It’s been 36 months since the world plunged into a pandemic.

And though we’re still in its grip, with no clear end in sight, scientists are working hard to prepare for the next global threat.

They know another pandemic pathogen will emerge. Where and when — and what exactly will cause the initial outbreak — are among the many things they’re trying to predict.

“There will be another pandemic. Like death and taxes, it’s an absolute certainty,” says Dr. Allison McGeer, an infectious disease specialist and professor of laboratory medicine and pathobiology at the University of Toronto’s Dalla Lana School of Public Health.

“It could happen any time between tomorrow and 30 years from now.”

No matter the timeline, it’s clear preparing for it can’t wait. Evidence is building that climate change, combined with our ever-greater encroachment into wildlife habitat, is fuelling the risk of viruses spilling from animals into humans.

Many scientists caution that SARS-CoV-2, the virus that causes COVID-19, is far from the worst-case scenario.

To mark the world heading into its fourth COVID year, the Star asked four Canadian scientists about their own pandemic research and their roles in leading the country’s response to the next threat.

Each scientist provides a snapshot of their research. They also make the case that sound science is only one key component of pandemic preparedness. That solutions found in labs aren’t enough and must be paired with other measures, from better biomanufacturing capabilities to stronger public health networks to greater social supports.

All said that fighting pandemics demands a more equitable response.

With another health crisis looming, here are four experts on the scientific advances that offer hope — and the big worries that keep them up at night.

Gerry Wright, McMaster University

Gerry Wright feels confident that science will find the solutions to the next pandemic.

Perhaps not as quickly as we’d like. And not without obstacles. The race to fight COVID, which drew on decades of research, revealed how quickly scientists could rally.

But the flip side to these successes is the corresponding and deeply alarming rise in misinformation online.

To Wright, a professor in McMaster’s department of biochemistry and biomedicine who holds a Canada Research Chair in antibiotic biochemistry, the spread of anti-science sentiment seems to have swept across the globe at nearly the same speed as COVID-19.

“The thing that terrifies me is that a person with an iPhone can think they’re an expert,” he says. “That people think their opinions matter just as much as those of people who’ve dedicated their lives to understanding science — and that this is now almost a widely accepted concept — is going to result in a super-dangerous future.”

Wright says he first became alarmed in 2020, when then U.S. president Donald Trump flouted the advice of top science agencies by touting the unproven benefits of the anti-malaria drug hydroxychloroquine to treat COVID.

He says his worries deepened the following year when ivermectin, an antiparasitic medicine used to treat some human conditions and which is also a veterinary drug, was falsely hyped as a COVID miracle cure, even as effective vaccines were being rolled out.

“I just knew that we were in deep, deep trouble.”

While McMaster researchers worked flat out to find solutions for COVID, Wright says he knew it was equally pressing to combat misinformation.

He now heads the Global Nexus for Pandemics and Biologic Threats, a McMaster-led initiative that brings together scientists and medical researchers, along with experts in economics, political science and the social sciences. Its goal is to prepare for future pandemics by developing and testing new treatments, vaccines and diagnostics, advancing epidemiological models to inform policy and figuring out how to better support vulnerable communities during a health crisis.

“I understand molecules. I don’t understand people,” says Wright, noting the hub will also provide interdisciplinary training for students, so they can think across typically siloed fields. “This new school tries to marry both the social sciences and humanities with biomedical and clinical research. Because, to me, that was the biggest gap of the last three years.”

With one eye on future health threats, Wright continues to research the molecular mechanisms of antibiotic resistance. He calls antimicrobial resistance, or AMR, “a silent pandemic” and argues that antibiotic-resistant organisms are the biggest threat to our medical systems.

Antibiotics power modern medicine. Without them, people are more susceptible to infections, and routine life-saving medical procedures, such as open-heart surgery or chemotherapy, become impossible.

Wright says medicine’s ability to control and prevent infection with antibiotics and vaccines added more than 20 years to the average life expectancy in Canada. The rise of antibiotic-resistant organisms threatens to turn back the clock. Already, antibiotic-resistant bacteria kill thousands of Canadians every year.

