What Lessons Can We Learn From the COVID-19 Pandemic to Prepare for Future Crises?

[This text was originally published in Catalan in Diputació de Barcelona’s EspaiS@lut bulletin.]

The COVID-19 health crisis has affected our society far beyond the pandemic’s direct impact on people’s health. The virus and its consequences have indirectly influenced the management of other diseases and the mental health and well-being of the population, as well as the economy, society and education. For quite some time, public, private and academic institutions have been raising the alarm about the lack of preparedness systems for emerging diseases with pandemic potential, especially since the wake-up call of the first SARS epidemic between 2002 and 2004. Nevertheless, the lack of public and private investment in this area led to COVID-19 having devastating consequences globally, regionally and locally.

Unfortunately, COVID-19 will not be the last pandemic we or future generations will face, since changes in the environment and animal health are making us more exposed to emerging and re-emerging infectious diseases. However, in addition to the risk of infectious diseases, our societies are facing the negative effects of climate change and natural disasters, as well as possible chemical, radiological or biological accidents. As a result, it is clear that we need to improve our approach to all sorts of crises by improving our preparedness, response, recovery and resilience (PR3) for potential public health and environmental crises in the future—in other words, we need to adopt an “all-hazards approach”.

We need to improve our approach to all sorts of crises by improving our preparedness, response, recovery and resilience (PR3) for potential public health and environmental crises in the future—in other words, we need to adopt an “all-hazards approach"

The COVID-19 crisis has left us with numerous lessons that we need to learn in order to prevent or mitigate the impact of future systemic risks. At ISGlobal, we have selected nine lessons that can help us emerge from this global pandemic better prepared to respond to future environmental or public health crises. These include positive lessons that we would like to see continued or improved for greater efficiency in the future.

Scientific collaboration and mobilisation to advance our understanding of the virus that causes COVID-19, in addition to scientific innovation, have enabled the development of safe and effective vaccines, diagnostic techniques and new therapies, as well as advances in innovative surveillance systems, such as wastewater monitoring, which allow us to anticipate risks. These advances should be harnessed to develop new strategies that will enable a better response to future pathogens. In addition, we have come to understand the key role that real-time integrated epidemiological data—epidemiological intelligence—can play in anticipating risks, monitoring the impact of the crisis and of control measures, and assessing the effectiveness of these measures.

Various challenges have become apparent, including the lack of integration of early warning and surveillance systems that would have allowed us to contain the spread of the virus more quickly. Another aspect that has had a very negative impact on the local and global response to COVID-19 has been the large quantity of information from sometimes less-than-truthful sources, amplified by the use of social media, which has meant that the population has had widespread access to disinformation. This, coupled with the implementation of contradictory recommendations, has led to a decline in public trust in health authorities.

Another key aspect has been the obstacles to governance at the local, regional, national and international levels, which have prevented a coordinated response and created fragmentation and inequalities at all levels. At the international level, several initiatives have been launched or are being developed to try to improve coordination among countries to respond to new threats from pathogens with epidemic or pandemic potential, such as the World Health Organisation’s new WHO Hub for Pandemic and Epidemic Intelligence, the new European Health Emergency Preparedness and Response Authority (HERA) and the ongoing discussions around the new treaty on pandemics promoted by the WHO.

Various challenges have become apparent, including the lack of integration of early warning and surveillance systems that would have allowed us to contain the spread of the virus more quickly

Zooming in on a more local level, the impact of the COVID-19 crisis has created large inequalities between different segments of society. Poorer and marginalised communities tend to have worse access to health care; their jobs and livelihoods have also been at greater risk. These vulnerable groups may live in overcrowded and unhygienic environments that amplify the risk of community spread.

The impact of COVID-19 has been greater in cities than in rural areas because cities are more densely populated and more connected to other places, due to transport networks. The lack of green space and environments where people can safely spend time outdoors has also exacerbated the impact of the disease. Unfortunately, there are other types of crises that can affect urban and local environments, such as the effects of climate change: floods, droughts, and extreme weather events such as heat waves and cold spells. There is also the risk of chemical or radiological accidents and fires. Cities will obviously have a very important role to play in preparedness and response strategies for future environmental and health crises.

Nigeria. Photo: Oluwaseyi Aiyeobasan / Pixabay

COVID-19 has prompted the development of different frameworks for action and recommendations that should be implemented to strengthen the preparedness of local environments against systemic risks. The WHO developed recommendations for local authorities on how to strengthen preparedness for COVID-19. UN Habitat has produced a report on lessons learned from the local response to COVID-19 and proposals for reshaping urban environments to blunt the impact of future pandemics, thereby reducing disease spread and adverse economic, social and environmental effects while also creating more sustainable cities. In a broader context of systemic risks, the WHO has created a framework of eight key areas for strengthening preparedness in cities and urban settings: governance and resources, multi-sectoral coordination, high population density and movement, strategies for community engagement and risk communication, targeting vulnerable groups, access to scientific evidence and reliable information, commerce and industry, and organisation and delivery of health care and other essential services. Finally, the WHO is offering a new course on health emergency and disaster risk management for resilient cities, which examines the risks that exist in cities and introduces participants to knowledge and strategies for managing these risks and building resilient cities from a health perspective.

In short, it must be noted that COVID-19 has had an enormous impact on all areas of our lives, but we need to draw lessons that will allow us to improve our existing preparedness and response systems or develop new frameworks for action. Local jurisdictions can be affected by different types of crises and have a very important role to play in managing risks and creating prepared and resilient communities from a public health perspective.