“To make no mistakes is not in the power of man; but from their errors and mistakes the wise and good learn wisdom for the future.”
- Plutarch, Greek philosopher, 46-119 CE
“Now is the time to plan, learn from mistakes, and create strong resilient health systems, as well as national and international preparedness strategies with lasting funding."
- The Lancet, May 7, 2022
On April 27, the U.S.’s chief medical officer, Dr. Anthony Fauci, described the state of the COVID-19 pandemic as a “transitional phase, from a deceleration of the numbers into hopefully a more controlled phase and endemicity.” But most public health experts agree that COVID-19 is not yet endemic.
On the bright side, we have learned an enormous amount in the past two plus years, including from many mistakes. One mistake we don’t want to repeat is celebrating victory too early. For the time being, as we navigate a “controlled COVID-19 pandemic,” it’s a good time to be reminded of the key lessons learned. That’s the subject of this week’s Germ Gems post.
Lesson 1. A multidisciplinary approach is essential. Just about every discipline one can think of has contributed to fighting the COVID-19 pandemic. Science—especially biology, medicine, and public health—has been at the ship’s helm, but social and political science, as well as information technology and business/economics also provided crucial guidance.
I’ve been greatly impressed by how much this pandemic has increased the level of sophistication of the general public about fundamental aspects of microbiology (in particular virology), immunology, and genetics. As we’ve all witnessed, the ongoing mutations of the RNA of SARS-CoV-2, the virus that causes COVID-19, allowed it to escape our immune system time and time again. As mutant variants and subvariants arise, antibodies directed against the spike protein no longer recognize their target. Currently, this viral property is the key driver of the pandemic.
At the present time, the so-called Stealth Omicron variant BA.2 is responsible for most new cases of COVID-19 in the U.S. But a number of Omicron subvariants, such as, BA.2.12.1, BA.4, and BA.5, are circulating in the U.S. or South Africa. In recent weeks, the White House has issued several warnings about potential surges of COVID-19 cases this fall or winter. These concerns are based on worries about new subvariants with mutations that make them even more contagious.
Lesson 2. Human behavior matters. Navigating the challenging waters of the biology of the SARS-CoV-2 virus is pivotal in determining our fate in this phase of the COVID-19 pandemic. But we must not forget the substantial influence of the social, political, and economic determinants of health. Social and political scientists, as well as psychologists, continue to tackle thorny issues like vaccine hesitancy, social distancing, and mandated closures of restaurants, theaters, and other gathering places.
Lesson 3. Trustworthy information is essential. We are all aware that even before the COVID-19 pandemic erupted, social media platforms were used to transmit harmful disinformation or misinformation via the Internet. In other words, an “infodemic,” defined as “an excessive amount of information about a problem that is typically unreliable, spreads rapidly, and makes a solution more difficult to achieve,” was a growing threat to public health and things only got worse during the pandemic. Addressing this challenging problem is now a high priority of many public health agencies. While progress is being made, meaningful solutions so far are scarce.
Lesson 4. The Internet is a double-edged sword. I strongly believe that your primary care provider is your best source of advice about how to manage COVID-19, but, realistically, accessing health care providers when you need them isn’t always possible. The really good news, in my opinion, is that reliable sources of information are available at your fingertips on the Internet. In fact, sorting out the mind boggling amount of information and complexities of COVID-19 wouldn’t be possible without the Internet.
Thus, we all need to know what sources of trustworthy information are available via the Internet 24/7 for advice about how to prevent COVID-19 (vaccines, masks, and social distancing) and how to treat SARS-CoV-2 infection when it manifests clinically. Here’s my advice: Start with COVID.gov. In March of this year, the Biden Administration launched the website COVID.gov, a new one-stop shop for vaccines, tests, treatments, and the latest information on the pandemic. One of the many advantages of such Internet-based information is that it can be changed instantaneously when new evidence emerges as it does with topics such as vaccine and drug efficacy and safety.
The information (and Toolkit) provided by COVID.gov are tailored to the County where you live. If you want to know the state of the art in your community about wearing a mask, what vaccines are recommended by age group and how many “booster doses” you need, as well as where to get a COVID-19 test, order at home rapid tests, or if you’re looking for guidance about travel, it’s all in COVID.gov.
If you want supplementary or more detailed information about any of the above topics, such as, advice about isolation and quarantine procedures, or travel abroad on cruise ships, you’ll find trustworthy answers to these issues in the website of the Center for Disease Control and Prevention (CDC) at Coronavirus Disease 2019 (COVID-19) | CDChttps://www.cdc.gov › coronavirus › 2019-nco).
For up-to-date information specifically about COVID-19 treatment, check out this website: NIH COVID-19 Treatment Guidelines. The recommendations given here are generated by a panel of clinical trials experts.
Lesson 5. We won’t get there if some people are left behind. Throughout the course of the pandemic, we’ve frequently been reminded that providing vaccines to prevent and drugs to treat SARS-CoV-2 infection in low-and middle-income countries (LMICs) is not only the right thing to do, but it is essential to getting us to an endemic phase of COVID-19. Equitable support for vaccines and drugs is sorely needed, but so too is improved infrastructure that fosters communication of trustworthy information.
In the U.S., President Biden has promised “to make sure every single American (households, and businesses alike) has access to high quality affordable high-speed internet.” He plans on spending $100 billion to close national broadband network gaps with the goal of making it as commonplace as the lightbulb, dubbing it ‘the new electricity.’
Many public health experts believe that policy choices and decisive action that build resilience could become a defining moment in the recovery from COVID-19. Several governments have included infrastructure spending as part of their response to the pandemic. Resilience is a key element to consider when planning and prioritizing investments, especially in the context of technologies and innovations that could enable lower cost and digitally enabled solutions for LMICs.
A Global COVID-19 Summit aimed at strengthening global efforts to fight the coronavirus pandemic was held on May 12, 2022. Senior officials in the Biden administration who attended reported that the summit produced more than $3 billion in commitments toward the global response and toward efforts to prevent future pandemics. While that funding falls far short of the $15 billion that the World Health Organization claims is needed, it does lay the groundwork for a new global preparedness fund.
