12 May 2021
Sarah Boseley Health editor The GUARDIAN
The Covid pandemic was a preventable disaster that need not have cost millions of lives if the world had reacted more quickly, according to an independent high-level panel, which castigates global leaders and calls for major changes to bring it to an end and ensure it cannot happen again.
The report of the panel, chaired by the former New Zealand prime minister Helen Clark and Ellen Johnson Sirleaf, a former president of Liberia, found “weak links at every point in the chain”.
It said preparation was inconsistent and underfunded, the alert system too slow and too meek, while the World Health Organization was underpowered. It concluded the response had exacerbated inequalities. “Global political leadership was absent,” the report said.
Clark described February 2020 as “a month of lost opportunity to avert a pandemic, as so many countries chose to wait and see”.
“For some, it wasn’t until hospital ICU beds began to fill that more action was taken,” she said. “And by then it was too late to avert the pandemic impact. What followed then was a winner takes all scramble for PPE and therapeutics. Globally, health workers were tested to their limits and the rates of infection, illness and death soared and continue to soar.”
Sirleaf said: “The situation we find ourselves in today could have been prevented. An outbreak of a new pathogen, Sars CoV-2 became a catastrophic pandemic that has now killed more than 3.25 million people, and continues to threaten lives and livelihoods all over the world. It is due to a myriad of failures, gaps and delays in preparedness and response. This was partly due to failure to learn from the past.”
Urgent action must be taken, she said. “There are many reviews of previous health crises that include sensible recommendations. Yet, they sit gathering dust in UN basements and on government shelves … Our report shows that most countries of the world were simply not prepared for a pandemic.”
The report was commissioned by the WHO director general at the instigation of member states, who called at the World Health Assembly in May last year for an impartial review of what happened and what could be learned from the pandemic.
The panel calls for radical changes to bring heads of state together to oversee pandemic preparations, ensuring the finance and tools the world needs are in place. They want a faster-moving, better-resourced WHO. And they want a commitment now from leaders of affluent countries to supply vaccines for the rest of the world.
The report says the Chinese detected and identified the new virus promptly when it emerged at the end of 2019 and gave warnings that should have been heeded.
“When we look back to that period in late December, 2019, clinicians in Wuhan acted quickly when they recognised individuals in a cluster of pneumonia cases that were not normal,” said Sirleaf.
An alert was sent out in Wuhan about a potentially new virus, which was “picked up quickly by neighbouring areas, countries, the media – on an online disease reporting site – and by the WHO,” she said.
“This shows the benefit and speed of open-source reporting, but then the systems that were meant to validate and respond to this alert were too slow. The alert system does not operate with sufficient speed when faced with a fast-moving respiratory pathogen.”
The WHO “was hindered and not helped by the international health regulations and procedures”, said Clark. The regulations that govern when the WHO can declare a public health emergency of international concern were adopted in 2007. They bind WHO to confidentiality and verification, preventing rapid action, and prohibit countries from unnecessarily closing their borders against trade.
Every day counts, said the panel, which believes the emergency could have been declared by 22 January, instead of 30 January, as happened.
During “the lost month” of February, countries should have been preparing. Some did and have suffered far less than those that did not. “Countries with the ambition to aggressively contain and stop the spread whenever and wherever it occurs have shown that this is possible,” says the report.
Some countries “devalued and debunked” the science, denying the severity of the disease. “This has had deadly consequences,” said Clark. “This has been compounded by a lack of global leadership and coordination of geopolitical tensions and nationalism weakening the multilateral system, which should act to keep the world safe.”
The report recommends the creation of a “global health threats council”, to be led by heads of state, to keep attention on the threats of pandemics between emergencies and ensure collective action. It calls for a special session of the UN general assembly later this year to agree a political declaration. The WHO must have more power and more funding, while its regional directors and the director general should serve just a single term of seven years.
The panel says it is “deeply concerned and alarmed” about the current high rates of transmission of the virus and the emergence of variants. Every country must take the necessary measures to curb the spread, says the report. High-income countries with enough vaccines ordered for their own needs must commit to providing at least 1bn doses by 1 September to Covax, the UN-backed initiative to get vaccines to 92 low- and middle-income countries, and more than 2bn doses by mid-2022.
The G7 countries must provide 60% of $19bn (£13.45bn) needed for vaccines, therapeutics, tests and strengthening health systems, with the rest from the G20 and other high-income nations. The WHO and the World Trade Organization must bring together vaccine-producing countries and manufacturers to help scale up production around the world – and if nothing happens, then the patent waiver that middle-income countries have called for and the US has backed should come into force.
The Guardian article describes a WHO commissioned report which simply states the obvious: the Covid-19 pandemic was a preventable disaster. It need not have cost millions of lives if the world had reacted more quickly, according to an independent high-level panel, which castigates global leaders and calls for major changes to bring the pandemic to an end and ensure it cannot happen again.
The damning report went on to state that preparation for a pandemic was inconsistent and underfunded, the alert system was too slow and too meek, while the WHO was underpowered. It concluded the response had exacerbated inequalities and global political leadership was absent.
Currently, 3.25 million people have died, and the pandemic continues to threaten lives and livelihoods all over the world. The reasons why the global community was unable to effectively combat this existential threat to humanity are multifactorial due to a myriad of failures, gaps and delays in preparedness and response. This was partly due to a failure to learn from the past despite the recent pandemics of SARS, Avian flu, Swine Flu and the Spanish flu dating back to the 1920’s.
The report says the Chinese detected and identified the new virus promptly when it emerged at the end of 2019 and gave warnings that should have been heeded. In late December 2019, clinicians in Wuhan acted quickly when they recognised individuals in a cluster of pneumonia cases that were not normal. An alert was sent out from Wuhan about a potentially new virus. While the report claims it shows the benefit and speed of open-source reporting, subsequent actions or perhaps lack of reaction brings us to the current status quo.
The systems that were meant to validate and respond to this alert were too slow. The alert system did not operate with sufficient speed when faced with a fast-moving respiratory pathogen. However, the WHO itself cannot abrogate its own failures which must include taking weeks to label the respiratory illness as a pandemic. Secondly, the WHO was effectively obstructed by the Chinese government from exhaustively investigating the origins of the virus. Subsequent delays in access amounting to more than a year since the outbreak was first reported in Wuhan, may mean that that the world will never truly learn how much of a contributory factor Wuhan was to the global spread of the pandemic. This is also tempered with the knowledge that retrospective analysis of blood samples from other countries have shown antibodies to COVID-19 in the months preceding the reports of an initial outbreak in Wuhan.
Some countries devalued and debunked the science, denying the severity of the disease. Trump (USA) and Bolsanaro (Brazil) are two of the most guilty political leaders in this respect by committing what could be construed as homegrown genocide against their own populations resulting in the highest infection and death rates amongst the members of the global community. The report further notes pandemic inaction was compounded by a lack of global leadership and the lack of effective mechanisms and systems to ensure that the world should have been safe and not assuaging to inhibitory geopolitical tensions and nationalism.
The report recommends the creation of a “global health threats council”, to be led by heads of state, to keep attention on the threats of pandemics between emergencies and ensure collective action. A comprehensive global action plan for combating the next and inevitable pandemic needs not just to be put in place but must be actionable by all governments through a coordinated, strategic and mandated platform.
This is a 7-minute read covering an in depth overview of the realities of resulting from a slow and uncoordinated global reaction to COVID-19
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