After two years of Covid-19, the world is no better prepared for a pandemic today than it was in 2019.

That’s the damning assessment of the latest Global Health Security Index released last week.

Upsetting, but not surprising.

A 🧵 on what worries me:
nytimes.com/2021/12/08/hea…
Many would assume our response would be better next time, especially after all we’ve learned.

But that’s not a given.

For me, we face 3 critical weaknesses and vulnerabilities:

1. Eroding trust in public health leadership

2. Misuse of travel bans

3. Global vaccine inequity
1. Eroding trust in public health:

Public health has always been political. But the pandemic pitted one against the other.

No, CDC & FDA haven’t been perfect. But politicians spouting falsehoods have aggressively worked to undermine confidence in our public health institutions
Many across the country are less likely to follow public health advice today than they were in Mar 2020.

It’ll take a long time to rebuild trust.

That’ll be near impossible if equating Fauci to a Nazi war criminal isn’t met with widespread condemnation.
2. Travel Bans

The way many countries responded to the emergence of Omicron was a stark reminder of how little we’ve learned.

Travel restrictions may help slow spread in some circumstances. But it quickly became clear that with Omicron, they’d do little more than stigmatize.
We soon found that Omicron was circulating in many places before it was first detected. It’s now in dozens of countries and throughout the U.S.

And yet the bans remain. As does their warning: being open about emerging health threats may get you cut off from the rest of the world
3. Global Vaccine Inequity

The # of booster doses administered in the US is greater than the # of 1st doses administered in the countries targeted by the travel ban.

Wealthy countries hoarded vaccine at their own peril while the rest of the world was forced to rely on handouts.
Instead of using this opportunity to expand vaccine manufacturing in places like sub-Saharan Africa—which imports 99% of its vaccines—we doubled down on the same trickle-down charity model that prioritizes pharmaceutical profit over future preparedness.

This is a huge failure.
This report should be a global wake-up call. Yet I worry it’ll be overlooked and ignored.

We all know this pandemic has been devastating. The only thing that would make it worse is if we don’t learn from it and sleepwalk into all the same mistakes the next time around.

End
(link to the 2021 Global Health Security Index report)

ghsindex.org

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More from @Craig_A_Spencer

26 Nov
Some thoughts on the new variant, B.1.1.529 (aka ‘Nu’):
First and foremost, there is reason for concern, but nearly everything is still unclear at this moment.

The incredible team of scientists in South Africa that identified the variant along with @WHO and others are doing the research right now to answer 👇 important questions…
What IS clear is that knee-jerk reactions like banning flights may be politically palatable, but will do little to slow the spread of this variant.

In the coming days more countries will identify cases. And there’s a good chance it’s already spreading here and in other places.
Read 10 tweets
12 Nov
Seven years ago today I walked out of the hospital after surviving Ebola.

That day at a news conference—my knees shaking—I begged the world to focus on the still-raging outbreak in West Africa. Instead, when the immediate threat was over, we moved on.

Years later, Covid hit 🧵
There were so many lessons we should've learned from Ebola.

Foremost amongst them was the importance of global solidarity in responding to global health threats.

But that's a lesson we just didn't learn. Instead, we dodged a bullet and we moved on.
thelancet.com/journals/lance…
Few people knew that the New York City hospital where I was treated for Ebola had more doctors than Guinea, Liberia, and Sierra Leone—the 3 hardest-hit countries of the Ebola outbreak—COMBINED.

And SO many frontline providers in those countries died of Ebola during the outbreak.
Read 11 tweets
6 Aug
Are you fully vaccinated but worried about Delta? You’re not alone.

In my latest for @TheAtlantic, I explain why everyone needs to relax. The vaccines are still working just fine.

theatlantic.com/ideas/archive/…
I understand everyone’s concern. Delta cases are surging nationally.

Some pharmaceutical companies say their vaccines hold up, while others are less sure.

And in the aftermath of the Provincetown outbreak, hot vax summer started feeling more like hot mask summer overnight.
Misleading headlines and leaked slides added to everyones worry. Everyone is asking me:

“I’m fully vaccinated…but do the shots still protect me?”

Of course they do.

The vaccines are incredible, but they’re not perfect. They never were.
Read 8 tweets
5 Aug
Moderna: Our vaccines are still SUPER effective!

Also Moderna: BUT you're def gonna wanna get one of our special booster shots! 😉

Pharma companies stand to make billions by pushing boosters, whether you need one or not.

For the great majority of you, you don't.
Oh boy, the replies. Ok let me clarify:

Who likely needs a booster: organ transplant recipients, the immunosuppressed (e.g. on chemotherapy), and some J&J recipients [particularly the elderly].

Everyone else? There’s no data they are indicated yet.

See 👇 by @celinegounder
“Ok, whatever. What’s the downside of getting one?”

For starters, globally vaccines remain in very short supply. Most are concentrated in wealthy countries.

What’s something that’ll actually make you safer? Get people around the world their first dose before we get our third.
Read 6 tweets
12 Jul
I absolutely agree with your goal Rep. @AOC—we desperately need to get the rest of the world vaccinated.

But instead of making nations reliant on US exports, we must expand vaccine manufacturing globally.

The US MUST help the rest of the world scale-up vaccine production. 🧵
Over 2 months ago, the US waived intellectual property protections for Covid-19 vaccines. Many (including myself) applauded the decision.

But there’s since been little movement on transferring the technical know-how needed to expand global manufacturing.

ustr.gov/about-us/polic…
If we want to end the pandemic and make a long-term difference, we need more than just donated doses.

US financial & technical support can help build critical vaccine manufacturing capacity in countries where production is severely limited or nonexistent.
doctorswithoutborders.org/what-we-do/new…
Read 7 tweets
11 Jun
I can’t remember the last time I saw a Covid patient in the emergency room. I couldn’t be happier.

I wrote about what it feels like to have my old job back.

I'll share a bit in this 🧵, but 👇story is describes it all...
elemental.medium.com/i-dont-miss-co…
As Covid cases decline, our job in the ER feels just like it used to for the first time since the virus surged into our hospitals.

It was a year ago that we made this animated video to show what a “normal” day on the Covid front lines looked like...

Even if our job is getting back to normal, to be honest, it was never a cakewalk. We see really sick patients every shift, and sadly some of our patients die.

But Covid brought a whole new level of chaos and craziness.

It's much better like it is now.

Read 5 tweets

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