The Lancet Commission on the coronavirus pandemic has delivered a harsh verdict on how the world responded — it was “a massive global failure,” the prestigious journal declared. Governments were too slow and cautious, faced deep public mistrust, were undermined by misinformation and failed to serve the most vulnerable. “The result was millions of preventable deaths,” the Lancet said. This sorry record must provide impetus to do better in the future.
The Lancet convened 28 experts under Columbia University’s Jeffrey Sachs for a two-year examination of pandemic preparedness, response and recovery, delving into public health, virology, social policy, economics, finance and geopolitics. The report is but one of several worthy efforts to draw lessons from the most grave public health disaster in a century. The authoritative new findings deserve attention, though we wish Congress and the White House had ordered up a comprehensive, 9/11 Commission-like national panel in the United States. They did not.
A major lesson is that when a highly infectious disease breaks out in a vulnerable population, rapid response is essential, and even more so when many infections are asymptomatic, as was the case with covid-19. A single new case became thousands within a month. “The ability of the public health system to identify cases, trace contacts, and isolate infected individuals can be overwhelmed in just a few weeks of uncontrolled community transmission,” the report says. That’s what happened, over and over. “National responses were often improvisational, occasionally bordering on the absurd,” the commission states. “Several national leaders made highly irresponsible statements in the first few months of the outbreak, neglecting scientific evidence and needlessly risking lives with a view to keeping the economy open.” Governments “showed themselves to be untrustworthy and ineffective,” and “rancor among the major powers” then “gravely weakened the capacity of international institutions” to respond, especially the World Health Organization, which comes in for sharp criticism for repeatedly erring “on the side of reserve rather than boldness.” The panel calls for strengthening the WHO and giving it stronger powers and more solid financing.
Another lesson is that a failure to grasp the viral transmission route led to cascading — and costly — miscalculations. Early in the outbreak, the commission states, “health authorities concentrated almost exclusively on spray transmission,” the idea that the virus was disseminated when people exhale droplets that fall by gravity after a distance of one or two meters. This led to emphasis on six feet of social distancing, extensive cleaning of surfaces and hand-washing. In fact, the virus was spreading in respiratory aerosols, microscopic particles that stay suspended in the air, not unlike cigarette smoke. Failure to focus more on this airborne route at the outset had serious consequences: “The use of face coverings, ventilation, and air filtration as effective risk reduction measures were not adequately encouraged,” the report says. The incorrect assumptions enabled the virus to spread “almost unabated, for months.”
A third lesson, uncomfortable but true, is that a pandemic demands cooperation, but individuals, governments and organizations often looked out for their own narrow interests. Rich countries, including the United States, bought up lifesaving vaccine doses while poorer nations waited in the back of the line. As of January, the report says, the share of fully vaccinated populations was 71 percent in the European Union, 63 percent in the United States and 10 percent in Africa.
The commission notes that Chinese scientists early on possessed the virus’s genomic sequence and in January 2020 “knew that Wuhan was facing a coronavirus epidemic.” Oddly, the commission report skims over that China’s leadership hid from the public the virus’s human-to-human transmissibility in the first three weeks of January 2020 — a dire mistake that allowed it to spread.
The panel did not resolve the ongoing dispute about the virus’s origins in China, whether it came from a zoonotic spillover or an inadvertent laboratory leak, saying both are “still plausible.” The report properly calls for “unbiased, independent, transparent, and rigorous work” to investigate the origins, including at laboratories in Wuhan that were engaged in risky research known as “gain of function,” in which viruses similar to the pandemic strain were being genetically manipulated. Mr. Sachs correctly called on the U.S. National Institutes of Health to be more open about its role in funding research in China. But he and others should also be just as insistent that China open its doors. It has slammed them shut on further inquiry.
Two and a half years after it began, the pandemic catastrophe has led to 6.9 million reported deaths. The actual toll might be three times as high. It is absolutely essential to apply the knowledge and lessons of this experience to prevent it from happening again.