swiss Re and GC Securities accepted to reinsure the World Bank for this program, so making it feasible. Finally, in 2017, Munich Re made pandemics and foodborne infectious diseases strategic priorities.
This is then the second lesson to be learned from the EcoHealth Alliance’s study. Advanced genomics, big data, and predictive analytics are not only changing our scientific and operational approaches to epidemics and pandemics, but they are also deeply changing the very notion of infectious outbreaks, which are now entering, in their own right, the world of predictable and preventable “risks”. The impact of this event is much wider than one could guess, also implying important communication consequences.
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