The ‘Catastrophe’ of 2020
As we entered the second half of the first year of our current pandemic, books already began to pop up discussing what went right, what went wrong, who’s to blame or celebrate, and other COVID-19 related topics. One such book is “The COVID-19 Catastrophe: What’s Gone Wrong and How to Stop It Happening Again” by Richard Horton. Dr. Horton is the Editor-inChief of The Lancet — a highly respected independent, international weekly general medical journal.
Part science, politics, and philosophy, the book reviews the virus’s progress and the response by governments of major countries around the world. Dr. Horton doesn’t hold back and makes it very clear he believes many countries, their politicians and scientists, failed to adequately protect their citizens from COVID-19. Going forward, his prognosis isn’t much rosier as he says “The virus that caused COVID19 isn’t going away. It will be with us for a very long time to come. The best we can hope for is peaceful coexistence,” even after a vaccine is developed.
Using the U.K., U.S., France, and Spain as examples of countries with talented researchers, he doesn’t know for sure why there was a collective failure to learn from the Chinese and Italian experiences and why so many nations continued to underestimate the virus. “Early government inaction led to the avoidable deaths of thousands of those citizens.” He speculates that scientists and politicians weren’t pessimistic enough in their predictions and policies. If they had been, “the deaths of hundreds of thousands of their fellow citizens around the world would have been avoided.”
Dr. Horton presents three countries that reacted quickly to the virus. China’s leaders were “scarred” by their experience with SARS so when they realized that a new SARS virus was circulating, instead of advising handwashing, they locked down entire cities and economies. As the first reports of COVID-19 emerged from China in January, the Taiwan government began screening inbound travelers, suspended all travel to China on January 21 and quarantined all arriving from the mainland. PPE was secured, schools closed, mask wearing compulsory on public transit and physical distancing implemented. Hong Kong initiated an aggressive testing strategy and quarantined those that tested positive in hospital. Contacts were told to self-isolate and people arriving from a country with cases were required to self-isolate for 14 days. Schools were closed, people were encouraged to work from home, and were asked to avoid mass gatherings and wear face masks. Germany followed suit with much of the same in early February, faster than most other countries.
He does acknowledge however that “Lockdowns around the world have increased some risks while reducing others.” The UN has estimated at least 15 million more cases of domestic violence due to pandemic restrictions. In the UK for example calls reporting concerns about child abuse rose 20%.
Johns Hopkins Bloomberg School of Public Health calculated that the pandemic lockdowns would lead, at the very least, to 253,000 additional deaths of children under five and 12,200 additional maternal deaths across 118 of the poorest countries in the world.”
In addition to the physical and mental health consequences of lockdowns the pandemic has also precipitated a deep recession and job losses with no prospect of a quick recovery. He does point out on the other side of the ledger road traffic injuries fell, air quality improved, and greenhouse gas emissions declined.
In the book, Dr. Horton discusses the potential for ‘immunity passports’ as a way for many of us to go around our usual life and unfortunately creating a divided society between the immune and the nonimmune. He believes its “far better, surely, to accelerate work to produce a vaccine and offer vaccination certificates instead. A vaccination certificate would shift incentives away from infection and towards immunization.”
He believes countries will work to strengthen and reform the WHO, even without the U.S. initially, collaborating to ensure progress for all nations toward universal health coverage. He says citizens will demand better responses and stronger systems of social protection, especially for the most vulnerable. His hope is that our leaders will grasp the opportunity to transcend their local interests and look outward. However, he isn’t optimistic, and without a global view, we are mutually bound to be fighting future pandemics again and again. Our health is interdependent. “COVID-19 is not an event. Instead, it has defined the beginning of a new epoch. It took a virus to connect us in life and in death.”