How to stop the next pandemic

— 6 minute read– by Sam Feierabend and Derry Salter

Lessons learned from COVID-19

An empty Times Square, New York City

By Sam Feierabend

Pandemics have been a part of human civilisation for centuries, each presenting unique challenges to deal with, whilst also stretching the limits of scientific knowledge. Yet it seems that the coronavirus pandemic has been the first pandemic of a global scale to affect the 21st century world, which has exposed some of the most important lessons for us to learn from. Each country has taken individual approaches that have varied in success of suppressing the virus. Therefore, it is vital to be able to learn from history before it inevitably repeats itself – meaning that by the time the next global pandemic comes, the way in which some countries have drastically failed to protect their populations has to be learnt from.

What COVID-19 has taught us is that any outbreak has the potential to threaten us. When the first cases of a new respiratory virus were confirmed in Wuhan, China in late 2019, the virus had unknowingly spread due to the vast movement of people in and out of the epicentre. Outbreaks of contagious diseases are a common occurrence, something highlighted by the handful of isolated cases of the bubonic plague discovered in Mongolia in late 2020 which sparked a small social media panic.

While the plague is still isolated as a disease, the strict methods of treatment are well practiced with a strong scientific knowledge of how the disease works. In a future pandemic, it is key to get an understanding of how an infection can work to help suppress it as fast as possible. This has been highlighted in February 2021 in Guinea, where the first cases and deaths due to the deadly Ebola virus since 2016 have been confirmed. The country’s ‘muscle memory’ in dealing with he epidemic has been put into the spotlight, given that the disease killed over 11,000 people between 2014 and 2016. Responses to the deaths have been swift and efficient, with strict quarantine rules enforced immediately for those in contact with habitants of the virus and a joint effort with the World Health Organisation ensuring that vaccines are being rushed to the West African country.

Guinea have been dealing with an outbreak of deadly Ebola. Photo by K. Tribouillard from AFP.

The difference with COVID-19 has been its infiltration into western countries from the offset of the pandemic. The sheer volume of tourists and businesspeople travelling between countries unknowingly accelerated the virus’ spread across the globe. World leaders all took differing approaches to suppress the virus. Some took more passive approaches, putting the onus on the population to self-identify symptoms and seek out their own tests and results before implementing isolation rules.

Given the economy-driven society we live in, this approach to handling a pandemic had the aim to ensure that minimal effect on business occurred. Yet this had devastating impact on human life. Western economic powerhouses such as the U.S. and UK reacted too late to the virus spreading – the government’s scientific advisory group suggested ‘locking down’ two weeks earlier – and have suffered some of the worst death tolls globally; the U.S. has reported over 500,000 deaths and the UK 120,000 at the start of this month. This is where lessons can be learnt in pandemic management, and whilst there is no reversing the tragedy of the volume of lost lives, measures can be taken to ensure that the scale of losses cannot be replicated in the future.

Many members of the public who have been sceptical of locking down as a method of controlling the virus have pointed towards Sweden’s ‘hybrid’ response. Within this they have shielded the most vulnerable individuals and over-65s whilst allowing the general population to carry on as close to normal as possible. Whilst not having the highest number of total cases or deaths, Sweden has seen 126 deaths per 100,000 people, making its epidemic more lethal than countries with much higher cases such as Brazil, Argentina and Colombia.

Therefore, it is important for governments to be more active in response to a pandemic. Countries in South East Asia, Australia and New Zealand have been particularly successful in eradicating COVID-19 and are now living lives that mirror that of pre-pandemic. New Zealand especially has taken advantage of its isolated geographical positioning and public health advice to lock down even when a small number of cases had been identified. Levels of government trust have also been higher which has led to more public compliance with emergency COVID legislation, something that has been lacking in other countries. It can be questioned whether the number of COVID-19 deaths in the UK would be significantly lower if people had more trust in the government. Many people have been hesitant to sign up for the NHS Track and Trace app due to some theories that suggest the government may use the data from the app for their own gain.

Jacinda Ardern has received global praise for her response to the pandemic. Photo by Mark Tantrum from Getty Images.

