Americans are increasingly acting like we’re out of the woods, but we may actually be at the riskiest stage of the pandemic.
Yes, after two years of struggling with COVID-19, we see hopeful signs. While the omicron variant has spread across the world like wildfire, it has resulted in a lower individual risk of hospitalization and death than with earlier variants — especially for those who have been fully vaccinated and boosted. The wide availability of vaccines, at least for those fortunate enough to reside in high-resourced countries, combined with the approval of new treatments and better understanding of how we can protect ourselves, bring rising optimism, but also may inspire complacency.
With complacency comes a treacherous risk: the risk of forgetting.
The extent of the damage and heartache that our city has experienced compels us to think differently and act differently moving forward, to anticipate that there will be ongoing risks of major health threats. Now is the time for us to stop and reflect on lessons learned and to take action to shape our planning for the future.
For the many who have suffered through this pandemic, whether through loss of a loved one, disconnection from family and friends, or inability to make a living and secure a home, it is not surprising that there is a thirst for normalcy, a need to close the book on this distressing period.
However, if COVID-19 has taught us one key lesson, it is that we cannot return to the prior status quo. If we are to guard against a repeat of this horrific experience — or something even worse — we must equip ourselves to anticipate public health threats before they strike, with the resources and assets in place to mount prompt, coordinated responses effectively and equitably, mitigating loss and suffering.
The past two years may seem like a blur, but it is important to remember that we have learned some critical lessons.
First, we have learned that we must bring together the brightest minds from every sector — researchers, data scientists, civil society and corporate leaders, in collaboration with government agencies and inclusive of elected officials and legislators — to give us the full range of tools and expertise to prevent, respond and recover from health emergencies. When politicians were motivated by politics rather than data, they put lives at risk.
Second, our public health response capabilities are frayed due to years of underinvestment — from surveillance to public messaging — and all desperately need upgrades and investment. After COVID-19, public health must be a top priority for city spending, and the private sector has a role in contributing to the funding mix as well.
Third, innovation led to the remarkable development of effective COVID-19 vaccines and treatments in record time. We must bring that same level of innovation to our health data collection, modeling and projections, and technological solutions. Examples include real-time data mapping and artificial intelligence-based evaluation to inform the most effective response to a given health emergency.
Fourth, perhaps no sector has been put under greater strain by the pandemic than frontline health workers, whether in the community or at health facilities. Expanding education and training programs in such areas as community outreach and engagement, contact tracing, disease surveillance, outbreak investigation and clinical care in the context of emergencies will be critical to an effective response to the next health crisis.
Fifth, the pandemic response has often suffered from messaging that was perceived as confusing or contradictory. Thus, we must ensure a bi-directional flow of data and information using novel communication methods and channels — so that communities are empowered to directly engage with health officials, and, in turn, the latter deliver coherent messages via community leaders trusted by their constituencies.
Finally, and most importantly, many communities have been disproportionally impacted by this pandemic — from people of color to LGBTQ+ New Yorkers to older adults living on their own. Indeed, COVID-19 has shined a spotlight on longstanding inequities in our society. For a public health system to be truly effective, it must make high-quality services accessible to all. A pandemic does not discriminate, and neither should our response.
The greatest danger we face today is to just move on without change, leaving us just as vulnerable as we were before the word COVID-19 entered our lexicon. As we look with hope towards the taming of this pandemic, let us resolve to remember what we have learned from this crushing event and make public health preparedness an integral part of our way of life going forward.
El-Sadr is university professor of epidemiology and medicine and director of ICAP at Columbia University Mailman School of Public Health. El-Mohandes is dean of City University of New York School of Public Health and Health Policy The authors are leaders of the recently launched New York City Pandemic Response Institute (PRI), led by Columbia University in partnership with the City University of New York and others.