Estimates suggest globally in the coming decades upwards of 10 million people will die every year because of antimicrobial resistance, says Wright.

“My lab is completely dedicated to making sure that does not happen.”

Wright’s team at McMaster was among the world’s first to systematically show that the origins of AMR are primarily found in the natural environment. His team collects bacteria and fungi in dirt and looks for molecules that can lead to new antibiotics.

In the past 20 years, Wright’s team has collected about 15,000 strains of soil bacteria and fungi, primarily from Canadian environments. They mine them for new antibiotics, new antifungal compounds and new anti-cancer drugs. After COVID arrived the team also started to screen their collection for antiviral properties.

Wright knows this kind of collective scientific push for global solutions is happening in labs all around the world. That gives him confidence that we’ll be able to find countermeasures to the next big crisis.

“The paradox is that science has never been more well prepared to deal with pandemics.”

Dr. Srinivas Murthy, University of British Columbia

Dr. Srinivas Murthy wants to make Canada’s health-care system more resilient to future health emergencies.

From overcrowded ERs to overflowing ICUs, it became clear during the pandemic that hospitals lacked the surge capacity to handle wave after wave of patients.

“We thought we had a health system that would be ready for an emergency,” says Murthy, an associate professor at UBC’s faculty of medicine who holds a research chair in pandemic preparedness. “We were unable to adapt. We need to figure out why our system doesn’t have the resiliency it needs.”

But Murthy, also a pediatric intensive-care physician, says one way to help hospitals respond in a crisis is to ensure new medical findings are more quickly used in day-to-day care.

One of his short-term goals is to expand a national platform to share data about patients hospitalized with severe acute respiratory infections. When such data is fragmented or not readily at hand, it’s hard to get a picture of who is getting critically ill, and how and where infections are spreading.

Murthy is also developing ways to integrate rapid clinical trials in routine hospital care.

“That will help us learn what works — and what doesn’t work — so that we can constantly improve,” he says.

A health-care system that learns on the go, with the help of clinical trials that take weeks or months to inform patient care, will help hospitals and other parts of the system adapt swiftly. This swiftness will help build resiliency, Murthy says.

He says he remains in awe of how fast the global scientific community raced to respond to COVID, generating vaccines, therapeutics and diagnostic measures. This was possible because scientists could draw on the decades-deep foundation of basic research in immunology, virology and other life sciences.

And while he’s encouraged by Canada’s recent investments in pandemic preparedness, Murthy’s big worry is that COVID has revealed that wealthy nations — and wealthy communities within nations — have largely been out for themselves, snapping up vaccines and therapeutics, leaving others behind.

“This is obviously the wrong response to an emerging pathogen,” he says. “Any pandemic, by definition, will require a collective response that embraces solidarity and embraces the diversity of our planet.”

Joanne Lemieux, University of Alberta

Joanne Lemieux has spent much of her career thinking about problems at the molecular level.

A professor of biochemistry at the University of Alberta, Lemieux is an expert in understanding how proteins can be used to create new vaccines and drugs.

She is also the scientific director of the Prairie Hub for Pandemic Preparedness — a role that has expanded her scope from mapping the structure of molecules to building scientific connections across three provinces.

The Hub’s focus is to boost Canada’s biomanufacturing capacity in basic research while building critical infrastructure and training scientists. Its cornerstones include the universities of Alberta, Calgary, Manitoba and Saskatchewan, and its Vaccine and Infectious Disease Organization, along with industry partners.

“We’re thinking about the next pandemic through a zoonotic lens,” Lemieux says. “We know the coexistence between animals and humans, whether it be domesticated, agricultural or wild animals, will influence the next pandemic.”

Along with COVID, Lemieux points to the 2003 SARS outbreak and MERS, which emerged in 2012 and has been reported in 27 countries, as examples of coronaviruses with animal sources that have been devastating to human health.

There are also viral hemorrhagic fevers, a group of deadly diseases, including Ebola and Marburg, caused by viruses that jump to humans from an infected animal or insect host.

Scientists are also closely monitoring the virulent bird flu virus, H5N1, now infecting mammals. As the climate warms, experts warn of even more viral spillovers.

