21st May 2024 – (Beijing) As spring blossoms unfurl across China, a palpable sense of trepidation lingers beneath the vibrant renewal of life. For while the nation has surmounted the initial onslaught of COVID-19, a foreboding realisation persists – this pandemic’s saga is far from concluded. The virus, an insidious metamorph, continues to evolve, its variants defying our hard-won defences with each mutation. And now, a new threat looms on the horizon, one that could presage an even more formidable foe: climate change.

At the vanguard of this battle stands Zhang Wenhong, director of China’s National Medical Centre for Infectious Diseases and a household name forged in the crucible of Shanghai’s war against COVID-19. His authoritative guidance proved invaluable during the darkest days of the pandemic, and now, he embarks on a new mission – to fortify the world against the next plague.

“After the end of the recent coronavirus pandemic, the whole world is actually preparing for the next pandemic,” Zhang solemnly declares, his words a sobering reminder that our respite from this scourge may be fleeting. While the tangible consequences of climate change – rising seas, scorching temperatures, and extreme weather events – command global attention, an insidious peril lurks beneath the surface. A burgeoning body of research now illuminates the intricate web of connections between a warming planet and the propagation of pathogens.

“The reservoir of bacteria and viruses is expanding as the Earth warms,” Zhang warns, painting a disquieting picture of a world where once-confined microbes breach their traditional boundaries, exposing new populations to novel afflictions.

From the subtropical expanses where ocean surfaces simmer, to the rapidly thawing permafrost of the Arctic, climate change is inexorably reshaping the terrain upon which the battles against infectious diseases are waged. Mosquito-borne scourges like dengue fever, once confined to the tropics, now encroach upon the Yangtze River Basin. Ancient bacteria and fungi, locked beneath frozen wastelands for millennia, threaten to awakene as the ice retreats.

“Some species that have not emerged before may enter our human society,” Zhang cautions, his words a clarion call to brace for the unknown.

Across the global south, the toll mounts relentlessly. “Not only has malaria not been eliminated, but the number of cases are at very high levels,” he laments, inextricably linking this resurgence to the escalating climate crisis.

Even as the world cautiously embraces a semblance of normalcy, COVID-19 casts a long shadow, its variants a harbinger of the challenges that lie ahead. The emergence of the FLiRT group, encompassing strains like KP.2 and JN.1, serves as a potent reminder that this virus’s capacity for metamorphosis remains undiminished.

“We don’t know what the next variant will be, so we need to conduct a longer-term survey on it,” Zhang intones, underscoring the imperative to maintain vigilant surveillance lest we be caught unawares by COVID-19’s perpetual masquerade.

For the most vulnerable amongst us, additional fortifications are crucial. “Individuals who are at higher risk for severe COVID-19 should also consider using additional measures to protect themselves, such as limiting time in crowds and wearing a high-quality mask in poorly ventilated indoor settings,” he advises, his counsel a pragmatic bulwark against an implacable foe.

However, perhaps Zhang’s most profound exhortation is one that resonates beyond the realm of epidemiology. “We have learned a lot over the past several years,” he reflects, “and it is time to use all those lessons to protect everyone in the community.”

In China, changes have already begun to manifest. Zhang points out that diseases like dengue fever are increasingly being detected further north than ever before, moving into central areas like the Yangtze River Basin. This shift challenges existing public health strategies and compels a reevaluation of disease monitoring and control mechanisms.

Globally, the situation is equally dire. Malaria, a disease intimately linked to climate conditions, continues to impose a high disease burden in Southeast Asia and Africa. The World Health Organisation has warned that the fight against malaria and other vector-borne diseases will become increasingly difficult as global weather patterns continue to be altered by climate change.

With the inevitability of future pandemics, Zhang emphasises the need for global cooperation and robust data collection to foster rapid responses to emerging pathogens. The recent memorandum of understanding signed between Shanghai’s Sci-Tech Inno Centre and the University of Hong Kong aims to facilitate this, creating a collaborative platform for experts across various fields to converge and innovate on pandemic preparedness and response strategies.

This initiative reflects a broader recognition that the next pandemic could arise not just from natural disease progression but as a consequence of environmental degradation and climate change. Thus, understanding and mitigating the effects of climate change on infectious diseases is not merely an academic exercise but a crucial public health strategy.

China’s proactive approach provides a blueprint for how countries can integrate climate change adaptation into their public health planning. By aligning efforts across multiple sectors and disciplines, from environmental science to public health policy, China is setting a precedent for comprehensive pandemic preparedness. Moreover, the collaboration extends beyond national borders, recognizing the global nature of the threat. The upcoming international conference, spearheaded by Zhang, aims to lay down a roadmap for worldwide pandemic preparedness, focusing on shared knowledge and unified strategies.