The Origins and Future of Sentinel: An Early-Warning System for Pandemic Preemption and Response

Abstract

While investigating a signal of adaptive evolution in humans at the gene LARGE, we encountered an intriguing finding by Dr. Stefan Kunz that the gene plays a critical role in Lassa virus binding and entry. This led us to pursue field work to test our hypothesis that natural selection acting on LARGE—detected in the Yoruba population of Nigeria—conferred resistance to Lassa Fever in some West African populations. As we delved further, we conjectured that the “emerging” nature of recently discovered diseases like Lassa fever is related to a newfound capacity for detection, rather than a novel viral presence, and that humans have in fact been exposed to the viruses that cause such diseases for much longer than previously suspected. Dr. Stefan Kunz’s critical efforts not only laid the groundwork for this discovery, but also inspired and catalyzed a series of events that birthed Sentinel, an ambitious and large-scale pandemic prevention effort in West Africa. Sentinel aims to detect and characterize deadly pathogens before they spread across the globe, through implementation of its three fundamental pillars: Detect, Connect, and Empower. More specifically, Sentinel is designed to detect known and novel infections rapidly, connect and share information in real time to identify emerging threats, and empower the public health community to improve pandemic preparedness and response anywhere in the world. We are proud to dedicate this work to Stefan Kunz, and eagerly invite new collaborators, experts, and others to join us in our efforts.

Emergence and spread of two SARS-CoV-2 variants of interest in Nigeria

“…As we have seen in recent years, novel variants of interest or concern can emerge from anywhere around the world, notably including undersampled regions such as Africa 13 , 14 . In a highly connected world, there is a proactive need to adopt early warning systems for pandemic preemption and response in Africa, such as SENTINEL 32 . This would enable equality in global genomic surveillance, especially in countries with fragile public health systems, in order to effectively detect and curb emerging outbreaks before they spread.…”

Microbubbles for improved nucleic acid extraction in wastewater samples for viral RNA detection

“…It is clear the need for monitoring of human viruses in the build environment will continue and likely expand as climate change and a globalized supply chain facilitates long range disease spread. This will include using wastewater, air filters and surface swabs in addition to testing individuals for SARS-CoV-2 (Zeller et al, 2021; Solo-Gabriele et al, 2022) as well as other infectious viruses of interest (Botti-Lodovico et al, 2021). With vaccinations unable to fully contain COVID-19 pandemic (Keehner et al, 2021) and universal mask wearing for long periods of time impractical and difficult to enforce, frequent wastewater monitoring using RT-qPCR and other genomics measurements can detect and enable health care alerts to prepare agencies and providers in affected areas.…”

Emergence and spread of two SARS-CoV-2 variants of interest in Nigeria

“…As we have learnt the hard way in recent years, novel variants of interest or concern can emerge from anywhere around the world, notably including undersampled regions such as Africa 13,14 . In a highly connected world, there is a proactive need to adopt early warning systems for pandemic preemption and response in Africa, such as SENTINEL 32 . This would enable equality in global genomic surveillance, especially in countries with fragile public health systems, in order to effectively detect and curb emerging outbreaks before they spread.…”