The Prairie provinces are home to a large collection of virologists and other researchers specializing in infectious diseases. Lemieux says harnessing their expertise and fast-tracking co-ordinated projects is one of the Prairie Hub’s top priorities.

“We’re trying to collectively think about where the next pandemic may occur and be ready with an arsenal of therapeutics, vaccines and diagnostics,” she says, noting it is equally important to build up biomanufacturing capacity, something the Hub is working on alongside scientific advances.

“Our response to this pandemic was, in part, delayed due to Canada’s lack of ability to manufacture vaccines in a sterile environment and distribute them to Canadians.”

In her lab, Lemieux continues to study how small molecules — a chemical entity or an organic compound with a low molecular weight — can block the activity of a protein, including those in SARS-CoV-2 and other related viruses.

Because small molecules also inhibit a virus’s ability to replicate, scientists quickly turned to these kinds of drugs in their search for COVID treatments. The antiviral Paxlovid is the first small-molecule compound designed specifically to target SARS-CoV-2.

Lemieux and other Canadian researchers believe small molecules hold even greater promise for COVID and other viral illnesses.

“We can’t stop now. We have to work on the next generation of these drugs.”

Jen Gommerman, University of Toronto

Jen Gommerman, a professor of immunology at U of T’s Temerty Faculty of Medicine, worries momentum to ward off future pandemics, gained during the COVID years, will soon fade.

Like most scientists, she agrees that lessons learned during the 2003 SARS outbreak were quickly forgotten.

“We can’t give up. We can’t just keep doing more of the same,” says Gommerman, who holds a Canada Research Chair in tissue-specific immunity. “We have to strive for better vaccines, the 2.0 versions of vaccines and therapeutics that will help us deal with what’s going to come next.

“Because there will be other pandemics.”

Gommerman is co-academic lead of the Canadian Hub for Health Intelligence and Innovation in Infectious Diseases, which links more than 80 partners in industry and academia, including eight Ontario universities and six research hospitals.

Led by U of T, it aims to boost Canada’s ability to respond quickly and equitably to future pandemics.

It will focus on three interconnected themes: to make better vaccines and therapeutics based on research investigating the immune system and different pathogens; to develop advanced biomanufacturing strategies within Canada; and to improve public health intelligence to understand what interventions a population will accept, and which communities will need such interventions the most.

Gommerman says Canada needs to shore up its public health network so it can detect a new pathogen at its earliest arrival, especially as evidence suggests a future pandemic virus will land in Greater Toronto early in its global sweep. Millions of people fly in and out of Pearson airport every year. The city was rocked by SARS in 2003. And the first Canadian infected with COVID arrived in a Toronto ER in January 2020.

She says governments need to fund basic science to keep Canada’s research ecosystem healthy.

In her lab, Gommerman is researching how to generate long-lasting immunity to pathogens. One such way is to train the immune system to fight hardest in the area of the body where the threat is most likely to land. For SARS-CoV-2, the threat is first introduced in the nose and mouth.

“We want to learn the signals that encourage immune cells to remain in tissues, such as in the upper respiratory tract or in the lungs.”

In the meantime, one of Gommerman’s biggest concerns is that the next pandemic pathogen will be even more lethal than COVID’s Omicron variant but with all its same tricks to rapidly infect populations.

When asked if anything else keeps her up at night, Gommerman recalls an anecdote from her hometown. Her father was among the hundreds of children who were evacuated during Winnipeg’s devastating 1950 Red River flood. In its aftermath, Manitoba’s premier built a floodway to protect the city.

“People would joke about it: ‘Why did we spend all that money for a once-in-100-years disaster?’ But another flood did come in 1997 and the floodway saved the city,” Gommerman says.

“We have to have the same mentality around pandemic preparedness. It’s an existential threat and solutions cannot be subject to politics or to shortcuts. It’s going to be expensive. It’s not going to be sexy. But we have to do it. We have to be ready.”

Megan Ogilvie is a Toronto-based health reporter for the Star. She was also a sessional instructor in the School of Interdisciplinary Sciences at McMaster University in spring 2022. Follow her on Twitter: @megan_ogilvie or reach her via email: mogilvie@thestar.ca

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