The Guardian view on the next pandemic: can we learn Covid’s lessons? | Editorial

Though at times it can feel hard to believe – especially in recent weeks, perhaps – this pandemic will not last for ever. With more than 5 million dead and huge economic and social costs, its toll has been immense, and unnecessarily so. 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.

Yet if we learn its lessons, we will be better prepared next time. For there will be a next time. Covid is not a once-in-a-century crisis – an idea encouraged by its arrival 101 years after the last major pandemic, the “Spanish” flu, which killed at least 50 million. The mega-flu outbreak that many experts had seen as the next great threat is no less likely to arrive because Covid got here first. A pandemic of similar scale is likely within the next six decades, and could happen at any point in that timespan, according to research published in the Proceedings of the National Academy of Sciences (PNAS) in August; others have put the risk of a comparable crisis within the next decade at around one in four. And as Prof Dame Sarah Gilbert, the creator of the Oxford/AstraZeneca jab, warned recently: “The next one could be worse. It could be more contagious, or more lethal, or both.”

The price we pay then will depend on what we do now, using Covid’s lessons. We have seen international scientific collaboration, incredible dedication by researchers and healthcare staff, and the ability and willingness of local and national communities to pull together. Richer nations will be less likely to take health security for granted. Covid-19 has also shown that the right decisions at the right time can make a profound difference. With a dozen direct flights from Wuhan each week, Taiwan was heavily exposed to risk. But, driven by the experience of the 2002-03 Sars epidemic, it rapidly introduced health screening for arrivals, border controls, effective contact tracing and mask-wearing, and gave its citizens clear and consistent messages. Fewer than 900 of its 22 million-strong population have died.

Wishful thinking

Yet the global response has too often looked like a triumph of science and a failure of politics. The wishful thinking seen in the first wave has been repeated again and again. And the way we live is increasing the risks of another major pandemic. The aforementioned research published in August in PNAS estimated that the probability of novel disease outbreaks will grow threefold in the next few decades. International trade and travel allow diseases to spread far more quickly. Some scientists argue that we have already entered another great pandemic: a wave of antimicrobial resistance that could see tens of millions die from currently treatable diseases, coming gradually, but ultimately proving far more punishing than the sudden Covid crisis. The overuse of antibiotics to treat humans and livestock is endangering us all.

Both the frequency and severity of “spillover” events, where diseases jump from animals to humans, have increased as we encroach on and destroy animal habitats. Zoonotic diseases, transmitted from animals, represent around three-quarters of newly emerging diseases. And research suggests that, as many species become extinct, those that thrive are more likely to be ones known to host pathogens dangerous to humans. Though all this is frequently presented as a developing-world issue, the global north is responsible too. Deforestation is often driven by the cultivation of crops for export. The focus on the perils of “bush meat” and “wet markets” has not been matched by attention to the risks posed by intensive, industrialised farming. Humans will come into even closer contact with nature as global heating reduces available land, and will be pushed into denser habitation and forced to move en masse. Existing diseases such as chikungunya may spread, as warmer temperatures allow their insect carriers to move into new areas.

Covid would have been far worse without the pandemic preparations that countries had been making for years, however inadequate they proved. Many of the proposals now are essentially for more (or a better version) of the same, focusing on data collection and analysis, improvements to public health communication and exploratory work that could accelerate the development of vaccines and treatments. Above all, experts warn that there needs to be a massive expansion of surveillance to detect novel pathogens.

Prioritising public health

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, to $15bn a year. The price tag is tiny set beside the cost of Covid, but many fear that even now our leaders are reluctant to spend enough.

Specific preparations to fend off or tackle another pandemic could mean everything from better protective gear for abattoir workers to rethinking the ventilation requirements of buildings. But protecting ourselves also requires far more fundamental reassessments. Beyond addressing the climate crisis, it means prioritising public health and acting on what the pandemic has demonstrated so graphically: that inequality – both within and between nations – kills; and it kills mostly, but not solely, the poor. Covid (and especially the Omicron variant) has shown that we cannot isolate ourselves from the physical or economic effects of disease elsewhere. By hogging vaccines and opposing patent waivers, wealthier nations have imperilled their own citizens too. They should think again, and make amends by helping to improve regional manufacturing capacity for tests, vaccines and treatments. Since global solutions are needed, it is positive that the World Health Assembly has agreed that work should begin on a pandemic accord covering prevention, preparedness and response, even if its parameters fall short of the tougher treaty that many hoped for. Finally, we must address questions of trust, and tackle the fissures in our societies – in many ways deepened by Covid.

The challenge is truly daunting. But so is the alternative: “What we are going through is also a crisis of meanings,” Elif Shafak has written. “Do we want to go back to the way things were before the pandemic? Was that really normal?” The risk is to our bodily health as well as our wellbeing in the broader sense that Shafak describes. Covid has reminded us that disease is a social as well as a physical phenomenon, produced and shaped by the ways we live. Will we do what is needed to protect ourselves?

Source link