Scientists and public health experts have been pointing out for many years the inevitability of a major pandemic; indeed, since the SARS outbreak in 2002/2003 and then MERS, coronaviruses have been well-recognised as a likely candidate. COVID-19 is but one of a series of zoonotic infections that countries have faced in recent years (Ebola, SARS, MERS, H1N1, Zika, Nipah, West Nile fever, etc.) but its characteristics make it particularly challenging and threatening. National risk estimates and registers in countries like the UK have suggested a high probability that one such zoonotic would lead to a global pandemic in short order.
Yet the level of global preparation in recent years has arguably been limited by a failure to appreciate the significance of such warnings. Why is this the case? Is it due to overconfidence within the decision-making process because SARS was effectively contained, or because influenza is perceived as a usually a minor disease for most of the population that can be dealt with by vaccination, despite the fact that it regularly kills the elderly or the infirm? Is it the result of a reaction against messages from scientists indicating uncertain but potentially devastating disease spread that might be seen as unnecessarily alarmist, and the consequent costs that would necessitate? The preparative costs involved might have little public support in the absence of a certainty of impact, making such long-term planning a low priority relative to short-term demands. This latter can be framed as particularly cogent in the context of short political cycles and a consumerism culture focused on the here and now. Indeed, in many countries we have seen, even after this pandemic had started, a reluctance to focus on the needed preventative health measures and interventions for fear of either economic or political cost. Even now, there is rhetoric, at least in the USA, bemoaning decisions being made in the interest of public health that do not meet technocratic and plutocratic interests. There remains an array of denial and misinformation that bends the narrative to support political and economic interests.
There have been quite different scientific responses in different jurisdictions. Some countries started looking to the long-term some weeks ago: for example, approaching the International Network for Government Science Advice (INGSA) for help in identifying novel strategies for addressing the almost inevitable community transmission phase. Others have delayed even minimal containment measures until the severity was apparent to their publics. There has been wide variation in the speed with which foreseeable needed measures, such as building testing capacity, in the interval since the severity of the epidemic became shockingly apparent in Hubei province and global spread was first recognised. The WHO was relatively slow in calling it a pandemic, while some countries such as New Zealand had already reached that conclusion somewhat earlier. Attempts to find technological solutions remain disparate and confounded by political and commercial barriers.
While we are still in the acute phase it is hard to think about the longer term. But we must.
What lessons can we learn?
- Have we got the right structures for thinking about risk and planning into the medium and long term? Can we get better at horizon scanning and foresighting?
- Have we got the right institutions for linking science, society, and policy?
- What can we learn for science communication (which in general we have done very well), and for transparency in policy making?
- Are there sufficient inputs from other disciplines in considering how societies and individuals react in the context of communal crisis?
- Can we see better ways to get transnational cooperation in emergencies and for collective expert advice, beyond the role of virologists and epidemiologists? Or will differing short-term national interests always be barriers?
- Can we deal better with the engines of misinformation; a problem that transcends borders?
- And in New Zealand what lessons will there be for the crisis management system, for the health system, for the science system, for managing fragile supply lines and enormous disruption to our physical connectivity to the rest of the world?
- What long-term changes will the pandemic bring? Will countries seek to be more self-sufficient? And if so what will that mean for commodity-based exports? What does it mean for inventory control for businesses? What will it do for international travel and its infrastructure and for our connectivity? Just as the Great Depression Influenced thinking for decades, is this a similar tipping point for public values and policy settings?
The next 12 months, at least, will be first a period of managing an acute phase, followed by a containment and then a recovery phase. Enormous disruption to social lives and sense of community, to family life, to mental health, to business, to economy and perhaps to social cohesion is inevitable.
Understandably, much focus will remain on the short term. But it would be a terrible mistake if attention is not given now, and progressively, to the long-term matters that this epidemic will throw into sharp focus. For example, while on a very different time course, climate change shows many of the same issues – the conflicts between science, policy, vested interests and politics and a tendency to think that addressing it can wait. Overall there remains denial of the big changes that will be needed while we pray for a technological solution.
Koi Tū’s contribution will be directed towards these longer-term issues rather than to the present, but we will do so in a manner that is supportive of the present. We can integrate a wide range of experiences, knowledge sources and perspectives in new ways to better understand the barriers and opportunities thrown up by seemingly intractable problems that threaten our long-term wellbeing as a society. Our national resilience will be tested, but we are better placed than most countries to both manage the acute phase and plan for a different future.