Former federal virus hunter says U.S. needs to act before new germs ‘kick your door in’

When the federal government decided to investigate the threat viruses in animals posed to humans, Dennis Carroll helped lead the charge.

Carroll directed the pandemic influenza and emerging threats unit at the federal Agency for International Development (USAID) for nearly 15 years. In that time, he spearheaded Predict, a project that identified more than 2,000 zoonotic viruses, or germs in animals - the viral "dark matter," as he characterizes it — that could also sicken people.

It operated under Presidents George W. Bush and Barack Obama, but the Trump administration opted to shut down the project. Its operations will cease later this year, Carroll said.

Carroll retired from the federal government and moved to Texas A&M University. He now heads the Global Virome Project, a nonprofit cooperative dedicated to tracking more of these threats and developing a database of viruses.

His work gains relevance as countries around the globe scramble to contain the novel coronavirus that has sickened more than 169,000 people worldwide as of Monday morning with an illness known as COVID-19. The virus, suspected to have jumped to humans from an animal, represents just one in a wave of zoonotic diseases that have adapted to humans, said Carroll.

That wave is likely to continue, he added.

"When you look back over the last 20 years, our whole approach to emerging viral threats from SARS onward has been to wait and react. Wait and react," Carroll said. "And that is a recipe for global disaster."

Carroll spoke with KHN's Carmen Heredia Rodriguez about the Predict program, the likelihood of another novel animal virus threatening humans and whether the world is prepared for this pandemic.

This interview has been edited for length and clarity.

Q: Can you tell me about the purpose of the Predict project and how it worked?

I designed the Predict project a little over 10 years ago. It was coming out of the experience with avian influenza - the H5N1 virus — that sort of piqued everyone’s attention back in 2005.

Predict was really an exploratory effort. Could we begin quantifying what that larger pool of future viral threats might be? By 2018-19, we were able to begin understanding, if you will, that larger viral "dark matter" — what was that unknown pool circulating.

We had it operating in 30 countries in Asia and Africa. Basically, it was a scientific discovery investment. Working with local counterparts in those countries to be able to go out into the field - into the remote areas where wildlife was circulating and collect samples from bats, non-human primates, rodents, wherever they might be. The samples could be brought back to laboratories to identify novel viruses in those animals and characterize those novel viruses in terms of their relationship to known viruses.

Predict discovered more than 2,000 novel viruses from viral families we know have posed a past threat to people. We calculate now there are about a million and a half of which — maybe 500,000 to 600,000 - could be potential threats to people. So, you can appreciate that if it took us 10 years to discover 2,000 viruses, really elevating this to the scale that we could discover a million new viruses, Predict was not adequate.

Q: Who is left doing this work?

Congress in the last appropriation in December did signal to USAID its interest in USAID continuing the discovery work and being part of a global partnership that would build the kind of atlas on viruses circulating that could pose a future threat. We now need to translate that support from Congress into USAID stepping forward and investing in this global partnership.

The Global Virome Project is looking to forge [that partnership]. Obviously, this [SARS-CoV-2] virus is a clear example of why a discovery and capacity-building venture like the Global Virome Project is important.

Q: Speaking of COVID-19, how big a threat are zoonotic diseases to humans nowadays?

They’re extraordinary.

The threat posed by zoonotic diseases - those are basically viruses circulating in animals and particular wildlife — is becoming more and more part of our natural landscape and is largely being driven by the increase in population around the world over the last century. If you and I were having this discussion a hundred years ago, we would've been talking about 1.8 billion people on this planet. We’re now talking about almost 8 billion. With that comes all of the livestock and animal production to feed the human population. We’ve expanded our cities, our settlements, our agriculture into wildlife areas.

That means the frequency of interaction between people and wildlife is happening at a scale never before seen. We’ve calculated based on historical evidence that we’re looking at two to three to four new zoonotic disease threats emerging every year. So, it should not come as a surprise that today we’re talking about the COVID-19 virus.

Q: For you, what are some of the greatest obstacles to doing this work of predicting and identifying diseases with the potential to jump into humans?

Well, it challenges people to think differently. We can have the information at hand, but if you don’t use that information to act, that becomes the big challenge. In the United States and around the world, we are a reactive culture. We’re more comfortable waiting for something to happen and then react to it rather than be proactive, use knowledge that allows us to put in place capabilities to prevent future events from happening. So the biggest challenge we have is what you could think of as social engineering - changing politicians', investors', communities' approach toward facing risk. Don’t wait for it to kick your door in when you understand it is in your neighborhood. Step out and act on it now.

Q: For you, what does this outbreak tell you about the world's ability to predict and prepare for a pandemic of a novel virus of any kind?

We knew this was coming. Whether it was this coronavirus … or another influenza virus, we couldn’t say that. But we know, as I’ve said before, the frequency is intensifying. And because of globalization and population movements, an event anywhere becomes a threat everywhere. So, first off, no surprise.

Secondly, I think what we’ve seen is the fragmentation of the global partnerships that have been forged over the last decade based on the experiences of SARS, avian influenza, the flu pandemic of 2009 and Ebola. We've seen in the last several years the rise of political tensions, which have fragmented the global community. Our ability to act in a coordinated, forward-leaning way has been greatly compromised. We see that with our own country.

We learned about this virus over two months ago. Scientists took note, public health people took note. The political community could have, should have, taken note. In our own government, nothing happened. [Only this month] Health and Human Services actually put a tender out for urgently needed N95 face masks. They had 30 million face masks in their national strategic stockpile. They had months to bring additional masks. That puts front-line health workers at risk.

And then, in 2018, the White House closed the Global Health Security office in the National Security Council, which was the center for ensuring that the United States government had a forward-leaning capability to monitor what was happening around the world and to inform and guide all agencies in the United States about what needs to be done yesterday, not tomorrow. That agency was shut down, and there is an enormous vacuum. That left a vacuum that is clearly playing itself out in terms of leadership, global responsibility now.