The West should be on a war footing for the next pandemic

A health worker wearing personal protective equipment (PPE) walks past the funeral pyres of those who died from the coronavirus disease (COVID-19) during a mass cremation at a crematorium in New Delhi, India
It is estimated that 25 million people worldwide lost their lives to the pandemic - ADNAN ABIDI/REUTERS

People have been quick to forget how bad the pandemic was, but it’s important to remember the scale of the crisis. It’s estimated that 25 million people worldwide lost their lives.

We have had very few global events in human history that come anywhere near that. It really puts it in perspective if you look at the economic damage, it goes toward $15 trillion and we’re still suffering from the hit. It puts the pandemic about midway between the two world wars in terms of its human and economic impact.

Now the emergency has passed, policy makers are keen to move on. I hear time and again that we now have 100 years until the next pandemic because before Covid it was the Spanish flu which happened in 1918. But of course, it doesn’t work like that.

With climate change, globalisation, a growing global population – and the increased capacity for man-made bioterror through the combination of synthetic biology and AI – the risk of a new pandemic has actually increased. Our risk modelling estimates there is a 27.5 per cent chance of a Covid like pandemic in the next 10 years. That is in line with other estimates and the assessments of the insurance industry.

However unreal it might sound, 2020 was a mild pandemic. A very bad pandemic could kill one per cent or more of the entire global population. For instance, had the original Covid-19 wild type virus been as transmissible as Omicron, more than 300,000 thousand people would have died in the UK alone, nearly three times more than was the case.

Now in the US we have H5N1 avian flu which is spreading in cows for the first time. If bird flu mutates and the virus gains the transmission properties that can cause a global pandemic, it would be even worse because it has a much higher case fatality rate. It’s for those reasons most countries rank pandemics in the top of risks facing them.

Pandemics are an extreme test of any society. So in the West we should ask ourselves how we democracies fared compared to autocracies. Given that autocracies can take more draconian measures to contain a virus, it may be surprising to some that our analysis shows stronger democracies correlated with fewer excess deaths during the pandemic.

So why did democracies fare better? One reason is that democracies developed the best vaccines. The Pfizer/BioNTech and Moderna mRNA as well as Oxford-AstraZeneca vaccines came out of the Western ecosystem’s long-term investment in the bio-industry and populations in democracies were the first to access them. Another reason is trust in government. People need to trust their government, especially if they’re being asked to change their behaviours and take a vaccine.

The graph above shows that democracies had lower excess deaths, but there are outliers. For instance, the United States had a really bad pandemic despite having an excellent vaccine. In many places in the US there was a huge reluctance to have the jab. Not everyone had trust in it. Uptake was just too low.

Autocracies China and Saudi Arabia were also outliers in their approach and outcomes during the pandemic. China which followed a strict ‘zero-Covid policy’ had one of the lowest excess deaths and was also the first country to develop and roll out vaccines.  China was able to scale production to supply vaccines beyond its borders even before Western producers had enough supply.

One of the constraints on Western nations was the supply chain. It takes around 300 ingredients to produce one vaccine. Unlike the West, China had control over all aspects of the supply chain which enabled them to produce vaccines very quickly. So for the first year of Covid, China had all the vaccines, and the West had very few. This allowed China to go to Africa, to go to South America and provide vaccines and although they weren’t perfect vaccines it was better than having nothing.

But of course, few would argue that China, with its very protracted and damaging lockdowns, is the model to follow. Whilst lower excess deaths and fast vaccine development are good measurements of a government’s ability to minimise the impact of a pandemic on its citizens, avoiding lockdowns in the first place should be the north star.

The debate as to whether lockdowns were right or wrong, are to some extent missing the point; fundamentally, lockdowns are at odds with the central tenets of democratic and liberal societies and their implementation is a failure of pandemic preparedness. What is required are effective pandemic plans that remove the need for a lockdown when the next pandemic hits.

Although the West is today much better prepared than before Covid, there is still much to be done. The Pandemic Agreement, if it can be agreed upon, is part of the solution but it won’t be enough. Western allies need to develop a joint pandemic strategy and anchor it clearly in an international institution. NATO could be a good umbrella for coordinating pandemic response with government agencies. If we had a similar sophistication in surveillance, risk assessments, attack simulations and investment as they have in defence, we would be a long way forward.

Defence investment, especially in the US, has proven to be an important driver of innovation. Pandemic response goals such as the 100-day mission to develop an effective vaccine for a new outbreak are more likely to be successful with the urgency and logistical capacity of defence. Now the crisis from Covid-19 has passed, it’s time for the West’s pandemic preparedness to reflect the true severity of the risks. The good news is that democracies are better suited for these efforts than any other form of government.

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