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— Research

History Repeats

Future pandemics are inevitable. We must prepare now.

As 2019 turned into 2020, my husband and I took my parents on their dream vacation: a cruise around New Zealand and Australia. At the same time, a new virus, eventually designated SARS-CoV-2, was breaking out in China, causing a new disease that would be called COVID-19.

By the second week of the cruise, I was eager to get home. Despite reports that it was “contained,” the virus in China still clearly raged. In the modern era of travel, a respiratory virus cannot be contained. Indeed, cases of SARS-CoV-2 had already been reported in Italy and Seattle and in other cruise ships sailing the Pacific. It was on its way everywhere.

Thankfully, my family and I remained healthy. At the time, there were no known, effective treatments specific to COVID-19 and, of course, no vaccines. I had already lived through one pandemic. I knew there were challenges ahead. I knew we would need science to save us. In 1996, when I started my internship and residency at UC San Diego Health, hospitals were filled with patients dying of AIDS, the end-stage of HIV infection.

“Every shift began at the nurses’ station where I would ask if any of my patients had died overnight.”

But before my residency ended in 2000, many of my patients were leaving their hospital beds and going home because scientists, including several at UC San Diego, had developed antiviral medications that prevented HIV from ravaging their immune systems. Today, people with HIV who have access to these medications and are able to take them regularly can lead long, happy lives.

Two decades later in July 2020, the SARS-CoV-2 virus was in full swing in San Diego. Hospitals were filled with patients suffering from COVID-19, and I was back on the hospital wards that were once filled with HIV patients, an infectious disease physician caring for them.

I was putting in long hours, often for days on end, to keep my patients alive. And I was again thinking we needed science to save us. And, we needed to be better prepared for the next pandemic, which would inevitably come.


Action was needed. We set up international trials to study new vaccines and treatments for COVID-19, such as the ACTIV-2 study, which opened in August 2020. We found effective therapies, vaccines and testing methods and implemented them for our community by setting up large-scale testing, vaccine and treatment centers. We also worked with other regional health care providers. These efforts undoubtedly saved thousands of lives, yet they were all aimed at ending the current crisis. If we want to avoid history repeating itself, perhaps in even more devastating terms, preparations must be made now for the next pandemic, whatever its cause.


In October 2020, we began outlining the structure of a new institute at UC San Diego. The Pandemic Response to Emerging Pathogens, Antimicrobial Resistance and Equity (PREPARE) Institute is now poised to become a global leader in preparing for, responding to and thwarting pandemics. By connecting interdisciplinary scientists from UC San Diego and other local scientific partners, including the J. Craig Venter Institute, the La Jolla Institute of Immunology, the Sanford Burnham Prebys and Scripps Research, the PREPARE Institute will provide much-needed infrastructure and personnel to respond rapidly to future pathogens.

Effective collaboration across departments, divisions and institutions will equip the PREPARE Institute to rapidly translate lab discoveries to the clinical/patient interface where they can help stem epidemics before they consume our lives.

Together, we can leverage collective knowledge and innovation to reduce the impact of pandemics. Our members are experts in surveillance, proactive therapeutics and vaccine research, health behaviors and public policy. We are gearing up to defend against any infectious disease vector — bacteria, viruses, parasites, fungi or yet-to-be-discovered pathogens.

This is a massive undertaking; public and private support are critical. Whether you are a scientist, CEO, community member or philanthropist, you can help the PREPARE Institute redefine how pandemics are managed. Your knowledge, your innovation and your voice may save countless lives. For information about membership, services or gifts, please email prepare@ucsd.edu.