Lessons from the Pandemic

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Vaccination – part of the answer but not enough
Photo by Mufid Majnun on Unsplash

Covid has not just been a terrible pandemic, but also a stress test for the UK and the world, exposing all our system weaknesses in coping with an unprecedented global threat, and how such a threat disproportionately harms the poorest and those who are already suffering the most. We may have all been in the same pandemic storm, but we have been in very different boats.

Lessons from the Pandemic: A Preventable Global Disaster

Perhaps the most damning global critique comes from the Independent Panel for Pandemic Preparedness and Response (IPPPR). Their meticulous inquiry, commissioned by the World Health Organisation (WHO) and published in May, concluded that the pandemic was “a preventable global disaster”. Their report found “weak links at every point in the chain of preparedness and response. Preparation was inconsistent and underfunded. The alert system was too slow – and too meek. The WHO was under-powered. The response has exacerbated inequalities. Global political leadership was absent.”

Governments did not openly collaborate, nor react with sufficient urgency to the WHO declaration of a public health emergency on 30 January last year. The UK, and many others, adopted a ‘wait and see’ approach. The “golden months” of February and March 2020, when swift action could have saved many lives, were lost. And now we have vaccines, they are being very unfairly distributed around the globe.

The UK’s vaccination investment, development and distribution have been world class, and something to be proud of. But for a rich island nation with world leading public health expertise, our pre-vaccine management went badly awry and – given our carelessness in importing the delta variant in such large numbers – we may not be out of the woods come the winter.

The Need for a Public Inquiry

Given the scale of the loss of life, a public inquiry will eventually have to provide an outlet for the deep grief and anger of the bereaved. It also needs to cut through the bluff and bluster of politicians and get to the truth. In my view, anyone who says any of the following is either lying or woefully misinformed:

  • We were well prepared for the pandemic
  • Herd immunity was never the plan
  • We put a protective ring around care homes
  • There were no PPE shortages
  • We protected the NHS
  • Our test-trace-isolate system is world class
  • Our border controls are world class
  • Our roadmap out of the pandemic is irreversible

The emotional, educational and economic impact of this pandemic will be felt for years to come, with millions suffering either from Long Covid or Long Lockdown (or both). There will undoubtedly be other pandemics, and we must be better prepared for the next. But the most important wake-up call is to see Covid in the context of all the other global health threats we face as the world struggles to deal with the appetites, egos and effluents of eight billion hungry humans. Here are just some …

Global Health Threats: Air Pollution

Climate change and air pollution are now a permanent public health emergency. Nine out of ten people breathe polluted air every day, and microscopic pollutants contribute to the deaths of 7 million people prematurely every year from cancer, stroke, heart and lung disease. Around 90% of these deaths are in low and middle-income countries, with high volumes of fossil fuel emissions from industry, transport and agriculture, as well as dirty cookstoves and fuels in homes.  Deforestation also displaces animals into human populations, making the risk of zoonotic virus cross-overs like Covid greater.

Health Threats from Other Pathogens and Non-Infectious Diseases

As well as Covid, there are plenty more high threat pathogens out there. Ebola, haemorrhagic fevers, Zika, Nipah, MERS, SARS, pandemic influenza, dengue, malaria, HIV. The more humans conquer the planet, the more we will encounter micro-organisms that infect us, replicate inside us and use us for food.

Non-infectious disease is an even bigger cause of premature death. Diabetes, dementia, cancer and heart disease account for the vast majority of deaths worldwide. 15 million people are dying from these between the ages of 30 and 69 every year. And over 85% of these premature deaths are in low- and middle-income countries, driven by tobacco use, physical inactivity, obesity, alcohol and drug addiction, unhealthy diets and air pollution. A million people die from suicide every year, and a pandemic of mental illness and trauma may follow Covid.

Dangerous Environments

Environment is critical to health – no seed nor human can thrive in barren soil. We only occupy this planet thanks to a few inches of topsoil and some rainwater. The WHO calculates that more than 1.6 billion people (22% of the global population) live in dangerous environments where drought, famine, conflict, population displacement and weak health services leave them without access to basic care. 

Vaccines may have dug us out of a temporary hole with Covid, but we misuse antibiotics, and at least 700,000 people die each year due to drug-resistant diseases, including 230,000 people who die from multidrug-resistant tuberculosis. Antimicrobial resistance stems from overuse in both humans and animals, to improve food production yields.

Mycobacterium tuberculosis, the bacillus that causes TB:Source: eLife

Everyone on the planet should have access to the most basic healthcare – immunisation, contraception, breast-feeding and parenting support, child health monitoring, access to oral rehydration for diarrhoeal diseases etc. Millions don’t. A vaccine can’t succeed if no-one is trained to give it.

Clean water and vaccines are humankind’s greatest contributions to health, but not everyone has access. The WHO estimates that vaccines prevent 3 million deaths a year, but a further 1.5 million could be avoided if global coverage of vaccinations improved. A key reason for poor uptake is vaccine hesitancythe reluctance or refusal to vaccinate despite a vaccine being available. Measles has seen a 30% increase in cases globally, including in countries that were close to eliminating the disease, who have seen a resurgence. 

The huge success story of Covid has been safe and effective vaccines. But we still have to distribute them fairly and encourage people to have them. Wake up!

Ed: Dr Phil Hammond is an NHS doctor, Private Eye journalist and author of the Sunday Times best seller, Dr Hammond’s Covid Casebook, a collection of his highly praised pandemic coverage in Private Eye. He is also presenter of Dr Phil’s Bedside Manner on BBC Radio 4 and the Sounds App.

Cover shot of Dr Hammond's book

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