“It always seems impossible until it’s done.”
- Nelson Madela
“Hindsight must surely be the most useless function of the human brain, torturing yourself over the unalterable past.”
- Peter F. Hamilton, British author
In the October 11, 2022 issue of The Harvard Gazette, a comprehensive analysis of the status of the COVID-19 pandemic by Harvard University faculty is provided, “Is pandemic finally over? We asked the experts.” The authors point out that public health officials agree that the end of the pandemic is in sight but not here yet. They do share, however, the optimism of Tedros Ghehreyesus, director general of the World Health Organization (WHO), that many nations have a pretty good handle on what’s going on, given the rise of vaccinations, effective treatments, and immunity conferred by natural SARS-CoV-2 infection. In fact, this past week the WHO reported a 90% drop in world COVID-19 deaths since February.
This pandemic is waning and may soon be over. But if history teaches us anything, it is that we as a species will face others. (There have been an estimated 249 pandemics in recorded history from 1,200 BCE up to COVID-19.) It is not a matter of “if” but of “when.” In this Germ Gems post, I point to two priorities that need immediate fixing: building a stronger public health infrastructure and improving messaging to the general public.
Preparing for the next pandemic. Because no two pandemics are alike, it is impossible to rely on hindsight to predict the nature of the next pandemic. That, however, does not mean that we shouldn’t learn from our mistakes as well as from what’s been done well (like developing and delivering COVID-19 vaccines in less than a year’s time). Many public health experts have spelled out the mistakes or “lessons learned” from this pandemic. (I also discussed this topic in my May 7, 2022 Germ Gems post, “Navigating the COVID-19 ‘Controlled Pandemic’.”)
One of the most robust examples of learning from the past is published in the Lancet on October 8, 2022, “The Lancet Commission on lessons for the future from the COVID-19 pandemic.” According to this impressive group of experts, “The overarching lesson of the COVID-19 pandemic is the need for national preparedness along with global cooperation and concerted action.” A similarly noteworthy assessment appeared on October 7, 2022 in the Journal of the American Medical Association, authored by Thomas Frieden, MD and Amanda McClelland, RN, “Preparing for Pandemics and Other Health Threats: Approaches to Protect and Improve Health.”
At the time WHO declared COVID-19 a pandemic on March 11, 2020, not many public health officials predicted that it would wreak the level of global havoc that we have seen: in less than 3 years more than 600 million cumulative cases and almost 7 million deaths worldwide. Nor did many, if any, experts predict the startling impact of long Covid (a “pandemic within the pandemic”). Estimates of this complication of COVID-19 vary, but somewhere between 7% to 20% of adults with acute COVID-19 go on to develop long Covid. (This means many millions of people are currently suffering with this disabling illness). It’s no wonder then that a major protest erupted in front of the White House the day after President Joe Biden suggested on “60 Minutes” on September 18, 2022 that “the pandemic is over.”
Insights into dealing with pandemics. Although we can’t rely on hindsight or foresight for making perfect predictions about pandemics, I think the insights of American author and economist, Emily Oster, are noteworthy. In her October 31, 2022 article in The Atlantic, “Let’s Declare a Pandemic Amnesty,” she proposes we focus on the future, and fix the problems we still need to solve.
Professor Oster recognizes that many important choices were made under conditions of tremendous uncertainty and that “misinformation was, and remains, a huge problem. But most errors were made by people who were working in earnest for the good of society.” While it’s time to learn from our mistakes, she suggests we now need to let them (and the “fights” about who is right) go.
In my opinion, two problems that need major attention are: (1) building a much stronger public health infrastructure, in which primary health care providers work together with public health experts on battling pandemics, and (2) improving messaging about pandemics by public health officials. Admittedly, however, proper messaging is increasingly challenging in the current era when the lives of scientific and public health leaders are threatened for speaking the truth, that is, the adage “don’t kill the messenger” is becoming increasingly ominous.
