What do we need to build resilience against the next pandemic?
May 18, 2021
We have lost close to 3.4 million souls to COVID-19 globally over the last year. By some estimates, the real number may be much higher than that because the excess deaths this year are closer to between 7 and 13 million, after accounting for those who died without a diagnosis and those who died because they could not receive timely care for another medical condition. And the pandemic, despite the receding cases in high-resource countries, is nowhere near its end.
Lives lost are the tip of iceberg. We cannot quantify the pain felt by family members remaining behind. Livelihoods and businesses have been devastated. The pandemic’s impact reaches into all recesses of our personal and public lives. It has and will continue to undo decades of work globally on reducing poverty, improving education and health, and empowering women. An IMF study last year showed how, in the five years after major epidemics, income inequality continues to increase in affected countries. Similar trends are already being seen in five countries with the heaviest death tolls from COVID-19. As communities around the world deal with the wreckage of their economies, 95 million more people have been pushed into extreme poverty, with another 200 million predicted to be at risk between now and the year 2030. And this does not even cover the multidimensional impact of poverty. How long will it take for us to recover from this pandemic? How do we take stock and pandemic-proof our communities?
More urgently, COVID-19 may not be the last pandemic we face in our lifetimes. The existential threat of pandemics doesn’t decrease because we are already facing one. In fact, this pandemic worsens the risk for new threats because our effort and resources are depleted, and our surveillance and healthcare systems are overstretched. And because the risk of new infectious diseases seeping into the human population from animal reservoirs is going to continue to grow as we see grow in numbers, require more land, raise more animals, put down more roads, use up more wetlands, and close the gap between us and natural habitats where yet undiscovered viruses lurk. How can we ensure that economically devastated communities coming out of this pandemic recover without worsening the tenuous balance we have with the world around us?
Within our own lifetimes, we have seen the impact of climate change, another existential crisis, transition from something we heard about in news reports to something we experience in our personal lives in the form of changing weather patterns, health effects, increased risk of natural disasters, and rising sea levels. Over the next decades, these factors will exponentially increase the incidence of many infections and change the distribution of others.
And as we tackle these complex problems, new challenges are arising: despite becoming ever more globally connected, our perceptions of reality continue to be disparate. In the deluge of digital data, many among us are falling prey to misinformation and disinformation. The urgency of outbreaks, the shifting scientific knowledge base that comes from tackling emerging pathogens, and political interference have all contributed to the signal getting lost in the noise. The role of disinformation is only going to expand in future emergencies. How do we share timely information in crisis? How do we, in government, science, and public health, earn and build the trust of our communities so ours is the voice they listen to during the fray? How do we listen more carefully to them? How do we involve them in making us all safer?
We can no longer ignore infectious threats on the other side of the world, and we can no longer practice isolationist policies. Because COVID-19 painfully instructed us that outbreaks aren’t just something that happen on the news in distant communities, but instead, they can reach into our homes and rip away our loved ones.
There are moments in history when our actions require collective metacognition and urgency. This has to be one of those moments.
The Center for Emerging Infectious Diseases (CEID) Policy & Research was founded because the time is now for collective transdisciplinary research and response. Every step of the way in this pandemic, the questions haven’t been just scientific, they have also been legal, economic, cultural, and ethical. CEID’s mission is to tug at the threads of all the complex systems that leave us vulnerable to new epidemics and help us answer some of the questions posed above. Through research, collaborative action, community engagement, and training, we hope to find ways to secure us against future global threats. I hope you will reach out with ideas, collaborate with us, and check back often to see where our work is taking us.
We are not rudderless as we head into this future. The COVID-19 pandemic, like recent Ebola virus disease outbreaks and other recent emergencies, has shown that investment in sciences, global collaboration, public health, and health-systems readiness can decrease our vulnerability. We need not only to invest in diagnostics, vaccines, and therapeutics but also find a new way of approaching the problems. My own experience serving as an outbreak responder in multiple emergencies has underscored for me again and again that epidemics fracture us along lines of existing weakness. Because at the terminus of all international surveillance for outbreaks are many communities that do not have access to care. When families can’t access care, we can’t stop cases from becoming clusters, which then become outbreaks. When communities can’t equitably access vaccines, it makes it harder for them to recover, and we continue to suffer collectively from the global economic impact and through the appearance of new variants. When structural racism keeps parts of our communities from being protected, diagnosed, and cared for, all of us are at risk. When it comes to infectious diseases outbreaks, health inequity is a threat to all our survival.
At the launch of our center, we asked public health experts and scientists, “What do we need to do to build resilience against the next pandemic?” Over the next few months, we will continue asking this question to different disciplines, covering those working on health and economic equity, lawmakers, the business community, artists and musicians, and those in media and journalism. Because the solutions, like the questions, require all of us.
Nahid Bhadelia, MD, MALD
Founding Director, Center for Emerging Infectious Diseases Policy & Research (CEID)