Thread by @clarewenham

The thing that makes me the most frustrated about #COVID19 (and has for many months) is the failure to learn lessons from previous outbreaks, particularly about the downstream effects of #pandemic response policy. A thread 1/

This morning @BBCr4today @TheCrick discussed disruption to non-covid #clinicaltrials ; also have seen depressing delays to #cancer detection and treatment ; and changes to routine SRH, maternity, NCD, mental health services.

This is well documented impact during #Ebola 2/

Economic disaster at macro + micro levels follow outbreaks - look at economic impact SE Asia post #SARS and W-Africa post #Ebola ... and to look at individual narratives of household financial hardships & increases in poverty (w/associated disease, kids out of school to work) 3/

#socioeconomicdeterminants of health @MichaelMarmot show that disease burden fall on marginalised communities

#socialscience research in #ebola #zika shows socio-economic burden of #publichealth interventions (quarantine, closure of public life) falls on marginalised too 4/

Much concern over "securitized" response - ranging from military / police in implementing quarantine to re-organisation of @PHE_uk to be focused on "threats".

We have consistently seen this in public health policy at global and national levels for decades 5/

Govs fighting over #vaccine access and #treatment options - again, nothing new here - think about H5N1 and Indonesia virus sharing controversy.

Govs talk of global #solidarity and #publicgoods in the abstract, but at crunch time will always protect their citizens first. 6/

The 'blame @WHO or blame #China narrative' is also highly inevitable, and has been seen in #Ebola, #H1N1, #SARS etc.

Much easier for #govs to scapegoat than take responsibility for their own failures. 7/

I cant read another headline which highlights these highly predictable secondary effects!

The real controversy, and one for which we must hold #govs to account is if these are all well evidenced, why have we let this happen again? Why were these risks not mitigated against? 8/

A lot of this I suggested in March - and still valid.

But why hasnt any of this evidence (and the wealth of other excellent work by #globalhealthsecurity colleagues) been used to inform policy and prevent the chaos we are now living in? 9/

https://twitter.com/clarewenham/status/1235546249681657857?s=20