Unprepared and Unprotected: The Global Struggle to Combat Covid-19
In 2015, Bill Gates, presented a TED Talk on the implications of a global unpreparedness for the next pandemic. During the talk he stated that “The failure to prepare could allow the next epidemic to be dramatically more devastating then Ebola” (2015). However, Gates’ warning of a lack of preparedness is not new. For decades, science journalism and popular science literature has been littered with articles and publications that warn of the dangers posed by a global pandemic. Writing for National Geographic, Robin Marantz Henig states that she has stopped reading articles that detail early warning signs of Covid-19; “Scientists were detailing those early warning signs decades ago, and a handful of science journalists were writing about their work. I was one of those journalists” (2020).
Henig had begun research for her book, A Dancing Matrix: Voyages Along the Viral Frontier (1993) in 1990 and had encountered experts who “were identifying conditions that could lead to the introduction of new, potentially devastating pathogens.” For these experts, “climate change, massive urbanization, the proximity of humans to farm or forest animals that serve as viral reservoirs” would be key components in the transmission of pathogens between hosts. This spread then be accelerated by “war, the global economy, and international air travel” (2020). But Henig, who jokingly writes that A Dancing Matrix was the prequel to other books that made an impact, was not alone with her fears and need to warn of the devastation a global pandemic would cause if not prepared. Laura Garrett, just a year after Henig, published The Coming Plague: Newly Emerging Diseases in a World Out of Balance. In a striking statement, Garrett writes that, “While the human race battles itself, fighting over ever more crowded turf and scarcer resources, the advantage moves to the microbes’ court. They are our predators and they will be victorious if we, Homo sapiens, do not learn to live in a rational global village that affords microbes few opportunities”. Other publications, notably Spillover: Animal Infections and the Next Human Pandemic (2013) by David Quammen, and Richard Preston’sThe Hot Zone: The Chilling and True Story of an Ebola Outbreak (2014) have offered similar warnings. While the prescient and frighteningly timely Netflix Docuseries, Pandemic: How to Prevent an Outbreak - filmed in 2019 and released in January 2020 - brings contemporary urgency to the risk of a global health crisis as well as highlighting the complications of combating an ever evolving enemy.
So, further pandemics are inevitable?
Speaking to Louise Boyle of the Independent, Dr Enric Sala, a marine ecologist, stated that he is “absolutely sure there are going to be more diseases like this if we continue our practices of destroying the natural world, deforestation and capturing wild animals as pets or for food and medicine” (2020). Sala’s declaration is indicative of the growing concern among environmentalists that humanity is ignoring the links between the destruction of natural environments and emerging infectious diseases. Dr Samuel Myers, also speaking with Boyle, highlights that “human incursions into wildlife habitat bring people into closer proximity with wildlife populations...an enormous reservoir of pathogens, many of which we haven’t yet been exposed to” (2020). According the WHO, exposure to vector-borne diseases – pathogens that can be transmitted from one living organism to another, such as animals to humans, or human to human – accounts for more than 17% of all infectious diseases and results in 700,000 deaths every year (2020). A study published in 2008 showed that emerging infectious diseases had risen drastically each decade from the 1940s, peaking in the 80s due to the emergence of the HIV. Dr Myers states that the “HIV epidemic and Ebola were thought to have emerged from bushmeat hunting. MERS and SARS came out of live animal ‘wet markets’” (2020). Evidence seemingly suggests that the destruction of the natural world is starting to increase susceptibility to new pathogens that could prove devastating to human life. Live animal markets, destruction of habitats, and encroachment into rainforests are exposing human life to pathogens of which we are not designed or prepared to deal with. David Quammen, author of Spillover, writes that tearing down tropical forests for human expansion and endeavour “represent opportunity for unfamiliar viruses to get into humans and take hold” (2020). Therefore, without a long term drive to stop humanencroachment on the natural world, it is likely further pandemics of new infections will emerge.
What immediate preparatory measures could, or should, be taken to ensure pandemic readiness?
