10 Facts About Disease X, a Potential Disease That Was Mentioned by PM Lee in Parliament

When PM Lee addressed the nation with a Parliament speech this Wednesday (Sept 2), a lot of us were holding our breaths for some good news. Something along the line of: the virus is gone; Singapore is invincible; it’s a prank and 2020 hasn’t started yet.

Unfortunately, the speech is less celebratory than cautionary. PM Lee reminded us that dangers lurk right beneath the surface. Covid-19 will not be our last public health crisis; brace ourselves against ‘Disease X’.

Here are 10 facts about this mysterious disease that will help you understand why it is crucial to be prepared for it.

It is Hypothetical (For Now)

The best thing about Disease X it hasn’t happened. The worst thing: yet.

Disease X is a hypothetical epidemic that scientists predict to be very likely to befall humankind.

It belongs on the World Health’s Organization’s (WHO) list of blueprint priority diseases. It is a list reviewed yearly to identify 10 viruses that pose the most serious global health risks. They are thereby given priority in research and development as a preemptive measure.

It is an Emerging Infectious Disease (EID)

To be on WHO’s priority hit list is to be an Emerging Infectious Disease (EID).

EIDs are infectious diseases whose recorded incidence has risen in the past 20 years, and could increase in the near future. In total, they account for 12% of human pathogens.

For EIDs to spread and become a major pandemic like Covid-19 did, it only takes one virus that is capable of efficient transmission between humans.

Worse still, EIDs are characterized by our unpreparedness for its arrival. We have very limited preventive options available, the same way we have yet to develop a vaccine for SARS since its miraculous disappearance in 2003.

You can see why scientists tend to lose their cool on the subject.

It Was Created in February 2018

In February 2018, experts convened at Geneva for a forum on the 2018 R&D Blueprint. During the meeting, Disease X was added to the aforementioned list of top-priority health threats, alongside known deadly viruses like Ebola, Zika, Lassa fever and SARS.

The scientists came up with the idea under the presumption that we are overdue for a global pandemic. It could be naturally occurring, deliberately manufactured or accidentally released.

Predicted to be on the scale of the 1918 Spanish flu outbreak, it could also easily cost up to 50 million human lives.

It is Caused by Pathogen X

Of course, a hypothetical disease would have a hypothetical origin – Pathogen X. EcoHealth Alliance, who is hard at work finding and studying undiscovered zoonotic viral threats as part of the Global Virome Project (GVP), wrote on their website:

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Miles from the nearest city, deep in the dark recesses of a cave in Guangdong Province, it waits. Perhaps it silently stalks from high in the canopies of trees nestled along the Kinabatangan River. Or it lies dormant in one of the thousands of species native to the Amazon.

In short, the source of the virus is largely unpredictable. To our dismay, climate change further complicates the issue: think deadly viruses on course to be unleashed by melting permafrost after thousands of years of hibernation.

It is Created as a Vehicle for Research

According to WHO, “Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease. The R&D Blueprint explicitly seeks to enable early cross-cutting R&D preparedness that is also relevant for an unknown ‘Disease X’.”

In human speak, it meant that Disease X serves as a testing ground for epidemic studies. It’s a worst-case-scenario thought experiment from which we develop plans and policies.

It Helps Us Plan for the Future

Scientists first initiated the R&D Blueprint in 2016. It seeks to address the critical gap between pandemic outbreaks and global preparedness.

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Our lack of preparedness is evident in the current race for a Covid-19 vaccine. Even after 875,000 deaths worldwide (as of writing), a reliable antidote is still far from completion.

Disease X urges a drastic change from passive pandemic responses to one of active defense. Its study could help minimize the type of social, economical and political unrests we have been experiencing throughout the Covid-19 pandemic.


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Covid-19 Qualifies as the “First” Disease X

Depending on how paranoid you are, the accuracy of the Disease X prediction at that 2018 Geneva forum is either a testimony of modern science’s advancement, or a conspiracy two years in the making.

Back then, scientists foresaw Disease X as of animal origins. It would emerge from a place where economic development drives people and wildlife together.

Furthermore, it would first be confused with other diseases. It would spread quickly and silently, as easily as seasonal flu but much deadlier.

By hitching a ride on the networks of human travel and trade, it defies containment and reaches multiple countries, undermining financial markets before reaching pandemic status.

Sounds awfully familiar, doesn’t it? Covid-19 fits the narrative almost perfectly. Yet, it might only be the first Disease X. In other words, what we are going through is probably just the first of many more survival hurdles to come.


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It Will be Worse than Covid-19

The general consensus, shared also by PM Lee in his speech, is that Disease X would be deadlier than Covid-19, highly infectious and mutating rapidly.

Associate Professor Alex Cook, vice-dean of research at the National University of Singapore’s (NUS) Saw Swee Hock School of Public Health, weighs in: “Its mode of transmission wasn’t known at first, nor was its symptomatology or severity profile.”

Adding that the possibilities are endless, Prof Cook cautions against thinking of it as Covid-like.

Take, for example, the melting permafrost. Scientists anticipate a “Pandora’s box of disease” as bacteria as old as a million years start to wake up.


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There are Several Potential Candidates

Most experts believe Disease X to be from zoonotic transmissions – meaning an animal virus jumps to humans. It’s a natural process potentially expedited by economical activities that have intensified animal and human contact.

But there are other candidates. For instance, media speculated the possibility of bioweapons upon Disease X’s introduction in 2018. Synthetic viruses can now be created with gene-editing technology, and released by accident or in an act of terror.

Image: imgur

In September 2019, Public Health England (PHE) suggested that Disease X could manifest in the form of bacterial infection with increasing antibiotic resistance.

People Wrote Fiction About It

Disease X sounds almost too scary to be true. For some, it sparked their imagination.

There are fictional books written about it, such as Disease X by N. J. Croft and Disease X: The Outbreak by Shannon C. Burdette. The former features a doctor who encounters in Mexico what he would come to recognize as Disease X. The latter chronicles the battle against a bioweapon released by an evil organization.


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It would be interesting to read the authors’ interpretation on the deadly epidemic.


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