What is "Disease X" and how can we protect ourselves from it

High in the mountains of Davos, Switzerland, politicians and medical experts have been gathered together by the World Economic Forum to devise a plan to save mankind from the misery of the next pandemic. This very likely, but yet hypothetic event, has been branded by the World Health Organisation (WHO) as "Disease X".

Experts are predicting that with increasing obesity and diabetes rates in an ageing population, disease X could have an even greater impact than Covid-19. Not that we need reminding, a disease which killed 3 million people, created economic havoc which tipped vulnerable groups into poverty, left millions suffering the long effects.

Why is the WHO so certain there will another disease X pandemic.

While it's not possible to predict the exact timing or nature of a future Disease X, scientist are certain it will come. You only have to look at the history of outbreaks that have tormented the human race for centuries. Bubonic plague and small pox killed an estimated 700 million people. In the 1920's, Spanish Flu killed 50 million and since the 80's, 40 million have died of HIV/AID. What's More, respiratory infection still remains the 4th biggest killer globally (behind heart disease, stroke and chronic bronchitis).

Although, improved nutrition, better vaccinations and medical advances have prevented or dampened the impact of infection, saving millions of people across the World, there are some concerning socioeconomic trends which could increase the likelihood and severity of Disease X:

• Globalization, population density and increased interconnectivity between cities and countries make it easier for infections to spread rapidly.
• Ecological changes, intense farming, and encroachment into previously untouched ecosystems create opportunities for pathogens to jump from animals to humans.
• Escape of microbes from research laboratories, intentionally or accidentally, sounds like a scene from the latest apoplectic Zombie movie but the threat is ever present.
• Bioterrorism where deluded extremist intentionally release killer pathogens into the population - The film Twelve Monkeys poignantly depicted this scenario
• Vaccine hesitancy (Anti-vac) remains prevalent, on the whole driven by conspiracy theories and innuendo which is leading to a resurgence of diseases such as measles, mumps and polio.

What are the candidates for the next Disease X

The strongest candidate remains a mutated version of the SARS Coronaviruses, which is still very much with us. Official transmission rates in the UK only just started to dip and the true incidence is likely to be very much higher as most people don't report a positive test or even test at all. Fortunately, hospital admission rates and deaths continue to fall but this situation could, worryingly, change at any time if the virus evolves into a new aggressive strain.

Influenza viruses such as the H1N1 variant, regularly undergo genetic re-assortment creating new strains with pandemic potential. Paramyxoviruses, which lead to infections like measles and mumps, are also strong contenders. Before the introduction of the measles vaccine in 1963, major epidemics caused an estimated 2.6 million deaths each year. These viruses spread quickly through the air like influenza and covid, but the main difference is that they usually straightforward to vaccinate against and don't evolve or change as rapidly.

Zoonotic viruses which have originated in animals before jumping to humans include the Ebola virus and MERS. Vector-Borne Diseases such as malaria, Lyme disease or Zika virus, transmitted by mosquitoes and ticks in warmer countries. Global warming, can encourage migration to northerly countries spreading the diseases linked to their bites. Finally, an antibiotic resistant super-bug could develop from overuse and misuse of antibiotics.

What are governments doing to protect us from Disease X

Organisations such as the WHO, The UK Health Security Agency, the USA Centers for Disease Control and Prevention and many others are using the hypothetical Disease X to drive the discovery new anti-viral medication, faster vaccine development and implementation. Hopefully the World Economic Forum congress this week will also recommend more effective lockdown strategies which compartmentalise the most vulnerable and allow children to continue social integration and education and fit younger adults to continue to work to support the economy.

What can we do to protect ourselves from Disease X

Not all infections harm the most vulnerable. Spanish flu, for example, wiped out millions of young people but on the whole the fitter you are more likely you will survive a pandemic. Data from New York, at the height of the Covid-19 pandemic, showed <2% of the tragic deaths involved people who did not have either diabetes, heart disease, high blood pressure, obesity, chronic bronchitis, or other concurrent serious illnesses.

Obviously, the older we get, the more chance we have of getting one or more of these conditions, but one interesting study from China showed that 80-year-olds who were slim, fit, physically active without any chronic disease did not have much more of a risk than 50-year-olds. In general, many of these chronic conditions are strongly influenced by overeating unhealthy sugary foods, being overweight, not exercising and smoking.

Research conducted in the height of the pandemic also suggested that other self-initiated dietary strategies can help support the immune defence against viral attack and counterbalance the excess inflammation associated with them. In particularly these included gut health, vitamin D, and phytochemical-rich foods:

Poor Gut Health

Around the world, scientists have found that healthy strains of gut bacteria such as Lactobacillus were depleted in the majority of patients with Covid. especially those with more severe disease. The authors of these studies postulated that an imbalance of gut bacteria contributed to worse Covid damage via increased gut inflammation, impaired gut wall integrity, which correspondingly leads to systemic inflammatory dysfunction and reduced immune surveillance via process called the gut-lung axis. About this time, research generated from the UK Zoe app team also reported that people taking probiotics, which aimed to improve gut health, had fewer covid symptoms.

Vitamin D Deficiency

The Zoe app team also reported that people taking regular vitamin D supplements had less severe Covid. Other studies from China and the USA found that people with below normal levels of vitamin D3 had higher risks. This relationship was confirmed by the massive prospective UK Biobank study, which found a strong association between low serum vitamin D with Covid-19 severity, even considering and adjusting for obesity and ethnicity.

Phytochemical-Rich Foods

Phytochemicals provide the colour, aroma and taste of plants but also have enormous health benefits. Ideally, we should aim to have two or more vegetable, herbs, spices, fruit or other phytochemical rich food with every meal of the day. Laboratory research shows they have direct antiviral properties by slowing replication and blocking its spread. They also have the ability to dampen excess inflammation in the lungs and joints.

Boosting the intake of phytochemical rich foods, vitamin D, probiotics and prebiotics was shown to be beneficial in a major study conducted by a team from a Cambridge University-linked hospital. Participants randomised to the dietary intervention recovered much quicker, had less viral associated fatigue, cough, joint pains, bowel symptoms, breathlessness, better sleep patterns and overall quality of life. This blend of probiotics and vitamin D is now being investigated in a further randomised trial to see whether it could enhance the effectiveness and reduce the side effects of the covid vaccine.

In conclusion, combating the potential risks associated with Disease X requires global cooperation, proactive surveillance, investment in research, manufacturing and public health measures. Hopefully the World Economic Forum Conference will come up with some practical suggestions to governmental bodies which will help us prepare against the potentially catastrophic consequences. In the meantime, instead of betting on a paternalistic state to have all the answers, we can all take practical lifestyle changes to help ourselves. As well as the usual measures to promote fitness such as exercising 3 hours a week, maintaining a normal weight and quitting smoking, lessons learnt from the last pandemic suggests we should also be emphasising adequate vitamin D levels, better gut health and higher intake of phytochemical rich plant based foods.