Pandemic management 'a massive global failure', expert panel says | Coronavirus

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Managing the pandemic “a massive global failure”, expert panel says | Coronavirus

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A man walks in front of a mural depicting a female healthcare worker on Rideau Street in Ottawa in 2021.

Globally, the response to the COVID-19 pandemic has been a succession of “massive global failures”, writes a panel of experts in a new report published in The Lancet on Wednesday. They warn that without global cooperation, the pandemic is likely to continue.

This report is the result of two years of work by a commission established by the newspaper The Lancetcomposed of 28 of the world's leading experts in public policy, international governance, epidemiology, vaccinology, economics, international finance, and mental health.

A hundred other experts contributed to this highly critical report on pandemic management, at all levels and in most countries.

These researchers, who rely on nearly 500 studies and reports, observe a situation where failures have followed failures, in terms of prevention, transparency, rational decision-making, the implementation of basic public health measures and cooperation in terms of international solidarity.

The staggering death toll during the first two years of the COVID-19 pandemic 19 is a profound tragedy and a massive societal failure on many levels, said Commission Chairman and Columbia University Professor Jeffrey Sachs.

We have to face hard truths: too many governments have failed to meet basic standards of institutional rationality and transparency; too many people have protested against basic public health measures, often influenced by misinformation; and too many nations have failed to promote global collaboration to control the pandemic, Sachs laments.

The report lists ten major mistakes that have contributed to the pandemic lasting more than two years, including:

  • a too long delay before the announcement of the first cases of COVID-19;

  • a belated recognition that the virus is transmitted by aerosols;

  • a lack of coordination between countries;

  • a failure of governments to adopt the best health practices;

  • a lack of data;

  • an inability to fight misinformation.

The authors say the World Health Organization (WHO) moved too carefully and too slowly on several important issues, including recognizing the airborne mode of transmission of the virus; the recommendation to wear a mask; the declaration of a state of pandemic and the publication of international travel protocols.

They note, however, that the work of the WHO has been greatly weakened by some political interventions. They cite the US threat to withdraw from the WHO and tensions between China and the US over the origin of the virus as examples that have slowed down and influenced the organization's actions. . This also contributed to undermining the organization's credibility with the public.

WHO's response to the pandemic will be subject to independent assessment.

Most governments have also been slow to recognize the significance of the virus and have been too timid in their interventions, write the authors.

Only regions of the Western Pacific, including East Asia and Oceania, which have experienced other outbreaks of severe respiratory disease in the past, reacted urgently and adopted strategies to eliminate the virus. These regions have generally experienced lower mortality (about 300 per million people, compared to 4000 per million people in Europe and the Americas) and lower economic impacts.

If all countries had chosen suppression strategies [at the start of the pandemic], it would have been possible to stop the epidemic without resorting to prolonged shutdowns and confinements and the cessation of international travel, indicates the ratio.

In many cases, the epidemic response of several governments has been guided more by political and administrative considerations than by recommendations from health experts, they add. In many cases, policy and decision-making have not been informed by continuously updated syntheses of evidence, they write.

The report says that too often governments have adopted less stringent measures or loosened restrictions simply because they have emulated other countries to avoid popular discontent. Other times they have ignored imposing measures without considering any effect on or from other countries or regions.

Governments should have provided more support so that the public can adhere to sanitary measures. This includes:

  • the deployment of high quality, easily accessible and affordable testing;

  • isolation places for those who cannot isolate at home;

  • financial support for those in isolation;

  • impose air quality standards beyond basic standards encouraging the use of better filtration and ventilation systems;

  • free and easily accessible vaccination.

A cooperative approach was necessary, but was little adopted, the authors also deplore. No one is safe until everyone is safe is an epidemiological concept that has been generally ignored.

In fact, more than a year after the start of the COVID-19 vaccination campaign, only one in seven people in low-income countries have been vaccinated, compared to one in four people in low-income countries. high income. This not only increases the number of infections worldwide, but also the risk of a new variant emerging.

The authors also place some blame on the public: Pandemic control has been seriously hampered by public opposition to health measures, such as wearing masks and vaccinations.

This opposition has had too much influence on political decisions, the report reads. On the other hand, the authors add that a low scientific literacy, an inconsistency of government decisions and the vast disinformation campaigns on social networks have amplified this opposition.

Politicians should have done more use the recommendations of behavioral science experts to ensure that the public accepts and adheres to health measures, believe the authors of the report.

In Washington, a man walks through the memorial for Americans who have died of COVID-19. The United States has reported more than one million deaths since the start of the pandemic.

All of these failures have had a devastating effect and caused millions of preventable deaths, indicates the report.

The Institute for Health Metrics and Evaluation (IHME) estimates that the death toll across the world is at least twice as high as the 6.9 million deaths reported as of May 31, 2022.

IHME further estimates that 4.3 billion people, or 54% of the world's population, were infected between December 1, 2021 and May 31, 2022 alone.

An estimated 100,000 to 200,000 Americans have died from COVID-19 after refusing to be vaccinated.

Over 12.66 billion doses of the COVID-19 vaccine have been administered worldwide. In low-income countries, only 21% of the population has received at least a first dose.

Only better multilateral cooperation will end the pandemic, say the authors. They warn that the risk of a new variant emerging remains high and there is uncertainty about the long-term duration of immunity conferred by vaccination and infection.

Therefore, the report suggests that countries adopt a vaccine-plus strategy that includes:

  • mass vaccination;

  • increased availability of affordable tests and treatments;

  • better support for people with “long COVID”;

  • encourage the wearing of masks;

  • < p class="e-p">support for people who have to self-isolate;

  • support for less well-off countries to purchase vaccines and treatments.

These strategies must be put in place on a sustained basis, and not only when the signs point to a new wave.

The authors also point out that the premature lifting of sanitary measures has many problems.

First, the virus is not yet endemic and does not yet exhibit a seasonal and predictable cycle, like the flu. There is little assurance that we have achieved such predictability, and influenza too can give rise to devastating new variants and pandemics, such as the epidemics of 1957-1958 and 1968 which killed between 1 and 4 millions of people, the document reads.

Then lifting measures too quickly puts people who are immunocompromised unnecessarily at risk because they cannot develop sufficiently robust immunity.< /p>

Finally, the authors note, the more infections there are, the more people there will be with long COVID, which will have a major impact on health systems. They point out that up to 35% of people with COVID-19 and nearly 90% of those who have been hospitalized with the disease are living with long-term symptoms.

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