Preventing the next pandemic: a conversation with Carrick Flynn

Over the last two years, millions have died from COVID-19, a disease that takes away a person's breath and attacks their body on multiple fronts. Billions more have suffered, whether directly from infection with SARS-C0V-2, or from the measures put in place to slow its spread. No-one wants to repeat what we've been through in the last two years.

Unfortunately, there are reasons to believe that the risk of pandemics is increasing. Climate change is increasing the risk of natural pandemics, and our understanding of biology is bringing new risks of man-made pandemics. It's important that we act to reduce these risks.

Although biomedical scientists and public health professionals will be crucial to reducing these risks, much of the power to develop and implement the necessary measures lies with policy-makers. But politicians have shown reluctance to invest in these measures. One person who wants to change that is Carrick Flynn.

Carrick is running for Congress in Oregon's 6th Congressional District. I've known Carrick for a few years now [1] and I can't think of a better person to have as a policy-maker. As well as being extremely knowledgeable on a host of issues, he's one of the people I've met who seems most clearly motivated by a drive to make life better for other people, and who cares enough to think really carefully about how best to do that.

I caught up with Carrick recently to hear his thoughts on pandemic prevention, and how being a voice in Congress could help him prevent us going through another COVID-19.

Bridget: Why are you making pandemic prevention one of your focus issues in this campaign?

Carrick: In the last two years, nothing has more negatively impacted education, the economy, the budget deficit, homelessness, homicide rates, and health care than the Covid pandemic. A million Americans were forced to slowly suffocate to death, often alone, without even being able to say goodbye to their families. That is more than every single combat death in every war in American history. A pandemic like this didn’t need to happen. And we can’t let it ever happen again.

Can you tell me a bit about your previous work on pandemic prevention and preparedness? What prompted you to start working in this area?

I began my career doing global health and institution building work in Africa and South and Southeast Asia. This included large-scale interventions, like vaccination programs, to prevent infectious diseases. I really just wanted to help people as much as I could. I still do.

In 2015, while in Ethiopia, I came across a school of thought discussing how shaping the development of new, high-impact technologies can have an enormous, positive impact on the future. So I made the decision to pivot. The epicenter for these ideas is Oxford University, so I got a job there. This is when I got involved in pandemic prevention and using emerging technologies to prevent future pandemics.

I understand you worked on the American Pandemic Preparedness plan for the Biden Administration. Can you tell me how that came about and what that was like?

After Oxford, I got a position as research faculty at Georgetown, again focused on emerging technologies. While in D.C. I helped draft some legislation with Congress and advised other government agencies. When Covid broke out, someone I had worked with while at Oxford, Dr. Andrew Snyder-Beattie, put together “the A-Team” for developing and implementing pandemic prevention policy. Because of my experience both with pandemic relevant emerging technology, and working with Congress, I was head-hunted for this.

What we initially did was condense the recommendations of 125 of the world’s top experts into a few core, policy-digestible recommendations. We also produced a budget. The cost was well under 1% of the economic losses of Covid.

The scientists and the technologies in this area are brilliant–we really are at the point where we can prevent almost any pandemic. The science advisors at the White House were also great. They saw the value in this draft plan immediately and championed it. This is why it is known popularly as “Biden’s pandemic prevention plan.” The weak link in the chain was Congress. No one there opposed the plan, but no one would champion it either. What we faced was astounding indifference.

The plan made it into the first version of the Infrastructure Bill but was stripped from the second for cost savings. Cost savings. Covid–which is not nearly the most dangerous virus out there–cost the U.S. approximately $16 trillion dollars.

What developments in pandemic prevention and preparedness have you been most excited about recently?

The developments in cheap, rapid DNA sequencing and adaptable vaccines are just incredible. We are on the verge of having sequencers–that can identify a new virus–as standard equipment even in smaller hospitals. We are even closer to the point where we could have vaccines in our arms within a few weeks of finding a new pathogen. The technology really is already here. Almost any pandemic from at least this point on will be a political failure, not a technical one.

What do you think are the most promising strategies to reduce pandemic risk?

By far the best solution is to stomp out the embers before the forest catches fire. The four components laid out in the Pandemic Prevention plan do this:

1) Widespread Pathogen Detection. This means finding new viruses or bacteria we have not seen before using increasingly affordable and common DNA testing machines. These are like the fire-spotting towers.