Speaking about Ebola, Gates stated that there were fundamental problems with global response as there was no system in place to tackle the spread of infections. He argued that a lack of quick response epidemiologists and medical personnel, combined with submissions of inaccurate paper reports meant approaches to treatment, or the application of “tools” to combat the disease, were delayed. Gates emphasised that this was a “global failure” of humanitarian aid and highlighted that a pandemic would need a system in place that provides access to “hundreds of thousands of workers” who can mobilise quickly. Gates pointed out that, despite the challenges, the creation of an effective system is possible.
Gates stated that the development of a system that improves the preparedness for a pandemic was hard to cost, instead highlighting the World Bank’s prediction that a global flu pandemic could wipe three trillion dollars off global wealth, therefore making investment in response systems a financially viable expenditure. For Gates, the development of an efficient response system is dependent on five elements:
Create a Medical Reserve Corp
Gates points to the military and their availability at any indication of danger. They are specifically trained to deal with the situation at hand, and can be mobilised quickly. They are also able to bolster numbers by calling on reservists. The creation of a medical reserve corp would be an extension of the military and consist of individuals who have been trained to deal with medical emergencies. In the event of a pandemic, the medical reserve corp could be mobilised to the affected regions and provide fast response care to those who are ill.
Pair Medical and Military
By pairing the Medical Reserve Corp with the military, you gain a wealth or organised logistical knowledge that can mobilise extremely quickly and aid with infrastructure. For example, military aid helped construct the Nightingale Hospital that is based in the Excel Centre, London.
Carry out simulations
Much like military exercises to test strategiesand prepare personnel, government science departments must carry out simulations that enable a proactive response to the spread of the disease, as well as the economic implications that come about as a result. These tests do currently take place, but the results are not always seen as a warning. Ian Boyd, chief UK scientific officer from 2012 to 2019, wrotethat he had “simulated exercises to prepare my country for the practical, economic and social shock waves from rare but devastating events”. He recalls running a simulation for an influenza pandemic in which 200,000 were predicted to have died; “We learnt what would help, but did not necessarily implement those lessons” (2020). The data that these simulations provide, combined with the “experience” of handling a pandemic are vital in dealing with the emergence of a new disease. It can also give insight into the potential need for resources, meaning that governments and health services can stockpile supplies over a period of time, alleviating the need to reactively purchase large numbers of units and causing wholesale global issues.
Step Up R+D
Further advancement in the research of vaccines and diagnostic equipment could prove crucial to the fight against any outbreak of an emerging infectious disease. Gates highlights that breakthroughs with the development of Adeno-associated viruses as a source for gene therapy as on such area that offers promise for the development of vaccines.
Strengthen Health Systems
Gates states that strengthening healthcare systems, particularly in poorer countries, would be crucial in the fight against a pandemic as these facilities would be the front line of battle. Much of this will require extra funding, presumably from government sources and, in the state of poorer countries, international monetary aid. However, the current COVID-19 pandemic has highlighted severe failings of the healthcare system both at home, and abroad. President Trump attempted to prevent the distribution of PPE manufactured by 3M to anyone but the US. While the UK, also struggling for PPE due to the global shortage, has experienced difficulty in acquiring an adequate number of ventilators for the predicted number of patients that will require breathing assistance.
Following an appeal from the UK government, various companies, including Dyson and Airbus, have shifted their focus to the development and manufacture of ventilators. It is hoped that this will increase resources from 8,000 to 30,000. However, this reactive response could have been prevented had the government taken heed of the warnings that their own simulations produced. This is without taking into consideration the period before the virus arrived in the UK.
In the months leading up to the crisis, front line staff warned of PPE shortages, with the government claiming a competitive market and issues with the supply chain being the reason for key workers not having the necessary protection. However, much like companies response to appeal for ventilators, many businesses have begun to voluntarily repurpose materials for the development of PPE. On April 3, the British Medical Association reported that Australia had seen “130 manufacturing companies step up to produce everything from hand sanitiser, visors and face masks, googles, gloves, surgical gowns, mask fit test kits and thermometers” (2020). In the UK companies such as BrewDog, Silent Pool Distillers and Psychopomp Microdistillery have begun producing alcohol hand rub, while a South Yorkshire couple are using 3D printers to manufacture PPE.
