Biden Administration Question for the Scientific Community: Pandemic and Public Health Lessons Learned

Remove politicians from all key decisions and not let the political class dictate response to a the pandemic.  It is a sad advice to offer but less federal government interference into local affairs and a less authoritarian approach, anchored in preparation ahead of time that uses best behavioral sciences, engineering, and epidemiologic evidence may have helped. But maybe such wishes are overly optimistic in naïve hope that such knowledge would be used.  Pandemic response seems to have been determined by new media coverage and election posturing, not evidence.  If Biden et co want to help, they can start by not acting like despots, and trust local governments and individuals to solve complex optimization problems involved in surviving epidemics.  Humans and other creatures have survived far worse epidemics than COVID-19 without guidance from any authority.  This makes sense because there are next to no measures that impact course of epidemics such as COVID-19 once community spread sets in (or at least that is the evidence of all similar epidemics in the XX century). To help understand these points Pres Biden et co are advised to read pandemic preparedness documents from the Bush era, all in the public domain.  And then they can try to answer this question: Why did you do all the things that were determined to be counter-indicated by the most competent scientists training to deal with such issues, being either damaging or useless, in the current pandemic?

That our readiness to address wide scale health crises such as a pandemic is completely inadequate. Investment needs to be made in infrastructure, public education and contingency planning.   

Pandemic gave the attention for the unequal treatment and vaccine application around the world. Thus, the great work must be offered to  develope of advanced technology especially in the developing countries.

Pandemic gave the attention for the unequal treatment and vaccine application around the world. Thus, the great work must be offered to  develope of advanced technology especially in the developing countries.

Public Health Interventions always come with a cost. Therefore, an honest, and transparent, cost-benefit analysis MUST be performed not only once, but on an ongoing basis throughout all stages of planning and implementing an intervention. For public health interventions to be effective, there must be public trust in the process.

Gain-of-function research is helpful for developing essential animal models for emerging pathogens and for developing effective countermeasures. However, the ongoing coronavirus pandemic clearly shows the clear dangers posed by gain-of-function research performed under less than biosafety level 4 laboratory conditions. BSL-4 containment is necessary for any gain-of-function research because is not possible to predict transmissibility and pathogenicity of pathogens that are serially passaged on human cells.

Key to responding to public health needs in the future is commitment to global monitoring, global infrastructure (to ensure availability of supply chains no matter where the source of disruption originates), planning (both global and local), periodic reviews of the prior items to ensure they are in place, being adequately maintained, and that the planning remains relevant.   In short, you get what you measure and so you must have in place a mechanism to measure compliance.   Education and communication of knowledge gained are essential so things like good hygiene, commitment to common sense health steps (hand washing, vaccinations, mask wearing, preventive health care), and why these are necessary are not lost or forgotten.