2) Making and stockpiling Next Generation PPE. This would mean having a large supply of highly effective and wearable masks, gloves, gowns, etc. This keeps medical personnel and first responders safe. It also means we can be confident when we rush in to contain a potential outbreak that we are not accidentally spreading it. This is like digging a firebreak.

3) Adaptable vaccines. New types of vaccines only require substituting one part of the vaccine–like using a different socket on the same wrench. This is much faster and cheaper than old-style vaccines which are slow to invent and build and require starting almost from scratch each time. This speed means we can out-race the pandemic and only vaccinate those in the original location without vaccinating the whole world. This is like stomping out the embers before the fire even really starts.

4) Lab security. There are risks from bad actors with lab access, like the Anthrax Letter terrorist, and also from human error. Since labs hold all the most dangerous pathogens in history, it is important we reduce the number of purposeful or accidental escapes. This is like not setting off fireworks in the forest in July.

What are the biggest barriers to those strategies being put in place or working as well as we might hope?

The astounding indifference of Congress. The technology is ready, the scientists are ready–our first responders are always ready–but our representatives are asleep at the wheel.

We’re already seeing examples of governments being unwilling to make large investment in pandemic risk prevention measures even while COVID-19 is still causing thousands of deaths per day globally. How can we incentivize investment into pandemic mitigation measures ahead of time?

I don’t think we can. Politicians and policy makers get rewarded for actions with quick feedback loops. Or at least some feedback loop. If you spend several billion dollars to prevent a pandemic, and it works, it looks like you wasted several billion dollars.

The best I think we can hope for is getting across to politicians the scale of what’s at stake. The pandemic cost us trillions of dollars and over a million lives. The mind can’t even begin to comprehend those numbers. Legislators are faced with unfathomably large decisions every day, which is why it is so important they be deliberate and methodical in keeping the relative scale of these numbers straight. $64 billion (the cost of the pandemic plan) and $16 trillion (the cost of Covid) are unimaginably large amounts of money. Because Congress isn’t thinking clearly about the scales involved, it refuses to pay $6.40 to save $1600.00 (and a million lives).

How would a position in Congress help to get these strategies implemented or reduce pandemic risk in other ways?

The first thing I would do is become the champion of Biden’s Pandemic Prevention Plan. Implemented correctly, it would stop most would-be pandemics before they can spread.

Some other areas that are also promising include:

  1. Interventions in animal agriculture regulations to reduce the risk of zoonotic spread.
  2. Funding R&D in pandemic preventing technologies.
  3. Expanding and improving the Strategic National Stockpile and its approach to distribution.
  4. Reforming the agencies that regulate new technologies and vaccines, especially as it comes to emergency use authorization.
  5. Increasing safety standards for the personal protective equipment and other security measures for first responders, medical personnel, lab workers, and others.

How important is Congress in the decision-making that happens at the onset of a new outbreak that might have the potential to become a pandemic? What sorts of things does Congress decide, as opposed to other state or national governmental bodies?

I don’t think Congress will be very effective at the onset of a crisis. Nearly every national crisis bears this out. This isn’t necessarily a criticism though. It is supposed to be a large, thoughtful, deliberative body. Such an institution is needed. Not everything needs to be fast and dynamic. Different tools for different jobs. It is the executive that is designed to be agile.

Congress essentially decides most of the structure of the government and what its resources are. The best executive branch in the world won’t have any chance against a pandemic unless the groundwork has been laid by Congress. This is why it is so important for Congress to exercise diligent foresight; to see what is coming ahead of time and to be prepared to face it when it arrives.

How do you think about juggling the need to prevent pandemics and other issues that Congress could work on?

Personally, pandemic prevention is my first priority, but not my top priority. Pandemic prevention efforts need to be first in line now because the window of opportunity is closing. People are already forgetting how terrible Covid was to live through or die from. But after Congress passes pandemic prevention measures, if elected, I intend to make it a secondary focus, and to turn my attention primarily on economic growth: creating good, high paying jobs – like in semiconductor manufacturing or green tech. The best safety net across a range of disasters, whether natural or personal, is a savings account.

[1] I first met Carrick when he visited Melbourne in 2018 for a conference. We got to have a good chat when I drove him, and another conference attendee, through the hills of north-east Melbourne in a pick-up truck to see some Australian wildlife.