Covid has not just been a terrible pandemic but also a stress test for the UK and the world, exposing all our system weaknesses in coping with an unprecedented global threat, and how such a threat disproportionately harms the poorest and those who are already suffering the most. We may have all been in the same pandemic storm, but we have been in very different boats.
Perhaps the most damning global critique comes from the Independent Panel for Pandemic Preparedness and Response (IPPPR). Its meticulous inquiry, commissioned by the World Health Organisation (WHO) and published in May, concluded that the pandemic was “a preventable global disaster”. Its report found “weak links at every point in the chain of preparedness and response. Preparation was inconsistent and underfunded. The alert system was too slow – and too meek. The WHO was under-powered. The response has exacerbated inequalities. Global political leadership was absent”.
Governments did not openly collaborate nor react with sufficient urgency to the WHO declaration of a public health emergency on 30 January last year. The UK, and many others, adopted a wait and see approach. The golden months of February and March 2020, when swift action could have saved many lives, were lost. And now we have vaccines, they are being very unfairly distributed around the globe.
There will undoubtedly be other pandemics and we must be better prepared for the next. But the most important wake-up call is to see Covid in the context of all the other global health threats we face and the world struggles to feed the appetites, egos and effluents of eight billion hungry humans. Here are just some.
Climate change and air pollution are now a permanent public health emergency. Nine out of 10 people breathe polluted air every day, and these microscopic pollutants contribute to the deaths of seven million people prematurely every year from cancer, stroke, heart and lung disease. Around 90 per cent of these deaths are in low and middle-income countries, with high volumes of fossil fuel emissions from industry, transport and agriculture, as well as dirty cookstoves and fuels in homes. Deforestation also displaces animals into human populations, making the risk of zoonotic virus crossovers like Covid greater.
As well as Covid, there are plenty more high threat pathogens out there – Ebola, haemorrhagic fevers, Zika, Nipah, MERS, SARS, pandemic influenza, dengue, malaria, HIV. The more humans conquer the planet, the more we will encounter micro-organisms that infect us, replicate inside us and use us for food.
Non-infectious disease is an even bigger cause of premature death. Diabetes, dementia, cancer and heart disease account for the vast majority of deaths worldwide. Fifteen million people are dying from these between the ages of 30 and 69 every year. And over 85 per cent of these premature deaths are in low and middle-income countries, driven by tobacco use, physical inactivity, obesity, alcohol and drug addiction, unhealthy diets and air pollution. A million people die from suicide every year, and a pandemic of mental illness and trauma may follow Covid.
Environment is critical to health – no seed nor human can thrive in barren soil. We only occupy this planet thanks to a few inches of topsoil and some rainwater. The WHO calculates that more than 1.6 billion people (22 per cent of the global population) live in dangerous environments where drought, famine, conflict and population displacement, and weak health services leave them without access to basic care.
Vaccines may have dug us out of a temporary hole with Covid but we misuse antibiotics and at least 700,000 people die each year due to drug-resistant diseases, including 230,000 people who die from multi-drug-resistant tuberculosis. Antimicrobial resistance stems from overuse in both humans and animals, to improve food production yields.
Everyone on the planet should have access to the most basic healthcare – immunisation, contraception, breast-feeding and parenting support, child health monitoring, access to oral rehydration for diarrhoeal diseases, etc. Millions don’t. A vaccine can’t succeed if no one is trained to give it.
Clean water and vaccines are humankind’s greatest contributions to health, but not everyone has access. The WHO estimates that vaccines prevent three million deaths a year, but a further 1.5 million could be avoided if global coverage of vaccinations improved. A key reason for poor uptake is vaccine hesitancy – the reluctance or refusal to vaccinate despite a vaccine being available. Measles has seen a 30 per cent increase in cases globally, including in countries that were close to eliminating the disease. The huge success story of Covid has been safe and effective vaccines. But we still have to distribute them fairly and encourage people to have them. Wake up!
Dr Phil Hammond is an NHS doctor, Private Eye journalist and author of the Sunday Times bestseller Dr Hammond’s Covid Casebook. He is also presenter of Dr Phil’s Bedside Manner on BBC Radio 4