Bill Frist, Contributor
On the most recent episode of A Second Opinion podcast, I asked Dr. Francis Collins if we were going to be prepared for the next pandemic.
“Senator, I sure hope so! This has been the worst pandemic in 102 years, and if we are not able to learn from this and plan for what inevitably will be down the road, then we only have ourselves to blame. We don’t have a great track record there.”
Francis Collins and I have a long professional friendship. We worked closely together from 1998 to 2003 when I was in the United States Senate and he was leading the Human Genome Project, and I have found him to be not only one of the nation’s top scientific minds, but also an exceptional communicator.
Today, as the director of the National Institutes of Health, Collins has a bird’s eye view of the pandemic, our national response, and how the iterative nature of science brought us to be able to respond as well as we have.
The Human Genome Project, an international effort to sequence the human genome, is the only government initiative that I recall coming in early and under budget. While the United States contributed a bit more than half of the budget and the manpower, it was an international effort also involving scientists from the United Kingdom, France, Germany, Japan and China. It was a monstrous effort and Collins served as the project lead, ensuring that all worked together and the genome was completed in 2003—two years ahead of schedule.
“That had never really been tried at that scale before. It was crossing into this territory of Big Science for biology and medicine, but it worked,” Collins told me. The project also launched an era of data release and openness, with all of the human DNA information delivered into the public domain daily. The idea, Collins explained, was that DNA is our shared inheritance and all of us should be able to learn from it.
That mindset—that biomedical research happens faster with collaboration and sharing of data—is responsible for any success we’ve had with the COVID-19 pandemic. While there have been missteps, the technological advances of genomic sequencing and the international data sharing expectations sped our response by months if not years.
“You can draw a direct line from the success of the Genome Project to the fact that we learned so quickly about SARS-CoV-2: what kind of virus this was, what kind of approach might be necessary to go after it,” Collins said. After the Chinese lab released the sequence of the virus in January 2020—a process that takes a good lab just an hour or two now—researchers around the world could begin researching the virus without needing a sample. “That made it possible within 24 hours for the first vaccine design to get started!” Collins said.
The investments the American people made in the Human Genome Project—Collins told me they spent about $3 billion on the project, $400 million of which was on the sequencing itself—have repaid us hundreds of times over in biomedical, technology, computing, and economic advances.
Yet, one year ago, we still were not prepared for a global pandemic. Even though many of the scientific foundations were there, we have still spent 2020 learning hard lessons in funding, logistics, distribution, and more.
“We have this complacency problem, and we need not slip into that,” Collins told me.
I warned about this complacency in a series of 2005 speeches, noting that, “rapid, voluminous, and essential travel and trade; the decline of staffed hospital beds; and a now heavily urbanized and suburbanized American population dependent as never before upon ‘just in time’ but easily-disrupted networks of services and supply,” had left us unprepared to respond to the unknown, deadly pathogens that would inevitably come.
And come, they have.
Collins had kind words to say about my warnings 15 years ago, but, unfortunately, those speeches didn’t save us from our current reality. “Some listened, maybe some didn’t. Other pressures came along that seemed more urgent for that day’s needs and we kind of forgot about the difference between the important and the urgent,” he observed. “We better not do that this time.”
Instead, he highlighted what we have learned in the past 12 months that should serve us well in the future. We have developed new types of public-private partnerships and set up new funding models to more quickly enable urgent research. But there is more work to do. Collins called for active pathogen surveillance and platforms to quickly spin up development of vaccines, therapeutics, monoclonal antibodies, and diagnostics—at scale.
This work needs to be done around the world, not just at home. Collins and I agree wholeheartedly on this point. Now is our teachable moment: Viruses don’t need visas and pandemics have no borders. The U.S. has a significant leadership role to play here, but we can’t do it alone. “We’re in a circumstance, right now, where the boundaries between countries and cultures are increasingly porous both to ideas and ethical decisions—and viruses!” Collins said.
Accomplishing all of these goals will take purposeful funding, diligence, and consistency. “It’s going to take strong voices like yours and maybe mine to keep putting this in front of leaders of the country and the world,” Collins said. “If you want to save the next group of lives from the next pandemic—maybe it’s influenza, maybe it’s another coronavirus, maybe it’s a filovirus, I don’t know, but it’s coming!—this set of lessons must not be forgotten.”
Francis Collins, MD, PhD joined me on A Second Opinion podcast for Monday, January 11, 2021. For more of Dr. Collins’ insights on faith and science, the structure of NIH and how other countries have emulated it, science funding, and mRNA vaccines, see Episode 104 of A Second Opinion.
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