…If we are to improve our resilience to new and emerging threats, whether from pandemics or elsewhere, we need innovative ways of effectively navigating a sea of scientific knowledge, that is continuously growing. This will require not only time and effort, but also a change in mindset, towards a flexible and adaptive way of engaging with the data. Important messages need to be separated from the roar of background noise and communicated effectively in a clear and concise way to stakeholders and decision makers…
By Dr. Brian Johnston
Senior Public Health Intelligence Manager
London, United Kingdom
How to Combat Future Pandemics
The UK Covid-19 Inquiry has recently been set up to examine the national response to the pandemic, its impact and possible lessons for the future. Whilst this inquiry should be welcomed as a way of finding shortcomings in logistics and decision making, its findings and recommendations are likely to be out of date when they are eventually published. By its very nature, the enquiry will be retrospective and relate to our past relationship with COVID-19. Indeed, from the moment of its inception, the inquiry has inevitably been tied to an historic account of our interaction with the virus. Both the virus and our ways of dealing with it have moved on.
On first sight, this may seem a negative way of looking at inquiries, but the UK has a long history of conducting high profile, costly inquiries into other important issues (such as child abuse), which have proven less than fruitful. Often these inquiries make many recommendations, which are then not effectively implemented on the ground, leading inevitably to a similar tragedy to the one that sparked the initial enquiry in the first place. The media then ask why the recommendations from the previous enquiry were not followed and a new enquiry is called, to see how we can do it better next time…and so the carousel revolves.
To avoid this endless cycle, perhaps we could use the recommendations from the UK Covid-19 inquiry in a different way this time; by employing them as a framework for an annual audit into national preparedness for a future pandemic. The recommendations could be reformulated and reworded into quantifiable indicators (metrics) and the audit process made a mandatory report, which all local authorities have a legal obligation to complete by a specified deadline each year. In this way, potential weaknesses in our responsiveness to a pandemic could be effectively identified and monitored, on an ongoing basis. Complacency is our enemy when it comes to dealing with COVID-19 and similar pathogens, but the adoption of such an audit mechanism could prove a cost effective and practical way to refresh our preparedness for a future pandemic.
Of course, this audit mechanism should be flexible and not rigidly tied to an annual response format, if news emerges of a new threat. In such circumstances, the audit process could be quickly swung into operation and the local logistical “armour” quickly repaired and strengthened, in preparation for the oncoming pandemic. In some cases, where the onset of the pandemic is rapid, this recharging of the local logistical response would be made in the very early stages of the emergency. In other scenarios, where there is greater warning, the refresh of systems and processes could be carried out before the threat has even gained a foothold.
At a local level, the formation of multidisciplinary teams at the height of the recent COVID pandemic, clearly demonstrated what could be achieved when people from different professional backgrounds worked together to find quick and practical solutions to difficult logistical questions. This lesson should not be lost or forgotten, and where possible the networks formed at that time should be maintained and strengthened. Adequate funding, to help keep these structures in place, whilst maintaining their readiness for a future emergency, would be money well spent.
For future pandemics, the ability of health and care professionals to form mutually supportive and co-operative networks of responders to facilitate logistics, will be of great importance, especially in the early stages of a major outbreak. By having a dedicated person within each local Public Health department tasked with maintaining and growing such networks, the activation of a wide range of professionals across a variety of disciplines could be achieved very quickly and efficiently at a time of crisis. Virtual hubs of mutually supportive professionals could be created, and their contact details, skill sets, and areas of expertise held on shared directories to facilitate a rapid, flexible and co-ordinated response to all emergencies (not just pandemics).
Similarly, the creation of a specialist role within Public Health teams to horizon scan for new developments in science and technology, would be another worthy investment. More generally, there is currently considerable interest within health professionals in artificial intelligence (AI) and how this can be used to improve the treatment of patients, for example in breast cancer screening. This shared interest has already led to the development of platforms and forums for networking and the sharing of information. However, the sheer volume and diversity of the information generated by these initiatives can make it difficult for health professionals to keep up to date with important developments, not only in AI, but in science and technology in general.
By having a dedicated member within Public Health teams, whose primary focus would be to tap into these forums and liaise with them, would be a major benefit. Specifically, this individual would be tasked with the identification of practical and important intelligence and its presentation in user friendly digests to senior decision makers at a local level. This “research specialist” could also actively search the relevant scientific literature for new developments, discoveries and inventions, that could be applied locally. More importantly, these research specialists could inform the targeted commissioning of services and the creation of new and innovative strategies, which could make tangible and significant reductions in health inequalities.
If we are to improve our resilience to new and emerging threats, whether from pandemics or elsewhere, we need innovative ways of effectively navigating a sea of scientific knowledge, that is continuously growing. This will require not only time and effort, but also a change in mindset, towards a flexible and adaptive way of engaging with the data. Important messages need to be separated from the roar of background noise and communicated effectively in a clear and concise way to stakeholders and decision makers.
Any idea that is shared and acted upon has the potential to create a solution, that can then seed further ideas, and so on. However, in a world where health challenges come in many forms and sometimes with very short notice, we need quick and practical solutions to be accessible to a targeted audience and in a timely fashion. Only then can we hope to effectively combat future pandemics and health emergencies, without needless loss of life.
We must effectively catalyse data, science and technology to energise the logistical structures necessary to minimise the impact of future pandemics. Hopefully, rather than dodging these icebergs, we can have viable structures in place, to first slow them down, and then melt them, through the judicious application of science and technology. Similarly, by focussing a concentrated beam of relevant knowledge on any future pandemic, we will not only cut it down to size, but save lives through the timely and efficient use of people and resources.
By the same Author on PEAH The New Abnormal Living with COVID in a Transformed World Death in the Time of COVID Unleashing the True Potential of Data – COVID-19 and Beyond