Public health bodies must be more open about the scale of coronavirus
‘We may finally be grasping the true extent of the threat to world health and the global economy’
The emergence of coronavirus in China and its rapid escalation from outbreak to epidemic in three months have put public health arrangements on a global platform.
With a proud tradition in the field, dating back to when John Snow removed the handle from the Broad Street pump to end Soho’s cholera epidemic in the 1850s, we tend to assume we have little to learn from abroad. But if the response by Public Health England to coronavirus is anything to go by, we still appear to be equipped only for the 19th century rather than the 21st. Its response so far smacks of paternalism and secrecy.
The reluctance to put up credible people for interview has not gone unnoticed in the media, while at local and national levels public health representatives have been silent. Word has it that some were told to keep their heads down for fear of rocking the boat.
It took Chris Whitty, the Chief Medical Officer, two weeks to make an appearance on the Today programme to discuss the UK’S response.
Over 30 years we have experienced new threats to public health, including bovine spongiform encephalitis (mad cow disease), avian flu, severe acute respiratory syndrome (SARS), swine flu, ebola and now corona. With each, lessons were learnt that hopefully will carry forward for the next time.
One such lesson has been that tight control of information is all but impossible in the internet age. Any effective response must now view the public as equal partners in containing and controlling potentially serious outbreaks, and understand that good communications are of the essence. Public engagement is vital if this outbreak goes pandemic, when the community itself will bear the brunt of prevention and care of the sick.
Although the rapid and effective response to outbreaks depend on reliable data, it seems the nature of the Chinese regime militated against a proper understanding.
However, with the WHO stepping in and a sharp revision of the number of cases and deaths, we may finally be grasping the true extent of the threat to world health and the global economy.
It has become apparent that in the social media age, even regimes like China’s cannot keep the lid on public discourse. Yet if governments keep their populations in the dark, rumour and panic may be the beneficiaries. The UK has some of the world’s strongest technical capabilities; behind the scenes, staff will do all they can to contain the outbreak. But in a situation like this we must think the unthinkable and plan for worst-case scenarios in which hundreds of thousands might become infected, and thousands die.
To prevent this we need a wholesystem response coupled with an engaged population to head off a public health and economic disaster.
Open and trusted communications are essential yet so far have been weak. We have a short window of opportunity to ensure at national and local levels there are trusted voices to engage with the public. Only then can we strike the necessary balance between readiness and response, and anxiety and panic.
John Ashton is a professor at Liverpool University and was director of public health for the North West of England