In the original epicentre of the pandemic, Wuhan, central isolation has become standard policy by the government. Any confirmed cases are taken out of society to specific isolation centres rather than be left to mix with the general population. Countries such as China and South Korea have been effective in setting up efficient track and trace systems, allowing forceful active suppression of the virus with their approach of ‘test-isolate-trace’. This was modelled on Nigeria’s Ebola response in 2014 which eradicated the disease in little more than three months. Due to the efficiency of this, their coronavirus response has been far more successful than countries such as the UK, France and Spain who have still struggled to create a functioning track and trace system for their populations.

Therefore, COVID-19 has exposed not only the lack of leadership of some world leaders, but highlights how the modern world, despite the wealth of scientific knowledge we possess, has been underprepared for a global pandemic. More active responses from public health officials advising governments would allow less adaptation for society in a future pandemic and, moreover, as the speed of the development of a vaccine has proved, good public health at home and abroad is and investment, not an expense in the global fight against disease.

How do we prepare for the next pandemic?

Director-General of the World Health Organization (WHO) Tedros Adhanom Ghebreyesus. Photo by Denis Balibouse for Reuters.

By Derry Salter

Whilst devastating waves of COVID-19 continue to claim thousands of lives worldwide, a responsibility to prevent any further catastrophe is needed as it will not be the last global pandemic. The United Nations General Assembly recognises the world’s ‘panic-then-forget’ cycle, which prevents the development of effective medical preparedness. But it is clear that we cannot be complacent and ignore past mistakes.

The medical legacy of COVID-19 will long outlive the disease; the vaccine creation, the PPE manufacturing, the testing and diagnosis system. But this protection clearly has not been effective enough with COVID-19 claiming over 2.5 million lives, with numbers continuing to rise.

Reports concerning anti-virals show that the technology is allowing researchers to decrease the current drug-development timeline from five years to less than half a year. The race to create a COVID-19 vaccine was a short-lived success, with multiple companies finding a vaccine in less than a year. The fast-paced research has saved thousands of lives. It’s clear that without government funding and investment in the pharmaceutical sector, the preparedness for a future pandemic will be minimal.

Furthermore, to prevent a further pandemic there is a need to stop exploiting wildlife and invest in the sanitation of animal markets. Nearly all major outbreaks are caused by zoonotic transfer, the process which sees a pathogen jumping from an animal to a human. A way to prevent this is to close down the trading of wild animals, especially in wet markets. Credible genetic evidence suggests that COVID-19 emerged from a bat species traded in a market in China. Although wildlife trade is a major contributor to the global economy, it only increases the risk of pathogen transmission.

Foresight is essential in preparing for another pandemic. Countries in South East Asia acted quickly to contain the virus, after combatting an outbreak of SARS in the early 2000s. These countries, such as South Korea and Singapore, then contained further waves by tracing, isolating and combatting any new infections. Too many countries in the ‘West’ initially downplayed the pandemic, losing precious time and thousands of lives. The UK failed to quickly implement an effective tracing system, whilst hospitals struggled under the weight of ever-increasing cases.

New Zealand alone has saved thousands of lives because of its effective immediate measures in isolating the country. When a new infectious disease emerges elsewhere in the world, a warning system needs to be implicated to prevent the disease from spreading globally. Countries that did not close their borders and implement a travel ban early on, like the UK and Brazil, have seen the highest levels of devastation.

Preparation at a community level is also vital to prevent any further suffering. For example, there have been various meetings to discuss how to get more PPE and vaccines to less economically developed places. Yet, there is a pervading ignorance concerning the reality of communities within these poorer countries. In India, there are only 0.8 doctors per 1,000 people. For poorer countries, there are a lack of available health workers to fight the pandemic, rendering PPE and vaccines useless. It is essential for governments to fund opportunities for people to enter into medical professions.

Moreover, international inequalities and competition only hinder the successful combatting of a disease. If countries worldwide showed solidarity with each other, the number of deaths would not be in the millions. Without sharing resources and knowledge of the disease, a country alone will struggle to fight another pandemic. The UK’s rather isolationist policies are a great example of this. One of the UK’s mottos at the beginning of the pandemic was to wash your hands with soap. But the staggering reality is that over 3 billion people worldwide do not have access to a water supply or soap. Increasing levels of ignorance towards third world countries only puts more lives at risk.

The clear priority now is to tackle the ever surging number of cases that the current pandemic is bringing, but the world also needs to start taking steps to minimise the damage and pain of a future pandemic.