Is SOHO Commercial able to manufacture PPE?
Unfortunately, we do not manufacture any of our own products. However, our commitment to assisting with the national PPE shortage has seen us attempting to procure equipment from a number of sources. This, given the level of demand for personal protection equipment, has been difficult. However, as of April 20, we will be able to supply customers with the Durable UK face mask with visor due to their repurposing of materials that are used to manufacture filing products, such as document folders and storage boxes.
This robust, reusable face mask with visor, has been designed to ensure its functionality does not compromise effective working practices. The visor, shaped to follow the natural curve of the face and provide complete protection, is resistant to glare, condensation and sweat, ensuring that key worker visibility remains “glass-clear” throughout wearing. Despite the visors full facial coverage, it remains non-restrictive and allows for the full range of head movements.
Durable have also gone to great lengths to ensure that key worker comfort and safety are paramount. The visored face mask has been fitted with a hinge, attached to the visor and headband, that allows the wearer to lift the protection at times when it is not required. The elasticated, padded headband protects the wearer against discomfort during long periods of wear, but also makes it suitable for all head sizes. It can also be removed using the headband, meaning that the wearer is protected from contact with contaminated or contagious materials that may have collected on its surface.
With many PPE products being single use, Durable UK have developed a product that can withstand continuous disinfecting, meaning that the financial viability of the product is greatly enhanced. It also reduces waste, and alleviates the pressure on key workers to reuse products that should be discarded once used.
For further information, or to discuss placing an order, please contact on 0208 394 2088 or by emailing sales@sohocommercial.com
Sources
Boyd, I. (2020) ‘We practised for a pandemic, but didn’t brace’, Nature, 30 March. Available at: https://www.nature.com/articles/d41586-020-00919-3 (Accessed: 15 April 2020)
Boyle, L. (2020) ‘“We should start thinking about the next one”: Coronavirus is just the first of many pandemics to come environmentalists warn’, Independent, 14 April. Available at: https://www.independent.co.uk/environment/coronavirus-uk-pandemics-environmentalists-warning-a9413996.html (Accessed: 14 April 2020)
British Medical Association (2020) ‘Health and manufaturing unions join forces in call for mass PPE manufacturing effort’, BMA, 03 April. Available at: https://www.bma.org.uk/news-and-opinion/health-and-manufacturing-unions-join-forces-in-call-for-mass-ppe-manufacturing-effort (Accessed: 15 April 2020)
Garrett, L. (1994) The Coming Plague: Newly Emerging Diseases in a World Out of Balance. London: Penguin Books
Henig, R.M. (2020) ‘Experts warned of a pandemic decades ago. Why weren’t we ready?’, National Geographic, 08 April. Available at: https://www.nationalgeographic.com/science/2020/04/experts-warned-pandemic-decades-ago-why-not-ready-for-coronavirus/ (Accessed: 14 April 2020)
Horton, R. (2020) ‘Coronavirus is the greatest global science policy failure in a generation’ The Guardian, 09 April. Available at: https://www.theguardian.com/commentisfree/2020/apr/09/deadly-virus-britain-failed-prepare-mers-sars-ebola-coronavirus?fbclid=IwAR18IyRclg9Jhc-cxhshRuhHC4Pa5-B4tZBrC9ZNkIj6QPewdG6ZZN9ghoo (Accessed: 10 April 2020)
Jones, K., Patel, N., Levy, M. et al (2008) ‘Global trends in emerging infectious diseases’, Nature, 21 April. Available at: https://www.nature.com/articles/nature06536#citeas (Accessed: 14 April 2020)
TED (2015) The next outbreak? We’re not ready. Available at: https://www.ted.com/talks/bill_gates_the_next_outbreak_we_re_not_ready?language=en (Accessed: 09 April 2020)
World Health Organization (2020) Vevtor-borne diseases, 02 March. Available at: https://www.who.int/news-room/fact-sheets/detail/vector-borne-diseases (Accessed: 13 April 2020)