Fight Covid by learning so we can roll with the punches: 7 lessons for 2022

Editor’s Note: Dr. Tom Frieden, director of the US Centers for Disease Control and Prevention during the Obama administration, when he oversaw responses to the H1N1 influenza, Ebola and Zika epidemics, is President and CEO of Resolve to Save Lives, an initiative of Vital Strategies and Senior Fellow for Global Health at the Council on Foreign Relations. Twitter: @DrTomFrieden.

It’s been two years since Covid emerged, one year since vaccine distribution began, and one month since Omicron upended hopes for a winter of recovery. As we move into a new year, here are seven life-saving lessons from 2021 that can get us closer to ending the pandemic.

1. Get and make decisions based on real-time data

Data is the lifeblood of public health. Real-time data allowed South Korea, Israel and the United Kingdom to make rapid adjustments and inform the world about vaccination, variants, masking and more. Many places have made mistakes – opening too early, not masking, not vaccinating rapidly – but the biggest mistake of all is not getting and acting on data quickly.

All countries need to improve data systems. In the United States, public health programs must navigate a dense forest of payers, providers, health information systems and laboratories. Progress will take a multi-year investment. Globally, strong surveillance systems backed by accurate and rapid laboratory networks will be essential to meeting the first “7” of the 7-1-7 target for global preparedness.

2. Communicate effectively: ‘Be first, be right, be credible’

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Providing informative, fact-based recommendations is critical, particularly now that politicization, lack of information, and misinformation duel for the eyes and ears of the public while fueling their fears. Effective leaders who communicated successfully were able to empower people to understand their own risks and take appropriate action. New Zealand, Senegal and the Indian Health Service built trust and increased understanding, leading to wider acceptance of mitigation measures.

Helping people understand how hard it’s raining Covid in their communities can increase awareness of their own risks so they can make informed decisions about what risks to take and when.

3. Build trust through non-partisan political leadership

No matter how well-prepared a country’s public health infrastructure, good public health capacity can be undermined by bad political leadership. That’s why good governance, backed by evidence-based policies and clear communication to counter misinformation, are critical for an effective response. Higher trust increases acceptance of vaccines. Africa CDC’s strong leadership and ability to mobilize a continent-wide response early in the pandemic is a good example of strong leadership catalyzing action and results.

4. Protect health care workers

TOPSHOT - An employee controls health protection masks in a production chain of the Kolmi-Hopen company's factory, on February 1, 2020 in Saint-Barthelemy-d'Anjou, western France. (Photo by LOIC VENANCE/AFP via Getty Images)

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Tragically and unacceptably, 2021 continued a long-term trend of failing to protect health care workers, with many dying from Covid. Low pay, weak infection prevention procedures, shortages of personal protective equipment, long work hours, and lack of legal or mental health support are all reasons for the estimated global shortfall of 18 million health care workers in the next decade. We need a strong and resilient health care workforce not just for Covid response but also to treat and care for everyday health concerns and ongoing threats.

That means vaccinating every health care worker in the world as soon as possible; investing in training, tools and resources to make health care facilities safer; improving accountability; and increasing national and donor support for programs focused on health care worker protection.

5. Vaccinate the world

We’ve had remarkably safe and effective vaccines for a full year, particularly the mRNA vaccines from Pfizer and Moderna. Most people in high-income countries are now fully vaccinated, compared with less than 10% of Africa’s population. Although vaccines alone will not end the pandemic, we won’t be able to end it without them. We have to vaccinate as many people in the world as possible, as quickly as possible.

In 2022, that means greatly increasing production of mRNA vaccines and making distribution more equitable, as well as funding vaccination programs – not just vaccines – in Africa and elsewhere. In the medium term, we need to transfer mRNA vaccine technology to regional manufacturing hubs with capacity to scale up rapidly to meet global needs. And long term, we must position mRNA and possibly other technologies as a platform to address future variants and other emerging viral threats.

US President Joe Biden speaks about the administrations response to Covid-19 and the Omicron variant at the National Institutes of Health (NIH) in Bethesda, Maryland on December 2, 2021.

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6. Find and stop threats quickly

We should develop a global movement to achieve the 7-1-7 organizing principle, target and accountability metric so every country can identify every new suspected outbreak within seven days of emergence, start to investigate and report it within one day, and mount an effective response – defined by clear, specific benchmarks for different pathogens – within seven days.

In 2022, the world must greatly increase the financial, technical, and political investments needed to strengthen global health protection. South Africa’s quick detection and flagging of Omicron to the world provides a model for speed and quality of detection and response.

7. Make the world safer

Covid isn’t the last health threat our world will face. Uncontrolled disease spread anywhere is a threat to people everywhere. Covid has already killed more than 10 million people and crippled economies worldwide, costing at least $15 trillion to date. But the world remains unprepared for and unprotected from epidemics.

More than 7,000 life-threatening gaps in countries’ core preparedness and response capacities have been identified; it currently takes far too long – an average of more than 11 days – to detect and report outbreaks. Time is lives, especially in the early stages of a rapidly growing pandemic.

Although the next deadly health threat is inevitable – more than 100 are found each year in Africa alone – the next epidemic or pandemic is not. To prevent epidemics and pandemics, the world needs stronger public health organizations with additional funding, as well as the technical and managerial expertise to translate this funding into real-time improvements.

Substantial additional funding would allow The Global Fund, which has been effective at improving the prevention and treatment of HIV, tuberculosis and malaria, to create a pandemic preparedness window. A commitment of $1 billion a year from the United States could help transform empty words and failed promises into real action that breaks our cycle of panic and neglect. With these resources, the Fund could strengthen disease tracking systems, laboratory networks, rapid response capacity and more. Because every dollar the United States gives to The Global Fund is matched by two dollars from other countries, and because the Fund has been efficient and is well accepted by countries, this is a great investment. A proposed global pandemic treaty led by the World Health Organization could also help, but the treaty process is slow and uncertain.

If in 2022 we don’t greatly improve preparedness, we’re not likely to do so in our lifetimes.