It’s hard to estimate just how many people were lost to the pandemic, but most estimates put the figure around 18 million — and counting (though the real number could be much higher). The world was unprepared and slow to react, and even with an unprecedented vaccine effort that exceeded all expectations, the pandemic is still far from over.
How did we end up in this situation, and what could we have done better? Perhaps more importantly, in the disturbingly likely event of a new pandemic, how can we better react?
We didn’t do so well
A new report published in The Lancet looked at these aspects. The report, which has been two years in the making, notes that across the world, governments were ill-prepared and slow to react. Countries did also take insufficient action to protect their most vulnerable citizens, and international collaboration was lacking, especially in regards to providing vaccines and other resources to low-income countries.
This isn’t just an ethical point of view — when dealing with an infectious disease that’s already spread to virtually everywhere on Earth, you want to limit it as much as possible to prevent the emergence of new strains. SARS-CoV-2, in particular, has proven that it can mutate and change very quickly. But developed countries hogged vaccine demand, in several cases generating an oversupply while developing nations struggled to get their hands on vaccines.
In fact, this inequality in vaccine distribution is likely why we have so many new (and dangerous) strains popping up, especially Omicron — it’s understandable that countries want to protect their own people, but this is a global challenge, and if we want to stop the spread of new strains, then we need to vaccinate as many people as possible in as many places as possible.
We were extremely fortunate that not one, but several vaccines turned out to be effective against the virus. What if we had been less fortunate, or if there had been less impetus from the scientific community? It’s hard to imagine what the situation would have been like.
The report also highlighted the role that disinformation and distrust played in the pandemic. Not only were countries slow to react, but their actions were hampered in many cases by a lack of trust. Governments need to have stronger relationships with local communities and also focus on behavior and social science to tailor effective interventions and communication strategies, the report stated, and these interventions could be crucial to a country’s success in weathering the pandemic storm. Being transparent and keeping the public continuously updated as the facts unfold is also a key aspect — but too few countries successfully implemented this approach.
Still, some fared better than others. Australia and New Zealand, for instance, implemented tight measures to control the spread of the disease. The results proved effective and people’s lives were saved as a result. Having strong, well-funded health systems was also a decisive factor in the pandemic — though as we saw early on, even in the case of developed countries with robust health systems like Italy and France, the medical system can still collapse under the sheer weight of the pandemic, if quick steps are not taken to limit the spread of the virus. In the same note, the report highlights the need for more behavioral science research to develop efficient interventions. For instance, the concept of “behavioral fatigue” was used in the UK to justify delaying a pandemic response, but studies have highlighted this concept as “a naïve construct or a myth.”
Doing better next time
COVID-19 took the world by storm, and the odds of something like that happening again aren’t as small as we’d like them to be. In fact, the way we use nature for our purposes (and animals, in particular) is continuously paving the way for a new pandemic to emerge. If that happens, we’d be smart to at least be prepared.
The report highlights the most important measures we can take to prepare. They zoomed in on 11 measures that range from establishing robust vaccination systems to developing preparedness and sustainability plans.
1. Vaccines plus other measures—establishing global and national “vaccination plus” strategies that combine mass immunization as well as testing availability and public health measures such as face masks.
2. Viral origins—an unbiased, independent, and rigorous investigation is needed to investigate the origins of SARS-CoV-2, the virus that causes COVID-19. Without this, public trust in authorities cannot truly rebound. In particular, the refusal of Chinese authorities to collaborate transparently is proving to be a major roadblock.
3. Bolster the World Health Organization and maintain it as the lead organization for responding to emerging infectious diseases. The WHO still has a shaky political ground to stand on, although we’ve seen how influential and important it can be in such a pandemic.
4. Establish a global pandemic agreement and strengthen international health regulations. This would include an annual WHO report on global pandemic preparedness and response.
5. Create a new WHO Global Health Board to support WHO decision-making, especially on controversial matters. Deciding on things with incomplete information, when the situation is evolving rapidly, is very difficult but also very important. A robust health board could help with this.
6. New regulations to prevent pandemics from natural spillovers and research-related activities and for investigating their origins. Diseases like COVID-19 come from animals, and preventing natural spillovers requires better regulation of domestic and wild-animal trade and enhancement of surveillance systems for pathogens (disease-causing microorganisms) in domestic animals and humans.
7. A ten-year global strategy by G20 (Group of Twenty) nations that would finance all WHO regions, including the world’s poorer regions, to produce, distribute, research, and develop vaccines, treatments, and other critical pandemic control tools.
8. Strengthen national health systems based on the foundations of public health and universal health coverage — ensuring that these systems are not only robust but also grounded in human rights and gender equality so that everyone can benefit from them.
9. Adopt national pandemic preparedness plans, which includes not just top-down plans, but also investments in public health and scientific literacy to “immunize” the public against disinformation and investments in behavioral and social sciences — as we’ve seen, these are crucial aspects that define how interventions can be tailored.
10. Establishment of a new Global Health Fund with a focus on primary care.
11. Sustainable development and green recovery plans. The pandemic has been a setback for sustainable development so bolstering funding to meet sustainability goals is needed.
Ultimately, if we simply try to go back to the way things were before the pandemic, this will happen again in the future — or could be even worse. Investing a lot of time, money, and effort into these interventions can seem like a lot, but if it can prevent the next COVID-19 from happening, then it’s much better than the alternative.
Andrei's background is in geophysics, and he's been fascinated by it ever since he was a child. Feeling that there is a gap between scientists and the general audience, he started ZME Science -- and the results are what you see today.