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Four years after the initial Covid lockdown, daily life seems to have returned to its usual state, but lasting effects of the pandemic still linger. It appears that many have forgotten the severity of the situation. Officials are eager to move forward and avoid revisiting the decisions, delays, and fatalities that were prevalent in public policy and media updates. However, we cannot allow such a traumatic event to be erased. Approximately 16 million people worldwide lost their lives due to Covid in 2020 and 2021, and 84% of countries, including Britain, saw a decline in life expectancy. Pandemics are not isolated occurrences and there is still a potential for another outbreak in our lifetimes.

Luckily, addressing the next pandemic remains a top priority on the global health agenda. In 2021, I was chosen as co-chair of the US National Academy of Sciences’ committee dedicated to advancing preparedness and response for pandemic and seasonal influenza. This committee was commissioned by the US government to offer recommendations on how to enhance preparedness for the highly probable next pandemic caused by the influenza virus. I also participated in the Lancet Covid-19 taskforce, a collaboration of international experts aiming to identify areas for improvement in the response to the Covid-19 pandemic and anticipate future challenges. These groups consist of some of the most brilliant minds in the realm of global health and preparedness for pandemics. Here’s what I gleaned from my experience.

Many governments are currently focused on the 100-day challenge, which involves finding ways to prevent the spread of a virus while also developing and distributing a scientific response, such as a vaccine, diagnosis, or treatment. For the United States, the goal is to have a vaccine available for the entire population within 130 days of identifying the pathogen, and to have enough supply for the entire world within 200 days. When dealing with Covid-19, the key lesson is to prioritize suppressing the disease until effective tools are available to reduce its mortality rate, as well as finding more efficient ways to deliver treatments. I often wonder how many lives could have been saved if governments had been able to slow the spread of the disease and wait until mass vaccination was possible.

However, implementing this plan is not as simple as it may sound. The first step is to invest in and develop “plug-and-play platforms”. This means that once the genetic sequence of a pathogen is identified, new medical products can be easily created. It is similar to a video game console that is ready to use, and only needs a new cartridge (the specific pathogen) to be inserted. This method is already being used for influenza, where existing vaccine platforms can be adjusted to target a new strain in a relatively short amount of time. To make this process even faster, we need effective surveillance worldwide to quickly detect the spread of a new virus and determine its genetic sequence. In the past, it took several months for the Ebola virus to be identified in Guinea, allowing it to spread unnoticed.

Our priority is finding a balance between speed and thoroughness in the evaluation of potential pandemic treatments. We aim to maintain the rigor of clinical trials, which assess safety, effectiveness, and appropriate dosages, while also expediting the approval of treatments that have the potential to impact the course of a pandemic. However, it is crucial to avoid rushing through the process, as it can erode public trust in medical products. This is why government agencies have a rigorous approval process in place, including phases 1, 2, and 3 of trials. These ensure safety, identify potential side effects and the intervention’s impact on the immune response, and involve a diverse range of participants in terms of age, gender, physical health, and racial background. Generally, these trials take several months to years to complete.

Although the scientific aspect may go accordingly, it is still a difficult feat to prevent the spread of a respiratory virus between humans for 100 days. Shutdowns were a drastic measure used by many governments in 2020 in response to the potential collapse of the healthcare system. Fortunately, we now have the opportunity to improve containment methods and explore ways to safely maintain open schools and businesses through more targeted public health interventions. This can include increasing ventilation, implementing diagnostic testing for infectiousness, and gathering more accurate data on community prevalence through surveillance.

The challenges faced by experts in preparing for a future pandemic are impeding progress. In meetings I have attended, frustration is felt as political priorities have shifted away from public health. In the US, President Joe Biden has been actively involved in global health security and his Secretary of State, Antony Blinken, personally invited experts, including myself, to brief him on post-Covid-19 response. However, with re-election and facing against Donald Trump, who showed no interest in this issue during his presidency, Biden’s attention may be divided. In the UK, it is difficult to advocate for a potential pathogen that could impact the country when the NHS is struggling.

In 2019, a meeting was held at Edinburgh University to discuss convincing low- and middle-income countries to prioritize pandemic preparedness. Unfortunately, the response from ministers in these countries was focused on providing basic healthcare to their citizens rather than preparing for potential threats. This sentiment is also seen in the UK, as it is difficult to advocate for future risk prevention when current issues such as delays in cancer treatment and difficulty accessing medical appointments are of concern. However, ignoring the possibility of future pandemics is not a practical approach. It is necessary to find a solution that addresses both current and future healthcare needs.

• Devi Sridhar, a professor at the University of Edinburgh, holds the position of chair for global public health.

Source: theguardian.com