Are We Prepared For The Next Pandemic? Will We Learn Anything After COVID-19?

Obviously, at the origin of the current pandemic is a new virus for science that we do not know how to deal with. But it also adds that, at the end of January, we were unable to understand the information available and foresee that an uncertain future was coming. We fell into an excess of confidence.

It must be acknowledged that the difficulty in reacting more quickly - with the consequent loss of the month of February, which would have been important for winning the battle against the virus - has been international and transversal.

It has affected many countries and experts of all kinds. Those who have responded best had experience of recent epidemics (Korea) or a strong network of public health and research laboratories (Germany).

Learning from mistakes

Why did it take us so long to react? There are psychological reasons. To begin with, with uncertainty we find it harder to understand and foresee the consequences of new and unlikely events. As a result, we respond in different ways that are difficult to coordinate.

In addition, a pandemic in the West seemed an unthinkable threat to us. Previous international public health emergencies were either not as scary (like the 2009 bird flu), or seemed exotic to us: wild poliovirus and Ebola in 2014, Zika in 2016 and again Ebola in 2019.

We wrongly forget about globalization and that the East is no longer far away. It is now just a few hours away, flying in planes that move hundreds of thousands of people in a week.

Unjustly, the credibility of the World Health Organization (WHO) was at a low ebb when all this began. Especially after the fierce criticism it received for its handling of the 2009 influenza A, when it was accused of overzealousness.

Later, in 2014, the management of Ebola, which left 11 000 people dead in West Africa, deserved harsh criticism. But the WHO reacted and, at the behest of the UN Secretary General and the G7, created the WHO Health Emergencies Programme in 2016.

Another factor to take into account is that we lived with the conviction that science, technology and medicine could solve any problem in the blink of an eye. To which were added the strong statements of some experts proclaiming that COVID-19 was "little more than a flu". Another mistake.

Let's face it: society as a whole was not very aware. On March 8 there were demonstrations and mass rallies. Two days later, many football fans surrounded the stadium where the game was played behind closed doors or traveled to Liverpool for the next day's match. Everyone was overconfident, including the experts. Blaming the government "in hindsight" is easy, but in my view it is puerile and opportunistic.

The time for de-escalation

In order to organize de-escalation and avoid new waves of COVID-19 it is important to give priority to public health measures to detect and contain the contagion.

Throughout this time, health care for the sick has worked, but in heroic conditions. We must ensure that from now on it works in bearable conditions, not on the verge of collapse.

The aim is to get as few sick people as possible into hospitals because there is no contagion. In such a pandemic, even the best-equipped health system cannot cope with an avalanche.

The castle defends itself in the palisades, the moats and the external defences and goes out to strike a blow against the enemy. When the invader surrounds it, the keep is already lost, however strong its walls and high its battlements.

Does the drop in health care costs have any effect?

Korea, the country that has best dealt with the pandemic, has a lower public and total health expenditure than ours, as well as a basically private health care system. But in 2015 they experienced the MERS outbreak, another coronavirus, imported by a traveler from Arabia.

With 185 cases and 38 deaths, it was not classified as an international emergency because it was contained within the country. However, the lethality was high enough to raise public awareness.

As a result, a comprehensive system of preparedness and prevention was set up after that, aimed at suppressing contagion through advanced contact analysis and follow-up.

This, together with the country's scientific and industrial capacity, is now bearing fruit.

On the other hand, if we look at the United States and France, which spend much more on health, we see that they are experiencing many difficulties.

Germany, despite its high spending, is resisting thanks to a strategy similar to that in Korea and its network of laboratories and industries.

Public health measures

From all this we can learn that what is really important is to plan, substantially expand and rapidly deploy public health weapons.

As well as directing them towards the suppression of contagion and not just its mitigation, now and in the future. In short, to be prepared in case a new wave arrives.

The main tools we have are known measures that, in part, are already in place:

1. Shielding of health professionals and other essentials.
2. Shielding and effective isolation of groups at risk in collective residences, such as the elderly and people with disabilities, by reinforcing their staff, including volunteers.
3. Early detection through mass screening and monitoring of contacts with new technologies.
4. Epidemiological studies of prevalence and incidence.
5. Vaccine research.
6. Design and clinical studies of new medicines.
7. Industrial deployment to locally produce personal protective equipment, life support devices and medicines.
8. Elastic supply of treatment stations in conventional or field hospitals.
9. Humane, quick and safe burials.
10. Flexible renewal of social isolation according to the evolution of the contagion.
11. Financial support measures, which also serve to discourage risky behavior.

Seen in this way, it is clear that we have an immense task ahead of us in the short term which, beyond partisan opportunism, requires a united effort, a world mobilization.

We cannot leave it only to the authorities, the health system and the essential workers on the front line. The collaboration of all, including a wide range of organized and protected volunteers, is essential.