Preventing the Next Pandemic
By Michael Greger, MD
The following is an excerpt from How Not to Die in a Pandemic, a webinar presented on April 8, 2020. An updated version will be offered on May 27. For more information, register here and subscribe to Dr. Greger’s e-mail announcements.
With COVID‑19, we realize coronaviruses don't just cause epidemics, but can explode into global pandemics. Coronaviruses have already told us they can become lethal and cause pandemics. It’s not hard to imagine a combination of transmissibility and lethality that could make the next coronavirus pandemic an order of magnitude worse. Remember, SARS was 10% fatality, not 0.5%. We've long known about the pandemic potential of the flu virus, but the deadliest it ever appeared to get was 2% fatality in the 1918 pandemic. Well, in 1997, a flu virus was discovered in chickens called H5N1. That appeared to kill more than 50% of the people it infected.
What if a virus like that triggered a pandemic? What if instead of a 2% death rate, it was more like a flip of a coin? The COVID‑19 pandemic is devastating, but food is still being restocked in the grocery store. The internet may be slow, but it's still up. The lights are still on and safe drinking water is still flowing out of the tap. The pandemic of 1918, in which 2% of the cases succumb, one in 150 Americans died. Imagine if it were ten times as bad as 2%, like one in 15 dying or 20 times as bad, killing one in six of us.
The good news is there's something we can do about it. Just as eliminating the exotic animal trade and live animal markets may go a long way towards preventing the next coronavirus pandemic, reforming the way we raise domestic animals for food may help forestall the next killer flu. In the last pandemic we got off easy. The swine flu only triggered a category 1 pandemic in 2009, but it showed a new origin point for viruses, industrial pork production. The emergence of H5N1 and ten new bird flu viruses infecting humans have been blamed on industrial poultry production.
Currently, the CDC considers the bird flu virus H7N9 to be our greatest threat for the next pandemic. The H7N9 strain from Hong Kong now has the highest potential emergence risk and the highest potential impact risk of all the new viral strains that are out there. In fact, there was a risk assessment done as to what an H7N9 pandemic would look like in the United States. They concluded it would result in millions of Americans dying. So far, H7N9 has killed about 600 of the first 1,500 people it infected, so that's about 40%. Two in five people died.
Thankfully, neither H5N1 nor H7N9 have acquired the capacity for easy human‑to‑human transmission, but they're still out there, still mutating. Pandemics are always a matter of when, not if. And a pandemic with more than just a few percent mortality wouldn't just threaten financial markets, but civilization itself as we know it.
Treating the Cause
How can we stop the emergence of pandemic viruses in the first place? Now, if there's one concept to draw upon from all my work on preventing or reversing chronic disease, it's whenever possible, you treat the cause.
An answer may be in what we eat. The American Public Health Association, the largest and oldest association of public health professionals in the world, has called for a moratorium on industrial farm animal production, so‑called factory farming. [2004] "The Chickens Come Home to Roost" [2007] went beyond for just calling for a deintensification of pork and poultry production and end of pig and chicken factories. The editorial questioned the prudence of raising so many animals for food in the first place, given the pandemic threat they may pose.
It is curious, therefore, given the pandemic threat, that changing the way humans treat animals, most basically, ceasing to eat them, or at the very least, radically limiting the quantity of them that are eaten, is largely off the radar as a significant preventive measure. But such a change could likely to prevent unknown future diseases. Yet humanity does not appear to consider this option.
However, thanks to food innovations, this may be changing. Have you looked in the dairy case at supermarkets lately? Some of America's largest dairy producers have recently filed for bankruptcy due to the constellation of new consumer choices in the dairy case.
Yes, you can pass public health regulations to stop the cannibalistic feeding practices of feeding slaughterhouse waste to dairy cows, or you can just provide the public with better alternatives and let the market eliminate the risk entirely because there's no prions, the infection particles in mad cow disease. HIV‑AIDS came from people slaughtering primates. Thirty million people wouldn't be dead right now if they were eating meals from bushes instead of bush meat.
A Way Forward
You can't get coronaviruses from cauliflower. There's no flu in falafel production, no matter how tightly you crowd the balls together. Our food choices don't just affect our personal health, but our global health, not just in terms of climate change, but in terms of pandemic risk. Thankfully, expanded options are now hitting the meat case as well, no longer a niche market for vegetarians. Major meat producers have started blending in vegetable proteins to make hybrid meat products, like Tyson has the sausage links, these whole blend sausage links which include plant protein, so‑called next‑generation chicken nuggets. Smithfield, the largest pork producer on planet earth, recently debuted an entire line of plant‑based products.
