As COVID-19 data pile up, we must use them wisely

MANY people have speculated in recent months about what the post-COVID-19 world may end up looking like, with predictions ranging from authoritarian dictatorships to utopian visions of more equal, environmentally sustainable societies.

The reality will likely fall somewhere in between, but it seems unlikely we will be able to return to business as usual.

A vital question for health authorities and political leaders is going to be what we will need to do to prepare ourselves for possible future pandemics, and what lessons we may learn from this one to help us do that.

Scientists have been warning for decades now that a warming world, combined with environmental pressures from burgeoning human populations, would increase the risk of infectious diseases jumping the species barrier from other animals into humans.

Many fiction writers too have explored that possibility in a way that now looks prescient. James Bradley’s Clade and Laura Jean Mackay’s The Animals in that Country are two excellent, if not exactly cheerful, recent Australian novels set against the background of a pandemic.

COVID-19 has often been referred to as a “once in a century” event. While that might be true looking backwards, there is a terrifying possibility it may prove not to be the case in future.

“What are we going to do if this starts happening every year?” a retired doctor said to me recently. “We can’t keep shutting down every time.”

Well, we could, but it would be a radically different world from the one we are used to. Shattered economies would have to be rebuilt on an entirely new basis, our major urban agglomerations would crack under the strain, and you could pretty much forget about international travel.

One thing the COVID-19 pandemic is going to give us is a wealth of data on the social, economic and health outcomes associated with various responses to the crisis.

The fact that responses have varied so widely across countries means we will have comparative data on a scale never before contemplated. The analysis will go on for years.

Despite the resurgence of disease in recent weeks, it still seems likely Australia will provide one of the more positive datasets, thanks in part to our relative geographical isolation, but also to the mostly bipartisan and science-based approach taken by our political leaders.

Some countries, sadly, are likely to provide evidence of what not to do.

In an impassioned, thoroughly researched piece in the September issue of the Atlantic , journalist Ed Yong dissects the unfolding disaster in the United States, where ideological warfare, misinformation and failures of leadership have drastically undermined efforts to combat the disease.

Yong points to the erosion of the nation’s public health capacity over decades, as well as more immediate failures to roll out effective testing programs for COVID-19 or to provide health workers with the protective equipment they needed.

“Despite ample warning, the US squandered every possible opportunity to control the coronavirus,” Yong writes.

“A sluggish response by a government denuded of expertise allowed the coronavirus to gain a foothold. Chronic underfunding of public health neutered the nation’s ability to prevent the pathogen’s spread. A bloated, inefficient health-care system left hospitals ill-prepared for the ensuing wave of sickness.”

As if those failures were not bad enough, we have also seen moves by the United States leadership to undermine, perhaps even destroy, the institutions that would be key to tackling future pandemics: the Centers for Disease Control and Prevention and the World Health Organization.

For a clear illustration of the US President’s failure to grasp the crisis he is responsible for managing, you could do worse than to watch his gobsmackingly incompetent performance during this interview with Australian journalist Jonathan Swan (son of the ABC’s Dr Norman Swan).

Yong also describes the ways in which the pandemic has exposed structural inequalities in American society, with the disease disproportionately affecting disadvantaged groups, people who in a country without universal health care were also those most likely to be without the insurance that would allow them to access quality treatment.

The ongoing casualisation of the workforce – an issue here in Australia too – has also meant people without access to sick leave have been more likely to continue going to work when ill, fostering the spread of disease.

If, as seems likely, we don’t have the luxury of a century to prepare for the next pandemic, we would be well advised to think long and hard about preventive measures we could take at the societal level.

Handwashing is all very well, but we need to address the deep environmental issues and to start building societies, cities, economies and communities that are more just, resilient and adaptable in the face of crisis.

We’re going to have a lot of data to help us work out what needs to be done. Let’s just hope we use them well.

Jane McCredie is a Sydney-based health and science writer.

The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.