The opening session of the Global Solutions Summit 2020 poignantly stated
Covid-19 pandemic demonstrates to us the value of freedom - the freedom to move, to be with those we love, to live in dignity and security - for ourselves and for those around us, from our loved ones to the refugees and the downtrodden. Above all, it shows us the importance of recognising the true purpose of all our businesses and economies, our political parties and governments, our local civic associations and our international organisations, our conventions and ideologies, and all our other systems: namely, to serve human needs and purposes.
Anyone who had listened to US President, Donald Trump in recent weeks would be forgiven for thinking that no one could have ever predicted or prepared for a global pandemic on the scale of COVID-19. At his daily press briefings, in relation to the national stockpile of medical products needed to protect people and combat the virus, he repeats the line that the "the cupboard was bare" when his administration took over from his predecessor, Barack Obama. While it is true that the US was short on some items such as the N95 masks following the H1N1 virus in 2009, the US national stockpile was not depleted. And even if Mr Trump's assertion is true, his administration has had since January 2017 to build up the reserves needed.
No politician can argue we were not warned
In April 2015, the founder of Microsoft, and now billionaire philanthropist, Bill Gates, gave a TED presentation entitled, "The next outbreak? We're not ready".
He started the presentation by saying, "when I was a kid, the disaster we worried about most was a nuclear war...today the greatest risk of global catastrophe doesn't look like this [shows a slide of a nuclear 'mushroom cloud'], instead it looks like this [shows a slide of a picture of a virus cell]. He then goes on to warn us that microbes are more likely to kill millions of people in the coming years, not war.
Drawing on lessons from the Ebola crisis, he says that three key pieces of the jigsaw required to control the outbreak, were absent:
- Surveillance and data - i.e. a team of epidemiologists to gather data on the prevalence, causes and spread, and IT systems to capture and process the information.
- Personnel - thousands of medical personnel were needed, but it took too long to assemble the resources needed
- Treatment - hundreds of thousands of workers were needed to deliver treatments for Ebola. In reality, there was no one looking at treatment approaches and diagnostics.
Rather ominously, he then went on to warn that the next threat could come from a virus on par with the Spanish flu of 1918, which could kill millions; "we should be concerned". However, Gates, is as much an optimist as he is a realist. His belief is that science and technology can provide the answers and solutions we need to tackle and eradicate the next global pandemic, if only the necessary investment is made across the globe. Mobile phones can be used to transmit information to and from the public, satellite maps show where people are and where they are moving, and advances in biology mean that pathogens can be analysed rapidly and vaccines produced. What is then needed is a truly global health system which brings all of the elements and data together.
While trillions has been spent on preparing for war, very little by comparison has been spent on pandemic preparation. Yet Gates believes that the approach we use for preparing for war can be used for pandemics. After all, the military has thousands of specially trained personnel ready to go where needed, to bring back information, and form a strategy to tackle a specific threat.
Moving onto the costs, Gates referenced the World Bank, which estimated that a global flu pandemic may cost the world US$3 trillion and may lead to millions of deaths. The cost of putting in place measures to control future pandemics, Gates believes, would be a small fraction of this amount.
Signing off, Gates says, "we need to get going because time is not on our side". Fast forward to 2020, and the question must be asked as to why, when the pandemic did come in December 2019, we were not ready.
What was learned from Exercise Cygnus?
You may never have heard of Exercise Cygnus, which took place in Britain in October 2016, especially given all of the Brexit related noise at the time, and also because its findings were not made public. Exercise Cygnus was a pandemic test drill involving all of the key governmental departments, the NHS, and local authorities across Britain. Simulations showed that the Britain was woefully unprepared in terms of critical care beds, morgue capacity, and personal protective equipment (PPE), while revealing large gaps in our Emergency Preparedness, Resilience and Response (EPRR) plan. According to a senior academic involved in Exercise Cygnus and the current pandemic research "these exercises are supposed to prepare government for something like this - but it appears they were aware of the problem but didn't do much about it.... We've been quite surprised at the lack of coherent planning for a pandemic on this scale. It's basically a lack of attention to what would be needed to prevent a disease like this from overwhelming the system. All the flexibility has been pared away, so it's difficult to react quickly. Nothing is ready to go."
The 2016 exercise revealed the lack of capacity to handle a serious pandemic, but it is less clear whether any conclusions were drawn regarding what we now know to be important.
The focus in Britain has moved to local lockdowns and, in England, 'test, track and trace' has become the mantra for fighting Covid-19, albeit the first NHS contract tracing app failed. Contact tracing is important and involves an infected person recounting their movements and activities to build up a picture of who else might have been exposed. A manual contract tracing scheme has also been running since May 2020.
The government explaints that the new NHS app will enable anyone with a smartphone to engage with every aspect of the NHS Test and Trace service, from ordering a test through to accessing the right guidance and advice. They claim it will allow people to identify their symptoms, order a test and allow them to feel supported during any subsequent isolation. It will also include a feature that will allow QR codes to be scanned for people to 'check-in' to public locations, such as pubs or restaurants, and then be informed if a coronavirus breakout has happened there.
We await further news about the roll-out date and the apps full functionality.
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