Dr. Tom Frieden Profile picture
May 13, 2021 24 tweets 9 min read Read on X
The Last Pandemic?

The Covid pandemic has killed 3+ million people and driven 115M people into extreme poverty. It will cost the world $22 trillion by 2025. And it didn't have to happen.

A new report could be pivotal in efforts to prevent the next pandemic. 1/
The Independent Panel for Pandemic Preparedness and Response (@TheIndPanel) was created last year by @WHO to ensure the world is better able to address health threats such as Covid. They released a sweeping new report. nyti.ms/2RS1TTV 2/
Because the recommendations detailed in the report are so important, I’m going to highlight some of them in the hope that the story of Covid isn’t repeated. Read the report here: bit.ly/3w6nEyr 3/
This is a succinct, chilling summary of the pandemic’s impact. 4/
Numbers don’t tell the full story. We won’t ever be able to account for the full impact of Covid and how the pandemic has disrupted and derailed people’s lives. 5/
Infectious diseases tend to be guided missiles aimed at the poor and disenfranchised. True to form, Covid has been a pandemic of inequality, injustice, and inequity. 6/
The pandemic is far from over. @TheIndPanel provides an excellent list to address Covid now. That starts with core public health interventions including masks, distancing, avoiding super spreader events, sharing vaccines/vaccine technology & setting focused goals at WHO level. 7/
February 2020 may not have been the cruelest month, but it was decisive in the world’s indecision. Countries that organized, followed science, and acted quickly did much better. 8/
The underlying causes of our lack of preparedness haven’t been addressed. Past reports and recommendations haven’t been heeded. We must break the deadly cycle of panic and neglect. 9/
These are five areas for urgent improvement. 10/
The report offers some details for how to improve leadership. A Global Health Threats Council has potential—parallel to, but learning lessons from UN Security Council. A Framework Convention is less risky than a Treaty, but either could derail progress unless handled well. 11/
Good details on ESSENTIAL reforms needed at WHO. Every one of these is important. The 7-year terms for the DG and RDs could be transformational, and the HR point is crucial, although success addressing this will be complex—the devil is in the details. 12/
WHO country offices must be strengthened for WHO to be effective in countries. Financial independence would be great, but may be difficult to achieve. 13/
It’s crucial that we invest in preparedness now. Our team at @ResolveTSL has called for a global 7-1-7 target, in line with these recommendations. bit.ly/3fcz2So 14/
We also urgently need better surveillance. That means the ongoing, systematic collection, analysis, and interpretation of health data, with the dissemination of the information to those who need to know. It must also lead to action. 15/
Surveillance requires healthcare and public health systems that people trust, functioning lab networks, trained epidemiologists, clinicians connected with public health, analytic capacity, the ability to collect and analyze info from multiple sources, and more. It’s crucial. 16/
It will require years of hard work for us to achieve effective surveillance. Digital tools can help, but lack of digital tools is very far from being the main barrier to improved surveillance, which must be real-time, sensitive, accurate, and actionable. 17/
Making a safer world is not only about people and systems, but also about stuff: Diagnostics, treatments, and, of course, vaccines. We and others have been calling for this for months. Now means now. politi.co/3w6kVFd 18/
All of that requires money. How would a global pandemic facility be created? Where would it sit? Who would fund it? @TheIndPanel is hoping the G20 will take the lead and move this forward next week. 19/
Every country in the world needs to up its preparedness game. Even Singapore, which has done superbly at Covid control, was caught unaware by explosive spread of Covid among their large and poorly-served immigrant worker community. bbc.in/3uPZJmw 20/
Just as MLK Jr. said injustice anywhere is a threat to justice everywhere, ill-health anywhere is a threat to health everywhere. 21/
At the end of the report, there’s a good multi-page timeline with all 28 recommendations (plus 6 for the current pandemic), including who’s responsible and when it should be done by. Here’s the link to the report again: bit.ly/3w6nEyr 22/
It’s up to the world to act. But “the world” isn’t one person or org. Every country has a responsibility. WHO has a responsibility. The G20 could be important. The IMF, Global Fund, World Bank and other financial institutions, WTO and others all have important roles to play. 23/
The recommendations in the @TheIndPanel report are all important, not to be cherry-picked. Yes, similar recommendations have been made before. What must be different now? We must act, or the next pandemic could be even more devastating. 24/end

