This report is the result of two years of work by a commission established by the newspaper The Lancet (New window)composed of 28 global experts in public policy, international governance, epidemiology, vaccinology, economics, international finance and mental health.
A hundred other experts contributed to the writing of 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, implementation basic public health measures and international solidarity cooperation.
The staggering death toll in the first two years of the COVID-19 pandemic is a profound tragedy and a massive societal failure on many fronts.said Jeffrey Sachs, chairman of the commission and professor at Columbia University.
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 bring the pandemic under controllaments Mr. Sachs.
A collective failure on all fronts
The report lists ten major mistakes that have helped the pandemic drag on for more than two years, including:
too long a delay before the announcement of the first cases of COVID-19;
late recognition that the virus is transmitted by aerosols;
a lack of coordination between countries;
a failure of governments to adopt best health practices;
a lack of data;
an inability to combat misinformation.
The authors say the World Health Organization (WHO) moved too carefully and too slowly on several important issues, including recognizing the mode of airborne transmission of the virus, recommending mask-wearing, declaring 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 certain 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 and influenced the organization’s actions. It also contributed to undermining the organization’s credibility with the public.
The majority of governments have also been slow to recognize the importance of the virus and have been too timid in their interventions, write the authors.
Only the Western Pacific regions, including East Asia and Oceania, which have experienced other severe respiratory disease outbreaks in the past, have responded urgently and adopted strategies to prevent 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 less significant economic impacts.
If all countries had chosen phase-out strategies [au début de la pandémie]it would have been possible to stop the disease without resorting to prolonged shutdowns and lockdowns and stopping international travelsays the report.
In many cases, the response of several governments has been guided more by political and administrative considerations than by recommendations from health experts, the researchers add.
In many cases, policies and decision-making have not been informed by continuously updated syntheses of evidencethey write.
The report says that, too often, governments have adopted less stringent measures or eased restrictions simply because they have emulated other countries to avoid popular discontent. Sometimes, too, they have imposed measures without taking into account the effects on or from other countries or regions.
Governments should have provided more support for the public to adhere to health measures, which includes:
the deployment of high-quality, easily accessible and affordable tests;
sites to self-isolate for those unable to do so at home;
financial support for people in isolation;
the imposition of air quality standards beyond basic standards encouraging the use of better filtration and ventilation systems;
free and easily accessible vaccination.
A lack of international collaboration and coordination
A cooperative approach was necessary, but was little adopted, the authors also deplore.
No one is safe until everyone is 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 high-income countries. . This not only increases the number of infections globally, but also the risk of a new variant popping up.
The authors further cast 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. The authors add that low scientific literacy, inconsistency in government decisions and extensive disinformation campaigns on social media have amplified this opposition.
Politicians should have relied more on recommendations from behavioral science experts to ensure the public adheres to health measures, believe the report’s authors.
Millions of preventable deaths
All of these failures had a devastating effect and caused millions of preventable deaths, the report says.
The Institute for Health Metrics and Evaluation (IHME) estimates that the global death toll is at least twice as high as the 6.9 million deaths reported as of May 31, 2022.
IHME also believes that 4.3 billion people, or 54% of the world’s population, were infected between December 1, 2021 and May 31, 2022 alone.
It is also estimated that 100,000 to 200,000 Americans have died from COVID-19 after refusing to be vaccinated.
Towards the end of the pandemic
Only better multilateral cooperation will end the pandemic, say the authors. They warn that the risk of a new variant emerging remains high and that there is uncertainty about the long-term duration of immunity conferred by vaccination and infection.
This is why the report suggests that countries adopt a
vaccine-plus strategy including :
increased availability of affordable tests and treatments;
better support for people with “long COVID”;
encouraging the wearing of masks;
support for people who have to self-isolate;
support to less well-off countries for the purchase of vaccines and treatments.
These strategies must be put in place on a sustained basis, not just 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 endemic and does not yet show a seasonal and predictable cycle, like the flu.
It is unlikely 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 million peoplecan we read in the document.
Then, lifting the measures too quickly unnecessarily endangers immunocompromised people, who cannot acquire robust enough immunity.
Finally, the authors note, the more infections there are, the more people there will be suffering from
COVID long, 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.
The authors warn that the failures observed since the start of the pandemic should serve as a lesson for leaders, who must also deal with important global challenges such as the climate emergency, the loss of biodiversity, air pollution, soil and water, and the large-scale migration of people due to conflict, poverty and environmental disasters.