“When asked what was the biggest disaster of the twentieth century, almost nobody answers the Spanish flu,” notes Laura Spinney in her book Pale Rider, of an event that killed as many as one in 20 of the global population. “There is no cenotaph, no monument in London, Moscow or Washington DC.”
Most of us will better understand that absence after Covid-19, which was declared a pandemic by the World Health Organization five years ago this week. Some cannot put those events behind them: most obviously, many of those bereaved by the 7 million deaths worldwide (not including those indirectly caused by the pandemic), and the significant numbers still living with long Covid. Others want to forget the loss of loved ones, the months of isolation and the costs to businesses, families and mental health.
Yet the political, economic and social ramifications are still playing out, just as the personal ones are. We now know more about the toll of the pandemic, and about how better preparation or a speedier and more adept grasp of the challenge could have reduced it. Some responses were exemplary: Taiwan, New Zealand and South Korea saved lives without excessive social costs.
In other places, secrecy, recklessness or complacency took a deadly toll. Too often, health workers and communities excelled while governments fell short. The first report from the UK Covid inquiry, published last year, pointed to “serious errors” by the state in pandemic preparations. Its next report, expected this autumn, will focus on political decision-making. The failures there are glaring. Almost 230,000 people died; studies suggest an earlier lockdown could have saved tens of thousands of lives.
A global reckoning is equally important. Though Covid-19 arrived just over 100 years after influenza swept the world, pandemics are not once-in-a-century events. The way we live makes them increasingly likely. The next pandemic could be caused by a virus more transmissible, more lethal, or both. Across countries, as well as within them, it was poor people who suffered most. But inequity in healthcare and vaccine distribution could cost everyone dearly. Efforts to produce a global pandemic accord have stalled and need reinvigorating when talks resume next month.
On the ground, there has been real progress, not just in vaccine technology but in measures such as access to medical oxygen, which are already saving lives. But preparedness means strong public health systems as well as good medical services. That’s a problem because one of the pandemic’s most potent effects was the sense of isolation and abandonment – even betrayal – that allowed conspiracy theories to flourish. While many felt immense gratitude to researchers and healthcare workers, others became increasingly distrustful not only of vaccines but more generally of science and authority. Robert F Kennedy Jr – who makes wild, false claims about immunisation and reportedly attempted to block the rollout of Covid-19 vaccines – is now the US health secretary. Measles cases are surging.
Covid-19 showed that pandemic response is not just about knowledge, policy and resources, but about people’s willingness to trust and protect each other. That more nebulous factor may be the harder part of the equation to fix, requiring social and political shifts. But as the WHO’s director general, Dr Tedros Adhanom Ghebreyesus, wrote this week, we have no alternative to pandemic preparation: “Our collective global security demands it.”
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