COVID-19: fail to prepare,prepare to fail

Abstract

Coronavirus, or COVID-19, is here and everywhere. It is passing between us silently, almost unnoticed, and seeking out the most vulnerable in society. There is no vaccine and no treatment. Clinical trials are only just beginning.

Every drug is a miracle cure when a trial begins, buoyed by the overenthusiasm of sponsors, but the data often end up telling a less favourable story.¹ Just ask Tom Jefferson, an investigator who is even today fighting for the truth in the face of corporate greed.² Imagine a world where clinical trials are independently run, free of sponsorship bias? Imagine an untainted answer to a research question about a new drug or device? For some people, this is their idea of heaven – and understandably so.

Yet, today, heaven seems more abstract than ever. COVID-19 has created hell on Earth, spreading fear and death, and exploiting our human desires to meet, gather and travel. We encourage active ageing;³ COVID-19 forces the elderly indoors. We hope to lift mood with literature and art;⁴ COVID-19 forces governments to close theatres, libraries and museums. Parents of young children depend on childcare to navigate their careers;⁵ COVID-19 ends childcare and disrupts careers. We aspire to extend life;⁶ COVID-19 brutally shortens it.

It needn’t have been so. A lack of diagnostic testing kits, inadequate personal protective equipment, an over-reliance on modelling and reluctance to share research and study designs, all point to one conclusion: we were not prepared for a pandemic of this nature. This is a surprise, given the extent to which pandemic preparedness is highlighted in global health policy circles. We all needed to be prepared and nobody was.

We also needed some slack in the health and social care systems, but when healthcare is crippled by demand and social care is unfit for purpose, there is no slack. The pressure in our health and social care systems is so great that even a minor crisis becomes hard to manage, an existential threat.

COVID-19 is a major crisis, the greatest health threat of our lifetimes – and we go into it on the back of years of austerity and a collapsing health service, led by politicians who built their careers rubbishing science and enjoying shallow populism. We had to be better prepared if we believed the science and recognised the interconnected nature of our modern world. We had to be better organised if we recognised a genuine threat from a global pandemic. Politicians in the UK and around the world have gambled on the low risk of a pandemic of COVID-19 proportions, and they have lost. Public inquiries must follow once COVID-19 is behind us.⁷ By failing to prepare, we failed the public.

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