Viruses are the ultimate freeloaders. The best among them — influenza, smallpox and SARS-CoV-2 — spread easily among human hosts while delivering high mortality rates. It would be easy to say that the severity of an outbreak is primarily the result of the strength of a pathogen. But in the past century of battling viruses in an increasingly connected world, human nature has played an outsized role in fueling pandemics.
We are unwittingly aiding and abetting our greatest common enemy: disease.
Our advancement as a species has been driven by our ability to cooperate at a global level. In our best moments, this quality has allowed us to build societies and economies, preserve world order and improve life for billions of people, especially children. Strong public health programs and scientific achievement lie at the heart of our capacity to meet our most pressing health challenges, providing us with the policy guidance and coordination to overcome disease outbreaks with increasingly sophisticated tools.
Yet, the best public health plan paired with the most innovative medical discoveries cannot overcome our human tendency to complicate how we fight disease threats. Instead of banding together and fostering collaboration, we inadvertently fuel outbreaks. Among the barriers that we put in place to confront disease threats effectively, four issues routinely arise.
First, we blame and stigmatize the source of an outbreak. Viral diseases can happen anywhere, at any time. Spillover events — when viruses transfer from animals to humans — are as likely to occur among species in Asia or Africa as they are in the Americas. But in our efforts to provide an explanation for natural phenomena, it is far easier to assign blame on the failures of a foreign government or community, which dramatically hinders a global, coordinated response.
Few Americans supporting restrictions against China for serving as the source of the coronavirus are aware that the tables were turned a century ago: evidence suggests that the deadliest pandemic in modern history, which infected half a billion people and killed 50 million worldwide, may have originated from a pig farm in southwestern Kansas. The 1918 Influenza Pandemic, as it’s now known, was not linked to the United States because of strict news embargo during World War I; it was called the Spanish Flu only because neutral Spain did not follow the news blackout practiced by countries fighting in the war. With nationalism on the rise again, spurred on by social media, partisan politics and 24/7 news cycles, the impact of isolating and penalizing countries for naturally occurring disease outbreaks can cost lives and economic stability.
Second, we apply inconsistent standards for monitoring, reporting and countering disease threats. When countries know that they will be penalized for reporting outbreaks, what is their incentive to be transparent? And even when governments play by the rules and apply the best practices for reporting disease outbreaks — as South Africa did with the detection of the Omicron variant in November — they are subject to unfair and counterproductive penalties.
The development and application of a disease surveillance and reporting protocol that is used effectively by all countries can speed response to outbreaks before they have a chance to reach pandemic proportions. This is not to say there’s been an absence of such protocols; the WHO and national health agencies have coordinated through the decades to address novel disease strains, frequently blunting the potential for a virus to reach its worst-case impact. However, as the conditions for novel pathogens to emerge, it’s time for new approaches to be considered.
We are witnessing the loss of wildlife habitats, increased proximity of humans and animal disease hosts, accelerated global travel and climate change, each of which play a role in disease transmission. Covid-19’s lessons should produce a universal system that prioritizes timely, accurate disease surveillance and rewards reporting transparency.
Third, when we prioritize vaccines and treatments for wealthy countries and place greater value on profits instead of a collective response to a pandemic, it is an expression of 21st century Apartheid. Both the Sars-Cov-2 and Influenza viruses have a powerful ability to mutate, developing new variants that take advantage of weaknesses in our global immunity levels. Just as Martin Luther King Jr. famously noted that injustice anywhere is a threat to justice everywhere, the same applies to epidemiology in our world today: a novel viral threat in a remote corner of the world is a danger everywhere.
Our inability to provide equitable protection for communities beyond our national borders is another form of injustice, plain and simple.
Human advancement is reliant upon our ability to overcome our inherent tribalism. This runs counter to millions of years of evolution. We’re hard-wired to focus on our community’s interests first. The problem is that Covid-19 may likely be a dress rehearsal for worse pandemics in the near future and our failure to overcome tendencies to prioritize vaccination in some regions over others could foreshadow harsher outcomes ahead.
Despite some initial shortcomings, the COVAX facility and initiatives taken by individual vaccine manufacturers could provide a blueprint for rapidly scaling vaccine production and distribution to reach rich and poor countries alike. These are important steps in the right direction.
Fourth, pandemics thrive on chaos. And for the past 24 months, we have inadvertently fostered a haphazard response at the local, national and global levels through a pattern of fumbled communications on public health guidance. All too frequently, the U.S. and other nations have undermined confidence in vaccines and medical science, health agencies and government policy by failing to deliver clear messaging that communities, businesses and everyday people can understand.
Miscommunication has plagued pandemic responses throughout the past 100 years, but the inability for national government health agencies — most particularly the U.S. Centers for Disease Control and Prevention (CDC) — to anticipate messaging issues may prove to be a principal driver for the erosion of trust that citizens have in their leaders.
There is no shortage of excuses for why miscommunication during the pandemic has been so rampant. Nonetheless, global health leaders and the communications advisors supporting them must take a hard look at how to improve communications practices moving forward.
We need to see consistent application of a simple standard for health communications: ensure guidance is grounded in science; make sure it is so simple that school children understand it; and think about how guidance can be followed in the real world, outside of policymaker echo chambers. Then, run every possible scenario past a merciless band of reviewers whose job is to think about how health guidance could be misunderstood or ignored and fix issues before anything is publicly communicated.
These four issues are nothing new. Like so many other problems coming to a boiling point during Covid-19, they have been recurring challenges in past efforts to respond to pandemic threats. Yet global public health leaders, policymakers and communicators have an opportunity and an obligation to minimize the impact of stigma, haphazard disease mitigation standards, nationalism and miscommunication on pandemic response. Covid-19 has been a horrific reminder of the importance of collaboration, transparency and clarity. Our generation may not be given the same latitude during the next pandemic. We need to show we can apply the lessons now.