Although far from over, the COVID-19 pandemic has already provided important lessons. From the public health point of view, perhaps the most important one is that the best service a government can give its citizens – and to the rest of the world- is to never ignore, dismiss, or hide the extent of an infectious disease outbreak, because it has the potential of becoming an epidemic or even a pandemic that will spread throughout most countries in the world.
Sound information is essential in controlling an epidemic effectively. The backbone of public health policies and actions entails accurate and reliable statistics about the number of cases and their location. When a viral infection evolves in a way that seems ominous from the beginning, the moral responsibility of all governments is to make this information widely known so that adequate measures of protection can be taken at the global level.
Further, it is important to convey such information through the World Health Organization (WHO), where all governments (including the United States) are represented, to insure the formulation of adequate policies. Delay in conveying this information has been costly in the fight against COVID-19, allowing the pandemic to progress at a vertiginous pace and causing an unnecessary loss of lives.
Equally crucial is to know how many diagnostic tests and hospital beds are available, as well as the number of health professionals with protective equipment and all other resources necessary to combat an epidemic. Where these resources are insufficient, the government should be prepared to take all measures to make them available at the first sign of an epidemic. Outbreak and epidemic preparedness plans already exist in most countries, so national authorities should make sure that they are periodically checked and updated.
Because a pandemic is a public health issue with heavy political overtones, it is tempting to put political figures in charge. This mistake is proving costly, since only public health experts have the technical knowledge to understand the dynamics of the outbreak and control its spread. Recent examples of political leaders touting untested cures that may end up being more dangerous than helpful show the dangers of this approach. President Donald Trump’s suggestions that the coronavirus could be treated with household disinfectants and UV light injected under the skin have caused surprise and consternation worldwide.
It has been estimated that one in three people turning 65 will require nursing home care at some point during her or his life. However, the low quality of care in nursing homes has been an important contributing factor in the high mortality rates of people 65 and older when facing an extraordinary event such as the COVID-19 pandemic. The government should have stricter control of nursing homes, making sure that care providers be adequately guided to avoid bringing the agents causing these outbreaks into such vulnerable populations.
Fighting any pandemic demands optimum coordination between the central government and the states, with clear cut directives and resources coming from the top. Instead, lack of centrally-led coordination with local authorities, as happened in the U.S., has led them to fierce competition for scarce resources to fight the infection. In addition, incendiary messages from the President created an atmosphere of unrest, detrimental to an effective and technically sound fight against the coronavirus infection. Several public health experts believe that better coordination and a technically sound response from the White House would have saved thousands of lives.
An important lesson unknown until recently is that people infected with the coronavirus are contagious before becoming symptomatic; thus, the failure to contain the pandemic from the very beginning. This underscores the importance of proper and widespread testing in order to isolate all those afflicted by the disease.
Effective measures implemented in South Korea, Germany, and Singapore, among other countries, to control the infection demand a strong, well prepared and financially sound public health system. The COVID-19 pandemic has been the greatest challenge to our civilization and to our way of life in the last century. Ignoring these basic lessons is an invitation to disaster.
Dr. César Chelala is an international public health consultant.