A major COVID-19 milestone was achieved last month that indicates the downward infection and hospitalization rates caused by it have now receded to justify dropping its designation as an active pandemic. The United States ended its federal Public Health Emergency on May 11 and used that announcement to herald the incredible national effort regarding testing, vaccines and treatment.
Of course, given recent history, there is a high likelihood that another global pandemic looms. In light of the enormous difficulties nations worldwide faced in developing effective COVID-19 coordinated responses, the task ahead will be equally formidable — namely, how to mitigate massive public health threats in a timely and effective way.
At home, it became clear that our public health infrastructure was not as confident or agile as it needed to be. That’s not a critique of the amazing scientific work marshaled to lower the deadly outcomes that were so prevalent in the early days of the pandemic. Instead, it is a recognition that a comprehensive internal assessment must be initiated soon to determine COVID-19 public health system gaps in readiness for the next pandemic.
But that should be only the first step, with a need to look beyond the confines of public health, as COVID-19 clearly demonstrated. The nature of scientific discovery when novel pathogens emerge means that data are being developed constantly. In turn, this requires updating recommendations that may seem ill-advised in retrospect. Advice about masking — first not recommended; then yes, certainly — caused massive confusion and ultimately diminished trust in the Centers for Disease Control and Prevention. Ditto for school shutdowns. The end result was a series of bitter political divides that remain even after the declarations of pandemic victory are trumpeted.
There is a systemic problem that has not been adequately addressed. As a nation and as a leader in the global community, we need to enlarge our thinking so that public health agencies do not operate in an isolated bubble or bear the burden of asserting sole authority to act. The extensive reach and effect of COVID-19 indeed taught us that public health is vital to develop and implement solutions based on scientific approaches and that pandemics require more than just a public health system approach.
Think back on all the moving parts necessary to formulate a COVID-19 coordinated response, which will be needed to work more seamlessly when the next pandemic emerges. Local, state, federal and international public health agencies are critical. But what about media organizations at all these levels, which also play critical roles in informing and educating the public? Or social media platforms that manage how we talk to one another digitally?
Research universities and Big Pharma, too, should have a seat at this larger pandemic planning table. So should the superpowers China and the United States, the global leaders in artificial intelligence, be increasingly important in innovating better real-time analyses that can speed up diagnoses and treatments.
Neither public health leaders nor government agencies can manage the complexity of a global pandemic by themselves, especially since it involves creating public trust on a massive scale. There already is a well-developed model, called multistakeholder governance, for bringing together all relevant stakeholders to determine their own roles and how to coordinate with one another.
This approach was notably advanced by the United States when a new model for governing the internet was developed in 2016. A multistakeholder process moved away from the top-down U.S. control that initially was thought to be the best way to have website domain names allocated and verified worldwide. A more open, resilient and secure internet was achieved with this new model since a broad foundation of interested parties — businesses, technical experts, civil society and governments — forged a consensus through a more inclusive bottom-up approach.
If this worked for such an essential global resource as the internet, it could serve as a potential model for pandemic planning. That would require gaining buy-in from these interested parties so that the necessary hard discussions can begin before dire infectious signs appear and a new pandemic is announced. This approach also will be beneficial in enhancing public trust for any solutions that are agreed upon.
Our collective COVID-19 buzz phrase has been the “new normal.” Let’s approach the planning stages for our next pandemic with a sense that a new normal must apply here as well.