FYears after the first coronavirus lockdown, life feels almost back to normal, although the legacy of the pandemic still lingers. It seems like mass amnesia is setting in. Politicians seem eager to move forward rather than reliving the decisions, delays, and deaths that have become the hallmark of public policy and press conferences. But it is hard to imagine such a brutal event, with coronavirus killing nearly 16 million people worldwide in 2020 and 2021, and estimated to have caused a decline in life expectancy in 84% of countries, including the UK. we cannot forget. The pandemic is not a one-time event. There is still a risk that something else will happen during our lifetime.
Fortunately, how to deal with the next pandemic remains at the top of the global health agenda. In 2021, I was asked to co-chair the National Academy of Sciences' Committee on Advancing Pandemic and Seasonal Influenza Vaccine Preparedness and Response. The group is sponsored by the U.S. government to provide recommendations on how to improve preparedness for influenza, which is seen as one of the most likely candidates for the next pandemic. I am also part of the Lancet COVID-19 Task Force, which brings together experts from around the world to consider how we can improve our response to COVID-19 and what challenges lie ahead. Did. These groups represent the world's best thinkers on global health and pandemic preparedness. Here's what I learned.
First, most governments are working towards a 100-day challenge. That means how to contain the spread of the virus until scientific responses such as vaccines, diagnostics, and treatments can be approved, manufactured, and delivered to the public. The United States recommends 130 days from the time a pathogen is detected until a vaccine is available to all Americans, and 200 days until there is enough vaccine for the entire world. His strategic lesson here from Covid-19 is to plan for maximum suppression of new diseases until tools emerge that make them less lethal and can provide faster and more widespread treatment. I often wonder, if the government had found a way to buy time and slow the population until mass vaccination, how many people would have survived?
But this kind of planning is easier said than done. The first requirement is to invest in and create a “plug-and-play platform.” This means that once a pathogen's genetic sequence has been identified, it is almost ready to create new medical products. Think of it like a video game machine that is ready and just waiting for a new cartridge (pathogen details) to be inserted. Influenza already works this way, and existing vaccine platforms are ready to be adjusted to deal with new strains relatively quickly. To do this more quickly, we need adequate surveillance everywhere in the world to detect whether new viruses are circulating and to sequence their genes. Ebola was prevalent in Guinea for several months in 2014 before anyone realized it was the Ebola virus and not some other virus.
Second, how to maintain the rigor of clinical trials testing safety, efficacy, and optimal dosing while moving fast enough to approve treatments that could impact the trajectory of the pandemic. you need to come up with. Because too much haste can undermine confidence in medical products, there is a rigorous approval process by government agencies to ensure safety and identify the effects of interventions on side effects and immune responses. Phase 2 and 3 trials are required. Ensure that hundreds of people are included with a variety of characteristics such as age, gender, physical health, and racial background. These exams typically take months, if not years.
Even if everything goes according to plan scientifically, delaying the spread of a virus, especially a respiratory virus, from person to person for 100 days is no easy task. Shutdowns are an extreme policy response, a tool many governments used in the face of healthcare collapse in 2020. We now have time to develop better containment methods and consider ways to keep schools safe. And we will begin to operate with more accurate public health interventions, including knowledge about infection (such as increased ventilation), diagnostics (testing for transmissibility), and better data (monitoring community spread). .
These are the challenges experts face when planning for future pandemics. But progress has stalled. At the meetings I attended, there was a sense of frustration as political priorities shifted away from public health. In the United States, President Joe Biden is actively working on global health security, and Secretary of State Antony Blinken has invited several experts, including myself, to speak directly to the president about the post-COVID-19 response. I asked him to explain. But Biden now faces a battle between his re-election and Donald Trump, who showed no interest in the issue during his presidency. Here in the UK, we find it difficult to make claims about potential pathogens that could affect the country now that the NHS is collapsing.
I recall a conference we held at the University of Edinburgh in 2019 on how best to persuade low- and middle-income countries to take pandemic preparedness seriously. The response from ministers in these countries was that they were more interested in providing basic health care to their citizens than in facing existential threats. Sadly, Britain falls into this camp. Make a compelling argument for investing to protect against future risks, as people today face delays in life-saving cancer treatments, long waits for ambulances, and inability to get GP appointments. It's difficult. But pretending we won't face the threat of another pandemic in our lifetimes is naive at best. Surely there must be a way to achieve both.
