It can feel hard to believe that this epidemic will not last for long, especially in recent weeks. The toll has been immense, and unnecessarily so, with more than 5 million dead and huge economic and social costs. Secrecy in China, complacency in Europe, reckless and callous rightwing populism in the US and Brazil, and the inequity in vaccine distribution have all contributed.
We will be better prepared next time if we learn its lessons. There will be a next time. The Spanish flu of 1918 killed at least 50 million people and encouraged the idea of Covid. The mega-flu outbreak that many experts had seen as the next great threat is likely to arrive because Covid got here first. According to research published in the Proceedings of the National Academy of Sciences in August, there is a chance of a similar crisis within the next six decades. Prof Dame Sarah Gilbert, the creator of the Oxford/AstraZeneca jab, warned recently that the next one could be worse. It could be more lethal.
The price we pay will depend on what we do now. International scientific collaboration, incredible dedication by researchers and healthcare staff, and the ability and willingness of local and national communities to pull together are some of the things we have seen. Health security will be less likely to be taken for granted by richer nations. The right decisions at the right time can make a difference. Taiwan was exposed to risk with a dozen direct flights from Wuhan each week. The experience of the 2002-03 sars epidemic led to the introduction of health screening for arrivals, border controls, effective contact tracing and mask-wearing, and gave its citizens clear and consistent messages. There are less than 900 deaths of its 22 million-strong population.
The global response has often been seen as a triumph of science and a failure of politics. The thinking seen in the first wave has been repeated many times. The way we live is making us more vulnerable to another major epidemic. The research published in August in PNAS estimated that the probability of novel disease outbreaks will grow threefold in the next few decades. Diseases can be spread quickly thanks to international trade and travel. A wave of antimicrobial resistance could cause tens of millions of deaths from currently treatable diseases, but it would be much more punishing than the Covid crisis, according to some scientists. The use of antibiotics to treat humans and livestock is endangering us all.
As we destroy animal habitats, the severity of spillover events has increased. Three-quarters of newly emerging diseases are zoonotic. As many species become extinct, those that thrive are more likely to be dangerous to humans. The global north is responsible for all this. Crops for export drive the destruction of forests. The risks of intensive, industrialised farming have not been highlighted as much as the perils of bush meat. Global heating will force humans to move even closer to nature and push them into denser habitation. Warming temperatures allow insect carriers to move into new areas, which may lead to the spread of existing diseases.
Without the inadequate preparations that countries had been making for years, Covid would have been worse. Many of the proposals now are for more data collection and analysis, improvements to public health communication, and exploratory work that could accelerate the development of vaccines and treatments. There needs to be a massive expansion of the number of people watching.
Public health prioritising.
An expert panel convened by the G20 has called for a doubling of international financing to tackle major weaknesses in surveillance and other Pandemic Preparedness requirements. The price is small compared to the cost of Covid, but many fear that our leaders are not spending enough.
Better protective gear for abattoir workers and rethinking the requirements of buildings are just some of the things that could be done to prepare for another Pandemic. It is necessary to fundamentally reexamine protecting ourselves. The climate crisis is not the only thing that needs to be addressed, it also needs to be prioritised over public health and act on the fact that the poor are dying more and more in the world. The Omicron variant has shown that we can't ignore the effects of disease elsewhere. By opposing patent waivers, wealthier nations have jeopardized their own citizens. They need to think again and help improve regional manufacturing capacity for tests, vaccines and treatments. It is positive that the World Health Assembly has agreed that work should begin on a pandemic accord even if its parameters fall short of the tougher treaty that many hoped for. We must address questions of trust and tackle the fissures in our societies.
The challenge is very difficult. The alternative is also a crisis of meanings. Do we want to go back to the way things were before the epidemic? Was that normal? The risk is to our bodily health as well as our wellbeing. Covid has reminded us that disease is a social phenomenon that is produced and shaped by the way we live. Will we do what is necessary to protect ourselves?