• FluTrackers.com Inc. does not provide medical advice. Information on this web site is collected from various internet resources, and the FluTrackers board of directors makes no warranty to the safety, efficacy, correctness or completeness of the information posted on this site by any author or poster. The information collated here is for instructional and/or discussion purposes only and is NOT intended to diagnose or treat any disease, illness, or other medical condition. Every individual reader or poster should seek advice from their personal physician/healthcare practitioner before considering or using any interventions that are discussed on this website. By continuing to access this website you agree to consult your personal physican before using any interventions posted on this website, and you agree to hold harmless FluTrackers.com Inc., the board of directors, the members, and all authors and posters for any effects from use of any medication, supplement, vitamin or other substance, device, intervention, etc. mentioned in posts on this website, or other internet venues referenced in posts on this website.
  • We are not asking for any donations. Do not donate to any entity who says they are raising funds for us.

CIDRAP- Lancet Commission on COVID-19 response: 'Massive global failure'

Lance

MPH, CSP & CIT Retired, CHMM Emeritus
https://www.cidrap.umn.edu/news-per...sion-covid-19-response-massive-global-failure

Lancet Commission on COVID-19 response: 'Massive global failure'


Filed Under:
COVID-19
Mary Van Beusekom | News Writer | CIDRAP News

Sep 15, 2022

A stinging new Lancet Commission report on the international COVID-19 pandemic response calls it "a massive global failure on multiple levels" and spares no one the responsibility—including the public—for millions of preventable deaths and a backslide in progress made toward sustainable development goals in many countries.

Noting an estimated 17.2 million COVID-19 deaths worldwide through May 31, the commission said, "This staggering death toll is both a profound tragedy and a massive global failure at multiple levels. Too many governments have failed to adhere to basic norms of institutional rationality and transparency, too many people—often influenced by misinformation—have disrespected and protested against basic public health precautions, and the world's major powers have failed to collaborate to control the pandemic."

Published yesterday in The Lancet, the report is aimed at United Nations (UN) member states and agencies and intergovernmental groups such as the G20 and G7. The commission included 28 experts from around the world.

It details national negligence in prevention, rationality, public health practices, and international cooperation, as well as "excessive nationalism" that led to unequal access to resources such as personal protective equipment (PPE), vaccines, and treatments. The report also acknowledges that many members of the public openly flouted government efforts to control the pandemic.

What went wrong


Specifically, the report details 10 failures:
  • A lack of timely notification of the initial outbreak of COVID-19
  • Delays in acknowledging that SARS-CoV-2 spreads by aerosols and to implement appropriate public health mitigation measures at national and international levels
  • An absence of coordination among countries to suppress viral transmission
  • Government failures to examine evidence and adopt best practices for controlling the pandemic and managing economic and social spillovers from other countries
  • A lack of global funding for low- and middle-income countries (LMICs)
  • A failure to ensure adequate supplies and equitable distribution of key resources such as PPE, diagnostic tests, drugs, medical devices, and vaccines—particularly for LMICs
  • A dearth of timely, accurate, systematic data on infections, deaths, viral variants, health system responses, and indirect health consequences
  • Poor enforcement of appropriate levels of biosafety regulations leading up to the pandemic, raising the possibility of a lab leak
  • A failure to combat systematic disinformation
  • The lack of global and national safety nets to protect vulnerable populations
The report proposes the five pillars of fighting infectious diseases, including prevention strategies such as vaccination, containment, health services, equity, and global innovation and diffusion. But the underpinning of success, the commission proposed, is "prosociality," or the reorientation of governments, regulators, and institutions toward society as a whole.

The commission said it aims to promote a new era of global cooperation to decrease the dangers of COVID-19, proactively address global emergencies such as pandemics, and enable sustainable development, human rights, and peace through UN institutions such as the World Health Organization (WHO).

The report provides a framework for understanding pandemics, a timeline of the COVID-19 pandemic, thematic findings, and policy recommendations, including investments in preparedness for future health crises through strong national health systems, international financing, and technological cooperation with LMICs. About $60 billion, or about 0.1% of the gross domestic product of high-income countries, would be needed each year to fund these efforts, it said.

In a Lancet news release, report coauthor Maria Fernanda Espinosa, MA, of the Robert Bosch Academy in Germany, said that while COVID-19 vaccines have been available for more than 18 months, "Global vaccine equity has not been achieved. In high-income countries, three in four people have been fully vaccinated, but in low-income countries, only one in seven."

