The next pandemic is already here. Covid can teach us how to fight it.

It was August 2017, and pleasant and breezy in the central mountains of Madagascar. The passengers loading their bags into the minibus leaving Ankazobe, a small town in the highlands, were grateful for the morning coolness. It would be warm and sticky on the trip they were taking to Antananarivo, the island’s million-person capital 100 kilometers to the south, and then to Toamasina on the coast, another 350 kilometers away. One of the passengers, a 31-year-old man, looked uncomfortable already. Four days before, he had arrived on a visit. Now he was headed home, but he was feverish, achy, and shaking with chills.

He never made it. The man died in the minibus after it drove through the capital; the panicked driver dropped his body off at a hospital and then continued toward the coast.

Within days, 31 people linked to the taxi trip and the hospital fell ill, and four died. Two weeks later, a woman with no known ties to the trip died in the densely packed capital. Shortly after, doctors discovered what was killing them: plague. By early October, there were 169 cases scattered across the island nation. By the end of the month, there were more than 1,500.

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