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. 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: 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. 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. 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. 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: 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

30 Apr
Globally, the end of the pandemic isn't near.

More than a million lives depend on improving our response quickly.

Don’t be blinded by the light at the end of the tunnel. There isn't enough vaccine and the virus is gathering strength & speed. Global cooperation is crucial. 1/
India’s surge is a reminder that the virus is learning about and adapting to us faster than we're learning and adapting to it. Covid, fueled by variants, is an ongoing & increasing risk. The pandemic is more severe than ever—more transmissible, more deadly, more human fatigue. 2/ Image
Dazzling scientific progress resulted in Covid vaccines that are more effective than many experts dared to hope. But although Israel, the UK, and, soon, the US will have a new reality with the virus largely tamed by vaccines, global vaccination lags badly. 3/ Image
Read 21 tweets
16 Apr
Benefits, Risks, and Future of Vaccines and the Pandemic

Our vaccine safety monitoring system works. Reports of blood clots led to quick investigation, quick action, and transparency about what is known, not known and next steps. Vaccines remain our way out of the pandemic. 1/14
Global collaboration has been critical throughout the pandemic. Public health and medical experts around the world are collaborating to determine whether the events associated with AstraZenenca vaccine are the same as these events which may be associated with the J&J shot. 2/14
Tech transfer is crucial. The pandemic is the world’s most important problem. mRNA technology is our best solution. Create high-quality manufacturing platforms and hubs around the world to improve vaccine access. mRNA technology is an insurance policy against the pandemic. 3/14
Read 14 tweets
9 Apr
The US vaccination campaign is facing a fundamental challenge: getting the vaccine where it’s needed most. Millions of Americans are still unprotected, many of them at high risk of severe illness. Our 4th surge is beginning. Lives are at stake. 1 of thread/
1 in 3 people in the US have gotten at least one dose of vaccine—but that means 2 in 3 haven’t. Millions of people age 50-64 and 65+ who haven’t yet been vaccinated can still get Covid and are at much higher risk of severe illness or death, especially with the new variants. 2/
Some states are doing much better than others reaching older people: NH, VT, ME, RI, CT, MA, SD have given >1 dose to more than 85% of residents 65+ years old. In TN, WV, MS, Alabama, HI, and PR that proportion is less than 70%. 3/
Read 18 tweets
2 Apr
Covid Epi Weekly: The Centrality of Equity

Lots of good news on vaccines, but the virus and variants are gaining ground. Variants are spreading rapidly in the US, driving (along with premature opening) the fourth surge that’s now underway. 1/
I had planned to stop Friday night threads, but couldn’t help sharing thoughts on this week’s developments—there have been so many.

Fourth surge is building. Cases up 8%, test positivity up to 5.1%. Michigan situation worse, other states could follow. 2/
News on vaccines just keeps getting better. CDC study of mRNA vaccines found that Pfizer and Moderna vaccines blocked 90% of infections. Vaccinated people won’t spread much disease. HUGE implications for guidance for fully vaccinated people and the trajectory of the pandemic. 3/
Read 22 tweets
27 Mar
Covid Epi Weekly: An Epidemic of Vaccine Inequity

As predicted, a US 4th surge appears to be beginning, fueled by variants and reopening. Cases up 7%. Positivity inching up, to 4.7%. Because of vaccination, deaths won't increase substantially. We must solve vaccine inequity. 1/
Michigan hospitalizations are increasing rapidly esp. among 40-49 y.o. Middle and high school 30% increase in cases associated with outbreaks in tandem with increased community transmission. Fewer people staying home, similar to prepandemic levels. Harbinger of spring surges? 2/
Important new data on the mental health harms of the pandemic in the US. Large increases in depression and anxiety, especially among young people and those with less education. Treatment hasn’t kept up. At least 12 million more Americans are struggling.3/
Read 23 tweets
26 Mar
It's very unlikely that SARS-CoV-2 was created in a lab. The genetic information strongly suggests that the virus evolved naturally.
Is unintentional lab release a possibility? Yes, as the review commission has noted.
The last human case of smallpox was the result of a lab error in the UK. It is believed—though not proven—that a flu strain accidentally released in the former Soviet Union in the 1970s spread around the world.
Read 6 tweets

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