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Six Unlearned Lessons of the Pandemic

Two years in, here are some signals and logical responses we have yet to grasp.

Crawford Kilian 30 Dec

Tyee contributing editor Crawford Kilian blogs about the pandemic here.

Two years ago, on Dec. 31, 2019, we got the news from Wuhan about a “novel pneumonia” that seemed like SARS. We knew nothing about the virus involved, but we soon had its genome. Since then we have gained detailed knowledge about SARS-CoV-2 and its many variants.

But as Australian surgeon Dr. Eric Levi recently observed on Twitter, “One thing we learned from the pandemic is that very few of us actually learned from the pandemic.”

Looking back over two years of chaotic response, I’m forced to agree. But I can see six lessons we should have learned by now. Maybe we still have time to learn them.

1. Decisiveness works, but so does follow-through

Most western nations dithered and then set up pointless travel bans when COVID-19 was already within their borders. But a few countries like Vietnam moved very fast to close schools and businesses and to test every person coming into the country. They were rewarded with low case and mortality counts.

But decisiveness without follow-through was in vain. Vietnam went for over a year with few cases and fewer deaths. On May 31, Vietnam tallied 7,625 cases and 47 deaths. By Christmas the count was 1.6 million, with 30,531 deaths. Vietnam had been slow to acquire and distribute vaccines, and even in mid-December only 57 per cent of its people were fully vaccinated, with another 19 per cent partly vaccinated.

China, most decisive responder of all, seems to have done much better. But at year’s end, COVID-19 in the city of Xian was doubling its case numbers from one day to the next.

2. Good scientists must also be good health communicators

As creatures of their governments, health agencies are political, and they can’t stray too far from their governments’ policies. That was disastrous in the case of the Trump administration, and in the cases of many Republican states and right-wing provincial governments, who insisted that all would be well.

But even health officials who were free to speak their minds too often hesitated or offered advice that was soon superseded by events. This compounded public mistrust: masks weren’t necessary until they were, kids were safe from COVID-19 until they weren’t, and so on. Very rarely did any health official say: “We were very wrong about that, and we’re sorry.”

Peter Sandman, who’s studied risk communication for over 40 years, recently published a critique of current U.S. health messaging; his conclusions apply to many other countries as well. Sandman says communicators have lost the public trust through many errors: overconfidence, failure to tell people what to expect, claiming a scientific consensus when nothing of the sort exists, and prioritizing health over other values — education, personal freedom, economics and so on.

Sandman asserts communicators sometimes mislead the public with cherry-picked data or false claims like Anthony Fauci’s early statement that the public didn’t need masks “because he was worried about the mask shortage in health-care settings.”

3. We’re not all in this together, but we should be

It’s a truism that every class is healthier than the one below it and sicker than the one above it. The wealthy and merely affluent have been able to work from home, while “essential” workers, many of them people of colour, have to show up and interact with perhaps hundreds of people every day, for very little pay. Many women have had to quit their jobs to look after their kids when neither daycare nor school is available.

Thousands of Canadians in nursing homes and long-term care died because they weren’t included in the original response to COVID. Kids were considered magically immune to the virus, and so could go to school, mingle in poorly ventilated classrooms and go home to fall ill or infect their relatives and friends.

And despite the repeated warnings of the World Health Organization, the rich nations failed to share their vaccines with the poor ones, which pretty well guaranteed variants like Delta and Omicron would appear in the poor nations and move quickly to the rich.

Such obviously selfish policies make it easy to mistrust governments and health experts. It may be too late for policies of equality to rebuild that mistrust, both within nations and between them.

4. Vaccine resistance is the virus’s ally

It’s especially pathological in Trumpist states and regions, where refusal to be vaccinated has become an expression of faith. (Trump himself was recently booed when he told a crowd he’d had the booster shot.)

But it’s also true even in sober, law-abiding Canada, where we’ve seen anti-vax crowds threaten health-care workers. Some Conservative MPs don’t want to say if they’ve been vaccinated.

Vaccines can’t guarantee immunity to all, and Omicron has found ways to attack even the fully vaccinated. But COVID vaccines can improve your odds against infection or serious illness — a simple fact that somehow continues to meet resistance among slices of nations’ populations large enough to threaten their health systems when variant waves arrive.

5. We need to rebuild our health-care systems

American ER physician Craig Spencer, who survived Ebola in West Africa, recently wrote: “There’s no nice way to put this: In much of the country, the next few months will be a really bad time to be really sick with COVID-19. Or to break an ankle. Or to get appendicitis.”

Health-care workers started the pandemic ill-equipped and overworked. They have had to deal with repeated onslaughts of patients, some of whom are actively hostile and even violent. Thousands of nurses and other workers have retired or simply quit. A StatsCan survey almost a year ago said 70 per cent of health-care workers reported worse mental health than before the pandemic began. That number is likely to have risen since then.

Since the pandemic is nowhere near over, our health systems will be increasingly unable to cope with future surges. Worse yet, thousands of COVID survivors are now dealing with long COVID. They will need care for months or years.

Meanwhile, WHO has developed materials dealing with pandemic-related damage ranging from alcoholism and drug abuse to stress in orphaned children and suicide in health-care workers. They amount to a reliable forecast of what’s coming next.

Somehow we will have to find or train enough qualified people to care for the long-haulers and those coping with mental-health issues. The Canadian government predicts a serious shortage of caregivers.

“For registered nurses and registered psychiatric nurses, over the period 2019–28, new job openings (arising from expansion demand and replacement demand) are expected to total 191,100, while 154,600 new job seekers (arising from school leavers, immigration and mobility) are expected to be available to fill them.” Demand for psychologists will also outstrip supply.

We’ll have to find or train most of those new workers here in Canada; it would be unethical to recruit them from poor countries trying to cope with similar problems. And we will have to retain them through future disasters.

6. We’ll never go back to the ‘before times’

The neoliberal world order established since the 1980s has been brutally shaken since New Year’s Eve 2019, exposing political failures ranging from worsening climate change to the migration crisis and systemic racism. Yet governments behave as if the pandemic scarcely exists. They play familiar Cold War games: Russia threatens Ukraine, China bullies its critics, the U.S. pretends it’s the leader of something called the “free world.”

It’s understandable to yearn for a world without a pandemic. But the “before times” got us into this mess. If we did go back to before-times economies and social relations, we would soon face still more pandemics and social conflicts.

As the pandemic continues, with occasional guest appearances by climate disasters like last summer’s heat dome and November’s floods, many of the world’s leading nations (and leaders) are hollowed-out remnants of what they once were. Internally divided, they pretend it’s business as usual. But they seem terrified of their own people and unable to define and carry out a consistent pandemic policy.

So, having learned nothing from the pandemic, they continue as they began — unless and until we elect new governments that really have learned from the past two years.

Happy holidays, readers. Our comment threads will be closed until Jan. 3 to give our moderators a break. See you in 2022!  [Tyee]

Read more: Health, Coronavirus

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