Thursday, October 31, 2019, 2:30 pm

If you look carefully at the ceiling stucco in the Red Salon, the elegantly appointed room just off the Schloss Library, you will see swallows chasing butterflies. The stucco is white, as are the walls, the name recalling the red brocade of the high-back chairs. The swallow, from the family of passerine birds, is known for graceful movement in flight, as reflected in the stucco, and its culling of mosquitos and other carriers of vector-borne disease.  

On a mid-autumn Thursday in late October 2019, a group of health professionals from across six continents gathered to discuss the interspecies transference of disease and to identify mechanisms for early detection and interdiction. They catalogued thirty “milestones across the livestock, wildlife, and environment sectors” that could allow experts to “find outbreaks faster and to create a ‘disease agnostic’ framework that could be used by every country.” They drafted protocols for early “event recognition” and “verification.” They proposed rapid response mechanisms. They outlined designs for smart phone applications that were “interoperable” and “geo-tagged” and “multilingual.” They identified the critical need for “bridging the gap” between the medical and veterinary sectors. This proposed “one health surveillance” was framed to serve as a pandemic early alert system that would be integrated, comprehensive, global, since—as was recently explained to me—“the majority of infectious diseases in humans originate in animals.”  

Three decades earlier, a similarly international group of Fellows had gathered at Schloss Leopoldskron to consider the global spread of a virus also later believed to have originated in animals before transferring to humans. In February 1988, Salzburg convened Session 266, “AIDS: Confronting an Epidemic,” which was one of the first international discussions of the AIDS crisis as a social and political rather than a purely medical issue. The session’s global representation reflected the global concern. There were Fellows from Austria to Brazil to China, across the global alphabet of nations, to Greece and Ghana to Indonesia and Israel and Italy to Spain and Sudan to the United States, the United Kingdom, and Yugoslavia. They also represented a wide array of sectors, from health care and public policy to gay activism and the Catholic Church. According to the session’s chair, Tom Delbanco from Harvard Medical School, the session convened a “Who’s Who” of global health leaders, some now “legendary,” in the fight against AIDS. “I’m still furious that we didn’t publish the results of the game we constructed,” Delbanco recalls. “It proved (unfortunately) prescient in terms of the international spread it predicted.”

Within a month of Session 641, “Finding Outbreaks Faster: Metrics for One Health Surveillance” and almost forty years since the start of the AIDS epidemic, a new disease was about to make the interspecies leap and spread internationally. Its symptoms included fever, coughing, fatigue, and perhaps most anomalous, the loss of taste and smell. “Government records suggest first person infected with new disease may have been a Hubei resident aged 55,” the South China Morning Post reported, “but ‘patient zero’ has yet to be confirmed.” The disease caused by the newly “identified” SARS-CoV-2, was abbreviated to “CO” for corona, “VI” for virus, and “D” for disease. It was tagged “19” for the new millennial year of its appearance. By the end of January 2020, COVID-19 had reportedly killed 213 people in China. Within the year, this airborne and highly contagious disease was to kill, according to the World Health Organization, more than three million people worldwide and cripple the global economy. 

Mark Smolinski, session chair at that November 2019 meeting later told Salzburg Global that the consensus of the experts at the session was “again expeditious.” Smolinksi, a former director at the US Center for Disease Control, is now head of the global initiative Ending Pandemics. Back in 2007, Smolinski was part of Session 444 on “The Global Nexus of Animal and Public Health,” which highlighted the growing risk of interspecies disease transfer. Recognizing Salzburg Global’s unique convening capacity, he urged Salzburg Global to develop sustained work in designing an interdiction regime. Smolinski wrote, “It would fulfill a big item on my bucket list if this pivotal meeting could be held at the Salzburg Global Seminar in 2018.” In November 2018 the first meeting was convened and the “Salzburg Metrics” were adopted by the World Health Organization by year’s end. Then in November 2019, Smolinksi was again at Schloss Leopoldskron meeting with experts to refine the metrics further to incorporate environmental monitoring for prediction and prevention, as well as for use in animal outbreak surveillance. 

Speaking in February 2020, as COVID-19 had begun to exponentially spread worldwide and governments started considering national lockdowns, Smolinski said the pandemic “is a wake-up call and outbreaks such as this that spread from animals to humans will continue to occur. My motto is, ‘Don’t be scared, get prepared.’” The Salzburg Metrics will hopefully help the world be more prepared in case of the next global pandemic. At the time of Salzburg Global’s 75th anniversary in 2022, the disruption wrought by COVID-19 continues; the threats remain, but Salzburg Global can take pride that its challenge to current and future leaders to shape a better world is still being met.