Issue Briefs
How Can We Prepare For The Next Pandemic?
Paolo von Schirach
April 10, 2020
WASHINGTON – Belatedly, all countries, including the most advanced, decided to adopt quarantines and “social distancing” as the only effective methods to slow down and hopefully stop the coronavirus contagion.
Better than doing nothing
While this is way better than doing nothing, it is somewhat disheartening that today –in the year 2020– the only contagion prevention tool in our tool box is the quarantine — a contagion prevention measure first employed as official public health policy by the Republic of Venice in 1347, during the Black Plague.
Quarantines are old remedies
Indeed, the English term “quarantine“, comes from the Venetian “quarantena“, a slight modification from the Italian “quarantina” which simply means “forty days“. At the time, Venice was already a major international port. In today’s terms, we would call the thriving maritime republic a Global Commerce Hub.
Venice depended entirely on commerce. It could not stop it, because it was the source of its gigantic wealth. But the Venetians did not want to be killed by epidemics brought in by sailors either. Therefore, the Venetian government during the 1347 Plague epidemic instituted the policy of isolating arriving ships and crews for forty days, (“the quarantine”), because they had realized that sailors and traders coming from foreign lands carried deadly diseases.
Dedicated hospitals
Well, guess what, quarantines worked, at least to some extent. Indeed, the Venetian example was soon adopted by other major port cities in the Mediterranean and beyond. The Venetians also were first in creating ad hoc health facilities for those who carried infectious diseases. Passengers coming from places known to have infections were forced to move to the island of Santa Maria di Nazareth, known as “Nazarethum”, that soon became known as “Lazzaretto”, or “Lazareth”. Besides, the Venetians created high level magistrates, called Public Health Procurators, whose job was the enforcement of the public health measures on which the very survival of the Republic depended.
Prevent diseases from crossing land borders
Later on, The Habsburg Empire created a massive system of military garrisons and fortifications along its long border with the Ottoman Empire. This system included dedicated spaces in the border areas whose main purpose was to quarantine anybody crossing into the Austrian Empire. The quarantine rules were clear and inflexible. Breaking them resulted in summary execution.
We had nothing
Well, fast forward to the present coronavirus epidemic, and we immediately realize that we are –belatedly and often half-heartedly– picking up the same anti-contagion tools first developed several hundreds years ago by the Venetians… simply because….we have nothing else!
Sadly, Western medicine has been blindsided by its own great successes. We defeated TB, smallpox, polio, and more. We have developed vaccines and treatments. We have antibiotics and what not. Therefore, somewhat superficially, we believed that we had won the infectious diseases war. Nothing more to worry about.
Bill Gates’ warnings
Strong warnings, such as the one articulated by Bill Gates in 2015 after the Ebola crisis in West Africa, were ignored. Gates did say –loud and clear– that Ebola was a Red Flag. A major pandemic coming to the US was a distinct possibility. And he did also say that we needed to prepare by creating early warning systems and well coordinates response mechanisms (including stockpiles of medical equipment) and the teams to manage them. He also suggested that the response mechanisms had to include a prominent role for the military.
Yes, Bill Gates did say all this, back in 2015.
Well, nobody paid any attention. Look, if we had listened to Gates and others who also warned about possible pandemics we could not have avoided this coronavirus pandemic, simply because, to date, we have no proven cure and no vaccine.
However, we could have dealt with this massive emergency in a smarter and much more efficient way, most likely saving many lives that have been lost simply because we were caught off guard. We know now that we had no system to quickly detect coronavirus virus carriers, so that they could be promptly isolated.
Taiwan has a system
The case of Taiwan’s public health early warning system proves this point. Taiwan learnt its painful lesson from a previous major public health scare. In the aftermath of SARS in 2003, (another deadly respiratory disease originating from China), Taiwan created a sophisticated early detection system, with dedicated professionals supervising it.
As soon as the Taiwanese authorities realized that something abnormal was happening in Mainland China at the end of 2019, they activated all their systems. Well, it may not be perfect; but Taiwan managed to quickly identify all or most coronavirus infected people, so that they could be promptly isolated, before they could spread the virus. But Taiwan could do all this only because it could activate a robust medical response mechanism it had spent years to create.
Guess what: prevention works!
US was unprepared
Here in the US, the list of what we did not have and of the systems that we could not activate simply because they did not exist is depressingly long. I really hope that this gigantic public health and now economic disaster, partly due to nature and partly due to our complete lack of any meaningful preparedness, will teach us a lesson.
We need reliable early warning
To begin with, the US and the World need much more sophisticated early warning systems. Theoretically, this should be the mission of the World Health Organization, WHO. But the record shows that the WHO is just another lumbering international bureaucracy, rarely ahead of the curve when something major happens. With all the talent in IT, superfast Supercomputers, Artificial Intelligence and indeed medical science that we have across the globe, setting up better early warning and crisis management systems is just a matter of will and coordination. We have the tools. Let’s organize them in a productive fashion.
New York City is under resourced?
Along similar lines, governments should create stockpiles of medical tools and related distribution systems that could be quickly mobilized in an emergency. It is a disgrace that New York City, the World’s financial capital, did not have the emergency facilities that could be quickly set up, along with all the medical devices necessary to deal with a sudden epidemic.
Emergency facilities are now springing up almost everywhere in the US. And this is good. This activism proves that America is resilient. However, we can no longer afford to be good only at reacting. We must learn to be proactive.
Yes, investing billions of dollars in facilities and supplies that may or may not be called into action sounds like a waste of money. And yet, if we look at the colossal economic damage caused by the need to shut everything down in order to stop contagion, all of a sudden, investing even a few hundreds billions in preventative measures looks truly cost-effective.
Those governments that lack the economic means to set emergency stockpiles should be connected to a global network that would immediately spring into action and deliver medical assistance where needed.
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Paolo von Schirach is the Editor of the Schirach Report He is also the President of the Global Policy Institute, a Washington DC think tank, and Chair of Political Science and International Relations at Bay Atlantic University, also in Washington, DC. |