[In January 2020, Christian Happi and Pardis Sabeti presented an Audacious idea] [Sentinel: An early warning system to detect and track the next pandemic] [Here's how it would work ...] Christian Happi: Sentinel is a proactive early warning system to preempt pandemics. It is built on three major pillars. Pardis Sabeti: The first pillar is Detect. Christian and I have been studying infectious diseases together around the world for two decades. We have been using genome sequencing. Reading out the complete genetic information of a microbe, it allows us to identify viruses, even those we've never seen before, track them as they spread and watch for new mutations. And now with the powerful gene-editing technology CRISPR, we can use this genetic information to rapidly design exquisitely sensitive diagnostic tests for any microbe. CH: One of these tools is called SHERLOCK. It can be used to test known viruses on simple paper strips. It is very inexpensive, and frontline health workers can use SHERLOCK to detect the most common or the most threatening viruses within an hour. PS: The other tool is CARMEN. It requires a lab, but it can test for hundreds of viruses simultaneously. So hospital lab staff can test patient samples for a broad range of viruses within a day. Our second pillar is Connect. Connect everyone and share this information across the public health community. In most outbreaks, hospital staff share case information through paper, Excel -- if at all. This makes tracking an outbreak through space and time and coordinating a response extremely difficult. So we're developing a cloud-based system and mobile applications that connect community health workers, clinicians, public health teams -- everyone -- and allows them to upload data, perform analysis, share insights and coordinate a response and action plan in real time. CH: Our third pillar is Empower. An outbreak surveillance system can only succeed if we empower frontline health workers that are already out there taking care of communities. It requires a lot of training. Pardis and I are very much aware of that. We've spent the past 10 years training hundreds of young African scientists and clinicians. Over the next five years, we will train an additional 1,000 health workers to use Sentinel detection tools and empower them to train their colleagues. This way, we will improve the original health care system and integrate surveillance into medical practice. [Since presenting their Audacious plan at TED, the world has changed ...] Briar Goldberg: So here we are. We're recording this. It's April 7th, 2020, and obviously, we are in the throes of this crazy global pandemic caused by this new coronavirus. So you two have been working together forever, and you really came together pretty aggressively with the Ebola crisis back in 2014. What does it feel like from your perspective? CH: Pretty much six years after the Ebola outbreak, we're really facing another crisis, and we still pretty much, like, we never learned from the previous crisis. And that, really, for me, is heartbreaking. PS: I think that this pandemic has shown us how unprepared we are everywhere in the world. Christian and our partners together had diagnostics at our hospital sites in Nigeria, Sierra Leone and Senegal in early February. Most states in the United States didn't have it until far later. It tells us that we are all in this together, and we are all very much behind the curve. BG: So, this Sentinel system is amazing, but I know that the question that's on everybody's mind is: How is that playing into the here and now? PS: You know, we describe Sentinel as a pandemic preemption system, and here we are in a pandemic. But what's great is that, actually, the same tools you need to preempt a pandemic are the ones that you need to respond to one. And so all of the technologies that we have laid out -- the point-of-care testing, the multiplex testing, the discovery and tracking of the virus as it's changing, and the overlay of the mobile applications to dashboard -- are all critical. CH: For us, it is a war. We are basically committed for 24 hours' turnaround time in order to give results, and that requires for us to work around the clock nonstop. So it's a pretty challenging moment. We are away from family. At least I have the privilege to see family today, and then I'm sure tomorrow I'm heading back in the trenches. In my lab, we sequenced the first COVID-19 genome on the African continent, and that really was done within 48 hours. This is revolutionary coming from Africa and then making this information available for the global health community to see what the virus within Africa looks like. I believe that with technologies and knowledge and then sharing information, we can do better and then we can overcome. PS: The whole idea of Sentinel is that we all stand guard over each other. We all watch. Each one of us is a sentinel. Each one of us, being able to monitor what is making us sick, can share that with the rest of our community. And I think that is what I profoundly want, is for us to all stand guard and watch over each other. [Dr. Pardis Sabeti and Dr. Christian Happi] [Ingenious scientists. Courageous partners. Global heroes.]