A litany of failures that led to too many graves
When alarm bells blaring turned into funeral bells tolling …
February 2020: A lost month that will haunt the world for years and years to come.
Failures of recognition and response, minimizing of urgency, chaotic and unco-ordinated international strategies, a lumbering reflex by the World Health Organization — think the Queen Mary executing a full-point turn at sea — all contributed to a “toxic cocktail” that allowed the coronavirus pandemic to flourish unchecked.
When there was still a chance to curb its global impact. It didn’t have to be this way. There are more than 3.3 million dead from COVID-19 and nearly 160 million infected.
“February was a lost month of opportunity to contain the outbreak, even as the evidence of infections spreading globally was apparent,” concludes a voluminous report issued this week by a WHO independent review panel.
The pandemic, continuing to rage in parts of the planet through third and fourth waves, was the world’s 21stcentury “Chernobyl moment” and nobody — no country, no institution, no scientific authority — rose with alacrity to the disaster looming on the horizon.
There’s plenty of blame to go around, but, at the apex of paralysis was the WHO itself, sluggish and bureaucratically bickering during that monthlong gap.
Instead of taking a bide-yourtime approach, the WHO should have declared a global emergency considerably sooner than it did, asserts the critical assessment report from a panel that spent eight months investigating the how and why of the pandemic.
It was on Dec. 9 that Wuhan doctors first reported clusters of pneumonia of an unknown origin. On Dec. 30, two urgent notices were distributed to hospital networks in the city.
Initially, the outbreak was linked to a wet market and zoonotic transmission, that is to say spread from animals to humans, although the report observes that more recent research links between 55 per cent and 67 per cent of the Wuhan transmission to the wet market, indicating the markets amplified rather than originated the spread.
At that point, by the end of the year, China had yet to disclose what it knew: SARSCoV-2, and the disease it caused, was “very likely” being transmitted person to person.
On Jan. 4, following a technical briefing, WHO issued its first hint of a befuddling illness, on Twitter, followed the next day by its first Disease Outbreak News notice.
Over Jan. 22-23, WHO’s Emergency Committee was still divided over whether the agency should declare a “public health emergency of international concern” (PHEIC), which wasn’t done until Jan. 30, when there were already 98 cases in 18 countries outside China.
And not until March 11 did WHO declare a global pandemic, with roughly 118,000 cases reported in 114 countries.
An entire month squandered, the organization steeped in innate conservatism and legally binding rights and responsibilities which obstructed urgency.
Travel restrictions imposed more hastily, more widely, would have seriously inhibited rapid transmission.
But on Jan. 30, WHO did no such thing, declining to recommend travel or trade restrictions, instead adhering to International Health Regulations that aim to “avoid unnecessary interference with international traffic and trade.”
In any event, the late January PHEIC was ineffective, says the report, the alarm bell registering only faintly around the globe. It didn’t trigger a “forceful and immediate emergency response in most countries,” despite rampant global transmission and hospitals in Italy beginning to be overwhelmed.
The tide was surging, crashing against countries’ shores.
Even after the emergency was declared, “too many countries took a ‘wait-and-see’ approach, rather than enacting an aggressive containment strategy that could have forestalled the global pandemic.”
While its authors take quite a hard line on mistakes made, there is still a hesitancy to point fingers at specific culprits; no country or organization is singled out.
For example, it merely suggests that China should have acknowledged human-tohuman transmission sooner than it did in early 2020.
But it’s debatable, and moot, whether the WHO would have got its act in gear, even then.
“The Independent Panel has found weak links at every point in the chain of preparation and response,” the report emphasizes. “Preparation was inconsistent and underfunded. The (global) alert system was too slow — and too meek.”
And, of course, capitals around the world, including Ottawa, were taking their cue from the WHO, giving only mild warnings and providing wayward advice, such as dismissing the need for masking and rejecting bans on foreign travel, out of concern for international trade being choked and lest there be an appearance of xenophobia.
Restricting travel was viewed as a “last resort.” (Now we put travellers in fever-shack hotels for potential infection, at their hefty expense.)
Twenty-twenty hindsight is easy. Except global health experts were already wellversed in how quickly an epidemic could race out of control, in particular, in the form of lessons learned from the outbreak of SARS, which struck Toronto in 2003.
The critical report lays bare the deficiencies of preparedness metrics which led, among countless cascading consequences, to a worldwide scramble for personal protective equipment (PPE), exacerbated by greed among manufacturers as prices for surgical masks shot up, N95 respirator costs tripling, procurement often requiring 50 per cent cash up front, with no quality assurances.
That led directly to COVID-19 ravaging long-term care homes and other congregate settings, where staff either were not provided with essentials or had to make multiple use of what they were given, with incoherent instruction on protocols.
By June 2020, the report notes, less than 20 per cent of global demand for PPE had been filled.
Why the torpid response across the board?
The panel identified two main reasons: first, countries “did not sufficiently appreciate the threat and know how to respond”; second, “in the absence of certainty about how serious the consequences of this new pathogen would be, ‘wait-and-see’ seemed a less costly and less consequential choice, than concerted public health action.”
Trillions of dollars later in pandemic-infused expenses and convulsing economies, we now know the financial calculations were tragically misguided.
Inequities, further, have been boundless, as seen even now in the global distribution of vaccines. More than 1.36 billion doses had been administered as of Wednesday, but that’s just 8.9 per cent of the global population fully vaccinated. India, a world leader in vaccine manufacturing, reeling under the onslaught of a record-breaking second wave, has fully inoculated only 2.8 per cent of its citizenry.
Vaccine nationalism and a “trust deficit” — this is seen in science, in political leaders — have worsened circumstances, despite the extraordinary of research and development that produced a variety of COVID-19 vaccines in under a year.
The report lists, in a companion volume, 13 “defining moments” of the pandemic as points of reference for the future. These cover everything from swift identification of novel coronaviruses to weaknesses in preparation systems and capacities.
Because there will be, indisputably, a next time.
The number of infectious disease outbreaks, from Ebola to Zika, has been accelerating.
Air travel has increased fourfold since 1990 and guarantees swift transmission across all corners of the planet.
Environmental stresses, encroaching of urban into previously wild areas, population growth and poverty … all are factors that haven’t been addressed seriously.
“We can no longer separate human health from ecosystems and animal health,” the report warns.
Among its recommendations for pandemic-proofing and reform proposals, the report urges establishing both a global-threats council with the power to hold countries accountable and a disease-surveillance system; publishing information without approval of countries involved; declaring classification of vaccines as public goods with pandemic financing; and issuing an immediate request for the wealthy G7 nations to commit $1.9 billion (US) to the WHO’s COVAX vaccine-sharing program, providing vaccine support to low-income countries.
The sobering gist: We’ve been here before. We’ll be here again.
“The risk of a new respiratory pathogen is high.”