Abstract
Two million deaths globally. Four hundred thousand deaths in the United States. A hundred thousand deaths in the United Kingdom. Nations across the world are facing their worst times in the life of this pandemic. So much for COVID-19 being gone by 2021. ‘Insanity’, said Albert Einstein, ‘is doing the same thing over and over again and expecting different results’. Yet, mistakes are being repeated – and a report by the Independent Panel for Pandemic Preparedness and Response lays out the failures clearly.
Proven public health strategies, non-pharmaceutical interventions, such as mask wearing, distancing, and test, trace and isolate systems, aren’t being implemented at the right time and in the right way. The pandemic is further exposing inequalities, with insufficient impetus for equity – take global vaccine distribution, for example. The global pandemic alert system failed, and needs to be remade for our real-time digital world. Many governments failed to recognise the serious existential threat of a pandemic, and were hence unprepared. Many, too, failed to cooperate with the World Health Organization; the world tended towards silos and fragmentation when unity and solidarity were required.
The upshot is that to face down the next waves of COVID-19 and future pandemics, nations must be better prepared and integrated between sectors 1 and across borders. Multilateralism is a buffer against a pandemic and multilateralism has become unfashionable in many places. Do we really need another world war to remind us of the importance of international cooperation? Do we really need to reach a point of no return in the climate crisis for us to understand that the planet and humanity can only be prolonged with solidarity?
Perhaps the central challenge is one of ideology? The recent change of leadership in the United States has reminded us of as much, as President Biden embraces his country’s responsibility to the international community, World Health Organization, and climate change. Brexit, by contrast, is isolationism with a global spin. But it all boils down to our view of how best to make the world? Is it best achieved by putting our faith primarily in the money markets or by putting ourselves behind a common purpose to create a better world? If it’s the latter, we need to embrace change. 2
Health or wealth is one of the false dichotomies of this pandemic. The two go together. Another is that people either follow the rules or they don’t. People most likely follow the rules to varying degrees, and we now know that mixed messages and inadequate policies make them angry and spur confrontation. 3 Health professionals are exhausted and frustrated, in the face of a pandemic that has overwhelmed services and created moral distress, with the looming threat of medicolegal action. 4 Little wonder, then, that the hidden crisis of mental health is upon us. 5
Could it have been different? Was all this death, hardship, and misery inevitable? Yes, to some degree but the extent of harm was avoidable on a global scale, as the Independent Panel report makes clear. If so, who is accountable? Seemingly nobody – and that is Einsteinian insanity, a mistake being made over and over again and expecting different results.