Brendan Shaw
" I declare an end to the public health emergency of international concern."
- Dr Tedros Adhanom Ghebreyesus, Director-General World Health Organization, 3 May 2023.
Significant news in the last few days with the World Health Organization declaring that Covid-19 is no longer a global health emergency.
Around 1,150 days after it first declared Covid to be a pandemic, the WHO has finally been able to designate Covid as no longer an emergency.
While the disease lingers on and, as WHO head Dr Tedros maintained, there is still scope for further Covid outbreaks and new variants, it is worth taking a moment to think back over the last three years or so and reflect on what humanity has been through.
One big question is to what extent have we gone forward or backward as a global society as a result?
What have we learned from the Covid-19 pandemic?
Health impact
When stories of multiple cases of an unknown pneumonia first started coming out of Wuhan in China in late 2019, few would have reckoned that this would have led to one of the worst pandemics in human history.
As of 3 May 2023, officially the WHO reports that to date there have been over 765 million cases of Covid and almost 7 million deaths since it first emerged in late 2019.
Of course, the official figures are much under-reported, given many deaths in many countries were not reported or not reported as being due to Covid.
Estimates by The Economist suggest that while the official global death toll from Covid stands at around 6.9 million, the total number of people who may have really died from Covid in the world ranges somewhere between almost 18 million and up to possibly more than 30 million people. The mid-point of the range is around 22 million people.
Source: Our World in Data. "Excess mortality during the Coronavirus pandemic (COVID-19)", https://ourworldindata.org/excess-mortality-covid?country=IND~USA~GBR~CAN~DEU~FRA, accessed 8/5/2023.
At these rates, this puts Covid-19 amongst one of the top 10 killers of people worldwide.
If you average the mid-point of 22 million people across the 1,243 days since the first confirmed Covid cases were reported in December 2019, that comes to 6.5 million people per year or just over 17,700 people every single day since the start of the pandemic over 3 years ago.
Moreover, global life expectancy has fallen across the world due to the outbreak.
Source: “Life Expectancy”, Our World in Data, Global Change Data Lab, University of Oxford, https://ourworldindata.org/life-expectancy, accessed 2/3/2023.
Whichever way you look at it, this has been one of the significant events in human history.
The longer-term health impact of the pandemic is only just starting to be understood. Long Covid is now becoming a recognised phenomenon, as is its impact on other non-communicable diseases, while the longer-term mental health impacts of the pandemic and society's management of it are becoming apparent.
Health systems themselves have changed as well, both for the better and the worse. New technologies like mRNA vaccines, genomic sequencing and digital health strategies have been given renewed emphasis, while health workforces around the world have been smashed as nurses, doctors, paramedics, pharmacists, administrators and other health system staff have faced structural burnout.
Social and economic impact
The economic impact of the pandemic has been astronomical. Various studies in recent times have documented its impacts.
The immediate short-term effects included lockdowns and border closures leading to substantial economic costs, disrupted supply chains, reduced workforces as firms were forced to close and many people left the workforce, airlines and travel companies were smashed and global trade declined substantially.
For countries and governments the costs were enormous. Surges in health spending required to deal with the pandemic, but these figures were dwarfed by costs to the economy, the cost of support packages and lost taxation revenue as a result of the economic recession induced by the pandemic.
The fiscal support provided by governments alone around the world cost around US$ 16 trillion and accounted for 15% of global GDP in 2020.
In 2020 alone, the global economy contracted by 3.5%, but today Covid-19 is disappearing in the rear view mirror at least insofar as its short-term macro-economic impact.
Source: Yeyati, E. & Filippini, F. 2021. "Social and economic impact of COVID-19", Brookings Institute, 8 June, https://www.brookings.edu/research/social-and-economic-impact-of-covid-19/, accessed 8/5/2023.
The longer-term economic impacts of the Covid pandemic are still being felt. The pandemic worsened economic inequality both within and between countries, government and country debt levels soared leaving countries potentially exposed to further economic shocks, and the workforces of many countries shrank as people left the workforce - either through death and disease or because of millions of individual epiphanies that they didn't like the hours and or the poor pay rates of their jobs.
The pandemic also contributed to the global surge in inflation (along with the war in the Ukraine) that has changed the medium-term global economic dynamics for at least the next few years and led to higher global interest rates.
In addition, the pandemic caused a broader re-think in policy, political and community circles about the merits or otherwise of globalisation, razor-thin margins in global supply chains, and relying on one or two countries to supply the world with vital global goods - everything from vaccines and personal protective equipment to vital rare minerals and tech.
The world is going through a period of de-globalisation - or at least some are trying to make that happen. Whether it proves successful or not remains to be seen.
Our language also changed. Phrases like 'the Great Resignation', 'WFH', 'vaccine strollout', 'resilience' and 'reshoring' became much more common - reflecting our changing view of the world and what we could achieve.
Unconscious uncoupling - what have we learned?
Ironically, hot on the heels of a global pandemic which, arguably, demonstrated the value of the world working together as one, we've yet again descended into bouts of decoupling and identifying the difference between us. History does sometimes tend to repeat itself.
This is the first global pandemic in human history where within a few weeks of discovering the virus we sequenced its entire genome, tweeted it around the world and within a year developed vaccines to protect us from it.
That's pretty good going. I'm not aware that, as a species, we have been able to do that before.
We saw governments and international agencies responding as best they could, with varying degrees of success. We saw new-found recognition of the value of health and health systems, at least temporarily. We saw the pharmaceutical industry work with scientists, governments and international agencies to develop, manufacture and distribute new vaccines in record time.
Source: Our World in Data. "Coronavirus (COVID-19) Vaccinations", https://ourworldindata.org/covid-vaccinations, accessed 8/5/2023.
Yes, there have been some major failures in how we've worked together during the pandemic. The spectacle of everything from vaccine nationalism through to panic buying of toilet paper over the last three years reflects the fact that we haven't got everything right.
Source: Twitter
Clearly, the fact that low- and lower-middle income countries still have not received the same level of vaccination as the rest of the world is something that we need to reflect on going forward. The initial scramble for limited supplies of vaccines and ongoing problems of vaccine nationalism over the past 3 years need addressing.
Source: Our World in Data. "Coronavirus (COVID-19) Vaccinations", https://ourworldindata.org/covid-vaccinations, accessed 8/5/2023.
The risk in all of this is that we don't learn the lessons during the pandemic about the importance of working better together as a species, about the social and economic value of health, and of finding new ways of collaborating. History shows what happens when we spend more time focussing on our differences than on our commonalities.
In a few weeks' time, this year's World Health Assembly will be getting an update on progress in negotiating a new global pandemic treaty - something that has come out of the experience in dealing with the Covid-19 pandemic.
Here's hoping this presents an opportunity to learn some of the good things we do together.
Three years on, for all the death, disease, hurt and cost from the Covid-19 pandemic, we owe it to ourselves and future generations learn its lessons and, perhaps, even use that experience to make the world a better place.