This is the first and last time I’m getting on a soapbox. Usually, I try hard to be balanced and objective when writing blogs about medicine or science. Not this time.

As we approach Thanksgiving in the USA, we’re more than 2 years into the SARS-Cov2 pandemic. Over 17 million people have died from infection, with millions still suffering from long-term effects. Then there’s the collateral damage to lives because sick individuals could not get the care they needed: some 150,000-170,000 deaths alone in the USA, so let’s not also forget about ongoing suffering because people still can’t get the treatment they need as the pandemic is not over. What about mental health? That’s a whole other story and it’s not pretty. I could go on, but you get the picture.

So, why are we in this mess?

Let’s start with public health. After SARS-Cov1, promises were made. National governments would be vigilant. Public health expanded and properly funded. But, after a few years we stopped caring. Public health was gradually run into the ground. Zoonotic disease vigilance programs were wound down partly because it was no longer a priority and partly because of lack of funds; the world cared much more about other things.

This pandemic should never have started in the first place but thanks to the ineptitude of health officials (I’m looking at you, China), and the spineless response at the WHO in recognizing and declaring a pandemic, it did. Countries, medical organizations, public health departments, and governments were caught completely flat footed because there was no preparedness whatsoever. There weren’t even realistic plans on the table. Watching contradictory messages coming from governments and public health organizations was like watching a ping-pong match. Let’s not tell the truth and hopefully it will get better.

Thankfully, there were millions who stepped up to the plate and did the right thing under appalling circumstances: I’m calling out all of you nurses, physicians and supporting staff, public health officials, scientists who developed and tested vaccines and drugs in clinical trials, and the countless people who continued to care. Humanity owes you a mountain of gratitude we can never repay. But, sadly it has not been enough.

Somewhere along the way, nefarious politicians whipped up a frenzy to ensure “rights” were not trampled on and so a third or more of individuals, especially in developed countries, decided that their rights were more important than public health safety and saving lives. These selfish people also ensured prolongation of the pandemic and that vaccination was going to fail. (I find it ironic that some of these people suffered the most in the pandemic but sometimes karma can be a bitch.) I said in past blogs that we had a short window for vaccination to work, and that was before the delta strain and its cousins appeared on the scene making it impossible in terms of curtailing infection rates but still incredibly important in preventing needless hospitalizations and deaths. Yes, the vaccine rollout and messaging were not managed well in the USA but the damage, as I’ve said, was done long before. Now we have mostly the unvaccinated and despicable politicians who are extending the drama in our healthcare facilities. And, despite all the promises from rich countries, many poor countries still don’t have access to vaccines, though some of the blame has to fall on their shoulders, too.

In all likelihood, it will be at least two more years before infections wind down and SARS-Cov2 is consigned to be a seasonal problem like flu, or just another coronavirus strain, like the common cold. But the problems it caused will likely take years, perhaps decades to fix.

Oh, I almost forgot the point of my soapbox spiel. A good colleague and friend asked me earlier this year what we should learn from the current pandemic so we can apply lessons learned to the next one. (Yes, there will be another. It’s not a question of if, but when.) Here they are:

  • A virus doesn’t care about your politics, beliefs, or stupidity: it will still get you and if you’re unlucky, kill you
  • The poorest and most disadvantaged people on the planet are always going to be ground zero in a pandemic, made worse when they don’t have access to a good healthcare system. Fixing this should be our first priority
  • If a large chunk of the public sees Public Health as the enemy, you’re not going to stop a pandemic. Make learning about public health mandatory at schools, like reading, writing, and maths.
  • Lockdowns have their uses but they are blunt instruments and wreck untold economic, medical, and mental health damage, so think carefully how you use them
  • Masks and social distancing work but they only work if everyone cooperates, so you need to make them mandatory in certain places with all the problems that it entails.
  • You can spend tens of trillions of dollars mitigating the effects of a pandemic or you can prevent one from occurring in the first place
  • I’ll say it again: The best lesson of all is to prevent a pandemic from occurring in the first place. That means vigilance and commitment. Not for a year, or even 10 years, but FOREVER.