Coauthor Salim Abdool Karim, MBChB, PhD, of Columbia University, said that a strategy of high vaccine coverage plus other public health measures will slow the emergence of new variants and reduce the risk of future pandemic waves. "The faster the world can act to vaccinate everybody, and provide social and economic support, the better the prospects for exiting the pandemic emergency and achieving long-lasting economic recovery," he said.

WHO: Key omissions, problems in report


In its response today, the WHO said the commission's recommendations align with its goals but called out "several key omissions and misinterpretations in the report, not least regarding the public health emergency of international concern (PHEIC) and the speed and scope of WHO's actions."

Since Day 1, the agency said, "WHO, together with our global expert networks and guideline development groups, regularly updates our guidance and strategies with the latest knowledge about the virus, including updates to the SPRP [COVID-19 Strategic Preparedness and Response Plan] and the COVID-19 global vaccination strategy, and to the 11th version of WHO's living guideline on COVID-19 therapeutics, which was published in July 2022."

The WHO also highlighted the many calls to action from Director-General Tedros Adhanom Ghebreyesus, PhD, to world leaders to protect people and share disease-mitigation tools.

The WHO also said it continues its search for the origins of SARS-CoV-2 with the July 2021 establishment of the permanent International Scientific Advisory Group for Origins of Novel Pathogens (SAGO) for both COVID-19 and emerging pathogens.

A chance to rebuild


In a related editorial, Lancet editors said that international systems developed after World War II didn't hold up to a modern pandemic. "Global collaboration and solidarity were good in business and science but poor in politics and international relations," they wrote.

They added that while the war in Ukraine and climate and economic instability have siphoned attention away from COVID-19, surveillance and testing capacity must be safeguarded and broadened to prepare for a possible winter surge in the Northern Hemisphere.

"The risk of new variants remains elevated and there are uncertainties around the strength and duration of immunity from vaccination," the editors wrote. "But perhaps most importantly, as many countries and institutions try to find a path out of the pandemic, many questions about what went wrong and how future pandemics can be prevented remain unanswered."

The best hope of regrouping the response to COVID-19 and gird for future pandemics lies in the release of the Lancet Commission's report, they concluded. The report, they said, "offers the best opportunity to insist that the failures and lessons from the past 3 years are not wasted but are constructively used to build more resilient health systems and stronger political systems that support the health and wellbeing of people and planet during the 21st century."
 
They also said the possible origin of the virus in a research lab has not been adequately or independently explored in related labs in China or the US.

Key findings
  • •The proximal origin of SARS-CoV-2 remains unknown. There are two leading hypotheses: that the virus emerged as a zoonotic spillover from wildlife or a farm animal, possibly through a wet market, in a location that is still undetermined; or that the virus emerged from a research-related incident, during the field collection of viruses or through a laboratory-associated escape. Commissioners held diverse views about the relative probabilities of the two explanations, and both possibilities require further scientific investigation. Identification of the origin of the virus will help to prevent future pandemics and strengthen public trust in science and public authorities.

As of the time of publication of this report, all three research-associated hypotheses are still plausible: infection in the field, infection with a natural virus in the laboratory, and infection with a manipulated virus in the laboratory. No independent, transparent, and science-based investigation has been carried out regarding the bioengineering of SARS-like viruses that was underway before the outbreak of COVID-19. The laboratory notebooks, databases, email records, and samples of institutions involved in such research have not been made available to independent researchers. Independent researchers have not yet investigated the US laboratories engaged in the laboratory manipulation of SARS-CoV-like viruses, nor have they investigated the details of the laboratory research that had been underway in Wuhan.
[SUP]47[/SUP]
Moreover, the US National Institutes of Health (NIH) has resisted disclosing details of the research on SARS-CoV-related viruses that it had been supporting,
[SUP]66[/SUP]
providing extensively redacted information only as required by Freedom of Information Act lawsuits.
[SUP]67[/SUP]
 
WHO responds to The Lancet COVID-19 Commission

15 September 2022

WHO welcomes the overarching recommendations of The Lancet COVID-19 Commission’s report on “Lessons for the future from the COVID-19 pandemic,” which align with our commitment to stronger global, regional and national pandemic preparedness, prevention, readiness and response.

At the same time, there are several key omissions and misinterpretations in the report, not least regarding the public health emergency of international concern (PHEIC) and the speed and scope of WHO’s actions. ...