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More from @DrTomFrieden

May 3, 2023
Updated Covid booster recommendations and the unwinding of the public health emergency in the United States have raised questions and highlighted lingering challenges. How should we be thinking about these developments? Who should get a booster this spring? 1/thread
Covid hasn’t gone away, but it no longer poses the same threat to most people it did in the first years after its emergence. This is due, in large part, to lifesaving vaccinations and treatment, and also to prior infections, which reduce the risk too. 2/
Our wall of immunity, built up from both vaccinations and infection, is strong—but it’s not impervious. Protection wanes, and the virus continues to mutate. Even now, older adults and medically vulnerable people remain susceptible to severe illness and death. 3/
Read 19 tweets
Apr 8, 2023
In New York City, Covid killed more people than any other cause in the pandemic’s first year and caused life expectancy to drop by 4.6 years on average, according to the newly released annual report of NYC vital statistics. Confirmation of a devastating toll. 1/thread
What gets measured can be managed, which is why reports like this are crucial. More than 200 New Yorkers die every day, including >50 people under age 65, a data point I tracked closely as NYC Health Commissioner and focused intently on bringing down. bit.ly/41cFZcm 2/ Image
Every life counts. A moving piece published last week in @nytimes shows vividly the necessity—and challenge—of tracking all births and deaths. 3/ bit.ly/3Gmll1O
Read 10 tweets
Mar 17, 2023
The past three years of fighting Covid feel like a fog of war. Although everyone wants to move on, we must reckon with how bad the pandemic was—and how much worse it could have been. 1/thread
20 million excess deaths have occurred during the Covid pandemic—more than all but the two other leading causes of death, cardiovascular disease and cancer. Without vaccination, measures to reduce infections and lifesaving medical care so many more lives would have been lost. 2/
Those who are intent on undermining public health action argue that there was nothing we could have done to counter Covid, that all of the infections and deaths were inevitable. But they ignore that some places had much lower rates of infections, hospitalizations and deaths. 3/
Read 15 tweets
Feb 23, 2023
Masks have been an effective tool throughout the Covid pandemic, despite erroneous claims to the contrary. 1/thread
The widely cited Cochrane review on masks was poorly done and even more poorly communicated. Regrettably, researchers analyzed the wrong datasets, in the wrong way, and overstated their conclusions—leading to sweeping and inaccurate characterizations. 2/
Many nuances around mask type, setting, behavior, and policy are explained in this helpful piece by @dr_kkjetelina. bit.ly/3ErwuNN 3/
Read 15 tweets
Feb 4, 2023
Over the past decade, global smoking rates dropped by 23% and 750 billion fewer cigarettes are sold annually. But despite this progress, tobacco is still the world’s leading cause of death and unless we do more, will kill ONE BILLION people in this century. 1/thread
The FDA recently announced a national ban on menthol cigarettes and a new California law to curb flavored tobacco was overwhelmingly affirmed by voters in November. Big Tobacco's reaction to these two recent public health wins underscores the fight we have ahead of us. 2/
Why are these wins significant? Big Tobacco has a long history of targeting Black communities with menthol cigarettes. The FDA ban could undo shocking disparities in lung cancer deaths suffered by Black Americans compared to their white counterparts. bit.ly/3JtXQWQ 3/
Read 8 tweets
Jan 29, 2023
Amid discussion of the future of Covid vaccination, we can’t lose sight of the present: Only 1% of immunocompromised people in the US received a full set of Covid vaccinations as of Aug. That’s a colossal failure. The 5 steps to avoid failure in public health explained 1/thread
500 people are still dying from Covid every day. That’s not normal and it doesn’t have to happen! Immunocompromised people—along with the elderly—are at the highest risk of dying from Covid. 2/
Vaccines are remarkably effective against severe disease, but their protection must be reinforced, especially for vulnerable people. Boosters reinforce our protection, and a new CDC study underscores their importance. bit.ly/4062XCq 3/
Read 24 tweets

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