If you want to know how the world is preparing for the next global pandemic, look at Rolaing, a Cambodian village located on a tributary of the Mekong River. For a few days in February this isolated spot became a hive of public health activity after an 11-year-old girl died of H5N1, the most virulent strain of bird flu — the country’s first fatality from the disease since 2014.
A rapid response team of local health workers was dispatched within hours to the village, a two hour drive from the capital Phnom Penh. They found a community of almost 2,000 people living in brightly colored wooden and sheet metal homes, close to their livestock and chickens.
In the space of just 24 hours they set up a makeshift testing center, identified a dozen of the girl’s closest contacts, took swabs and scoured for the pathogen. Her father tested positive. He was treated with anti-virals and recovered. At least 11 others, including close relatives she lived with, were found to be infection-free.
The team monitored the village for another three weeks, testing dozens more people. Only the two infections, which health experts said stemmed from direct contact with sick animals, were discovered.
The speed with which Cambodia, and other countries where novel viruses are known to emerge, can identify and respond to future virus threats will determine how effectively the world can contain the next pandemic.
The Cambodian response, honed by years of work with the World Health Organization and the U.S. Centers for Disease Control and Prevention, was remarkably swift for one of Asia’s poorest countries. It forms part of a much bigger global effort — combining government, industry and health officials — to be better prepared for the next pandemic, whether it is avian flu or anything else.
The world has been primed by COVID-19 and torqued by reports of new variants of H5N1 avian flu — a threat researchers have been tracking for over a quarter of a century — that appear to be making it more transmissible between mammals.
The danger is twofold. Novel infections are emerging more quickly than in the past, leaving the public health community less time to regroup and respond to the chaos caused by entirely new pathogens. Since the 1970s, about 40 infectious diseases have been discovered.
Experts also worry that COVID-19 could be mild in comparison to what might come next. H5N1 kills more than half of those it infects. If it mutates to transmit easily between humans — the ultimate concern for public health experts — deaths could dwarf the 6.8 million caused by the coronavirus, with as many as 15,000 people a day in the U.K. alone according to one estimate by Airfinity, a health analytics firm.
There is a community of experts constantly on high alert, even when threat levels dip. So far there has been no human-to-human transmission identified, and only around a dozen people globally have been infected with H5N1 since January 2022.
“We built a strong health system here during COVID, and it has paid off,” said Or Vandine, Cambodia’s secretary of state for health. “Tools from the COVID response, we can use for this event. The master plan, these key elements, were still relevant.”