WHO’s rapid response

The Commission does not, however, convey the full arc of WHO’s immediate, multi-year, life-saving response, detailed below:
  • On 30 December 2019, WHO received the first alerts of cases of pneumonia of unknown cause in Wuhan, China, and notified the IHR focal point, seeking further information from Chinese health authorities the next day.
  • On 1 January 2020, WHO activated its Incident Management System to manage daily action. The team, which includes focal points on clinical care, infection prevention and control, diagnostics, logistics, communications and more, met daily throughout 2020, into 2021 and continues to meet this year.
  • On 5 January 2020, WHO issued a global alert to all Member States through a formal IHR system – the Event Information System – based on our initial risk assessment of the situation in China. This alerted Member States and advised them to take measures to identify cases, care for patients, and prevent infection and onward human-to-human transmission for acute respiratory pathogens with epidemic and pandemic potential. This was WHO’s first global warning to take concrete measures for an unknown respiratory disease. WHO has consistently driven knowledge-sharing through dedicated briefings for countries, during which the critical experiences of early-affected countries were shared and the elements of WHO’s comprehensive response were outlined.
  • On 9 January 2020, WHO convened the first of many teleconferences with established global expert networks, to discuss all available information on the cluster reported from China. These networks enabled the real-time exchange of direct knowledge, experience and early study findings, which fed directly into WHO’s early advice and recommendations.
  • Between 10 and 12 January 2020, WHO published a comprehensive package of technical guidance for countries. This package covered how to test for a high threat respiratory coronavirus, treat patients for severe acute respiratory infection, inform the public to prevent infection and human- to-human transmission, and to prepare health systems to deal with more cases.
  • On 13 January 2020, WHO published the first protocol to develop PCR tests to identify cases based on the release of the full genome sequence two days earlier. By 2 February 2020, WHO began shipping validated PCR assays to countries around the world.
  • On 22 and 23 January 2020, when there were nine cases and no deaths reported outside China, the Director-General convened the Emergency Committee (EC) under the IHR to meet, and advise whether the event constituted a public health emergency of international concern (PHEIC). The Committee advised that it did not. The Director-General saidpublicly: “Make no mistake. This is an emergency in China, but it has not yet become a global health emergency. It may yet become one”.
  • From 27 to 28 January, following the EC, the Director-General and senior staff travelled to China to meet with top government officials, gather information about the outbreak and seek cooperation.
  • On 30 January 2020, when there were 98 reported cases (and no deaths) in 18 countries outside China, the Director-General reconvened the Emergency Committee. It advised that the outbreak constituted a PHEIC. The DG took their advice and declared a PHEIC, issuing temporary recommendations for how countries could further prepare and respond.
  • On 4 February 2020, WHO’s Strategic Preparedness and Response Plan (SPRP) was published. It outlined comprehensive measures all countries needed to take to suppress transmission and save lives, using a package of interventions including early identification and isolation and care of cases, contact tracing and supported quarantine, use of medical masks, distancing, ventilation, infection prevention and control in health facilities, taking a risk-based approach to small and large gatherings, and for travel.
  • Following regular media briefings held in January, daily briefings began on 5 February 2020. Media briefings continue on a weekly basis, alongside regular live social media conversations with senior WHO experts, demonstrating the priority placed on communicating with leaders and the public.
  • From 11 to 12 February 2020, WHO led a Global Research and Innovation Forum on the new virus, convening nearly 900 experts and funders from more than 40 countries, to take stock of what was known about the novel coronavirus and to set the agenda going forward. A follow-up achievement was WHO’s Solidarity trial, which became one of the largest clinical trials for COVID-19 therapeutics, involving more than 30 countries, over 14 000 patients and nearly 500 hospitals at its peak. ...
https://www.who.int/news/item/15-09-...-19-commission
 

Stephen Goldstein @stgoldst

Evolutionary virology postdoc @ Univ of Utah. Previously Penn Medicine. Coronaviruses and the Wasatch.
Salt Lake City, UTJoined March 2013
2,361 Following
7,870 Followers
______________________________

Tweet

Stephen Goldstein@stgoldst
When @TheLancet
published its COVID19 Commission Report headed by Jeff Sachs, I noted specific technical errors it was important to correct. I submitted a letter to the journal on September 19 '22. On Sept 27 it went to an editor, and no action since. 3 months later, here it is.

5:19 PM · Dec 19, 2022

https://twitter.com/stgoldst/status/1604979736127512576
 
Back
Top Bottom