How many fewer curly tailed viral mixing vessels are there now that Dunkin' Donuts has a meat‑free breakfast sausage? How many fewer hens are packed beak to beak in cages now that egg‑free mayo has taken the sandwich spread sector by storm? Quorn, a brand of plant‑based meat made from the mushroom kingdom, opened a single facility to produce the meat equivalent of 20 million chickens every year.
Now, these products may not be the healthiest from a personal standpoint -- processed, added sodium. But from a pandemic standpoint, zero risk. A perfect case in point, if you really want to take it far, is an even more innovative approach to pandemic prevention suggested by Winston Churchill in 1932. In an essay he wrote in the 1932 issue of "Popular Mechanics" called "Fifty Years Hence," he predicted that in fifty years, "We shall escape the absurdity of growing a whole chicken in order to eat the breast or wing by growing these parts separately under a suitable medium."
Indeed, in terms of efficiency, growing meat straight from muscle cells, rather than animals, could reduce greenhouse gas emissions and water use by up to 96%, lower land use by up to 99%. When you factor in pandemic risk, the benefits to human health could arguably rival those to planetary health. The primary human health benefit of a slaughter‑free harvest would be food safety.
There's been a six‑fold increase in food poisoning cases in the last decades, sickening tens of millions of Americans every year in contaminated meats and animal products. Food poisoning pathogens, E. Coli, campylobacter, salmonella are a product of fecal contamination [in] about half of the retail ground beef and pork chops. But you don't have to cook the crap out of the meat if there's no crap to begin with. These are intestinal bugs, so you don't have to worry about them if you're producing meat without intestines. Just like you don't have to worry about brewing up new respiratory viruses if you're producing meat without the lungs. Again, that's the best choice for personal health.
This is a way people could have their meat and eat it, too, without exposing humanity to catastrophic pandemic risk. We may be one bush meat meal away from the next HIV, one pangolin plate away from the next deadly coronavirus, and one factory farm away from the next killer flu. Tragically, it may take a pandemic with a virus like H5N1 before the world realizes the true cost of cheap chicken.
A Reason for Hope
I was personally involved in the largest meat recall in human history. Remember the footage of those cows getting fork‑lifted? A hidden camera investigation at a California slaughter plant for spent dairy cows led to the recall of nearly 150 million pounds of beef for violations of food safety rules meant to protect the public from mad cow disease. Downed dairy cows, too sick to even walk, were being dragged to slaughter with chains into the federal school lunch program. But you don't have to worry about contaminated cow brains in your oat milk. Plant‑based milk, no‑brainer.
There’s actually a downed animal protection law that was introduced in the Congress year after year, and nothing, absolutely nothing! Who cares about cows? They're just cows, no political movement whatsoever. And then, boom! Mad cow disease. All of a sudden, downed animals, a sign of mad cow disease. Maybe the animal's down because they broke their leg, yes, but they also could be down because they can't walk because they have a neurological condition that can be passed along to people. And it's the kind of thing that can't be cooked out of the meat.
So, all of a sudden, there was a selfish motivation to stop treating animals this way, and Downed Animal Protection passed. It's illegal to drag animals to slaughter anymore. If you'd like to think it was the angels of their better nature, that they finally woke up and said, “well, this isn't very nice,” no. It was selfish. But look, the animal doesn't care why we do it. The selfish human health aspects were what really took it over the finish line. And so, I see the same thing with live animal wet markets.
There are animal welfare groups, environmental groups in China, in South Asia, who have been saying it's cruel to keep all of these animals crowded together, to transport them these long distances, just to keep them alive. What someone eats in a wet market has global, potential global health implications! It's not just a personal decision ‑‑ it could potentially affect all of us.
Under these circumstances, maybe live animal markets are going to be shut down. Maybe the exotic animal trade will be shut down because of this, and maybe we're going to change, accelerate the innovations in the alternative protein space. You see all sorts of things. Now we can make angel food cake with aquafaba, with whipped chickpea juice. Who knew that? You used to have to have eggs, chickens to make your eggs and angel food cake. And now that we do know how great the risks are, maybe there’s going to be change. Along with human culpability comes hope. If changes in human behavior can cause a new epidemic disease, well, maybe changes in human behavior may prevent them in the future. That is certainly my hope.