With a fatality rate 20 times that of COVID-19, and no vaccine, Disease X could swiftly bring humanity to its knees. Few would be left untouched by the pathogen were it to gain hold, causing healthcare systems to crumble and economies to collapse as the world once again tried to contain a force of nature.
Fortunately, Disease X is hypothetical – a placeholder representing yet-to-be-encountered pathogens capable of sparking pandemics.
But the World Health Organization took the opportunity at the recent annual meeting of the World Economic Forum in Davos, Switzerland, to ask world leaders to consider the daunting possibility of just such a scenario.
As far back as 2015, member organizations of the WHO recognized the international community's extreme lack of preparedness for significant disease outbreaks. A plan called the R&D Blueprint for Action to Prevent Epidemics was soon initiated, listing pathogens we had good reason to be nervous about.
Following a meeting in February 2018, the committee added a blank box to their compendium of potential killers: Disease X. Its intention was to force authorities to remain flexible in their preparations and not be constrained by knowledge of known diseases.
Two years later, the rapid spread of a novel form of coronavirus would put all pandemic plans to the test. The result was more than 7 million deaths, a compromise of sluggish preventions and rapid vaccine development – a number that could at once be far better, and far worse.
The list of priority pathogens was again scrutinized even as COVID-19 raged, with hundreds of scientists gathering in 2022 to consider evidence of 25 known microbial families and speculate over what threats a future outbreak could pose.
In a series of consultations with representatives from a number of states around the world, the WHO discussed matters of discovery, surveillance, research, and sociopolitical challenges faced in heading off a pathogen we currently know nothing about.
WHO Director-General Tedros Adhanom Ghebreyesus stated the organization was already putting measures in place, including the establishment of a pandemic fund and the building of a technology transfer hub in South Africa to address inequities of vaccine distribution.
"Of course, there are some people who say this may create panic," Tedros told the panel.
"It's better to anticipate something that may happen because it has happened in our history many times, and prepare for it."
Looking at our own behavior is as insightful in anticipating the threats of a pathogen as understanding the pathogen itself.
Perhaps one of the most profound lessons learned from COVID-19 was the challenges posed by misinformation and fear of conspiracy.
As if in illustration of political dissent, former Assistant Security for Public Affairs for the US Department of the Treasury, Monica Crowley, stated on X (formerly Twitter), "Just in time for the election, a new contagion to allow them to implement a new WHO treaty, lock down again, restrict free speech and destroy more freedoms."
Managing a pandemic equal to or worse than COVID-19 would mean developing effective public communication strategies to guard against misinformation, strengthening economic and mental health plans for coping with potential quarantines, and building greater flexibility into education systems, not to mention shoring up healthcare infrastructure.
We don't need to know much about Disease X to prepare for it. All we need to know is we're capable of great achievements when it means keeping our community safe from harm.