Lessons From COVID-19
By Neysan Donnelly
On 5 May 2023, the WHO Director-General Tedros Adhanom Ghebreyesus declared COVID-19 to be “an established and ongoing health issue which no longer constitutes a public health emergency of international concern (PHEIC).” With the acute phase of COVID-19 over, at least for the present, it seems a good juncture to reflect on what we have learned so far. What has COVID-19 told us about ourselves and our societies and what has science learned? What conclusions can we take with us to better prepare for future disease outbreaks and what lessons learned from COVID-19 can be applied to tackling other pressing issues of our time, most notably climate change? Beginning with its Online Science Days 2020, which took place as the first, deadly phase of the pandemic was still in full swing, the Lindau Nobel Laureate Meetings have served as a forum where Nobel Laureates and Young Scientists, many of whom were on the front lines in the battle against COVID-19, could come together to deliberate on what the disease was teaching us. While there is always the danger of speaking too soon while the wheel’s still in spin, to quote fellow Literature Laureate Bob Dylan, it is remarkable how quickly, almost in real time, participants began to draw profound, far-reaching conclusions from the emergency.
When confronted with a health emergency of such magnitude it is tempting to conclude that there have been no parallels in human history. However, that is not the case. Perhaps the most relevant example is that of the 1918 influenza pandemic, which was an H1N1 virus with genes of avian origin. Incredibly, it is estimated that fully one-third of the world’s population became infected with the virus, with at least 50 million people dying worldwide. In this excerpt from his lecture at the 49th Lindau Nobel Laureate Meeting in 1999, Nobel Laureate Peter C. Doherty describes the 1918 pandemic and its huge impact on the world. Although still talking about influenza, his words in the last minute of this snippet certainly sound prophetic in light of what has transpired since 2019.
Another recent and indeed ongoing pandemic is that of HIV/AIDS, which continues to be one of the most prevalent and deadliest global pandemics worldwide, with huge impacts on health, mortality, and society. In 2008, Françoise Barré-Sinoussi was awarded the Nobel Prize in Physiology or Medicine, together with her former mentor, Luc Montagnier, for their discovery of HIV. Some key lessons that she believes we can draw from this pandemic are the importance of a translational, multi-disciplinary approach in combating such emergencies and the critical role that scientists play in providing evidence for decision-makers, themes which she elaborates on in her talk from the 60th Lindau Nobel Laureate Meeting in 2010.
Inequality and injustice
One issue that came up again and again at Lindau, but also elsewhere, in discussions on the impact of COVID-19 was justice – or rather the lack of it. It became clear very early in the pandemic that, to use the analogy of Sir Angus Deaton, who received the Nobel Memorial Prize in Economic Sciences in 2015 for his analysis of consumption, poverty, and welfare, that COVID-19 was acting like a tide going out, exposing inequalities that were already there, but which perhaps had not been well appreciated. Further, however, it has become clear that, in its unequal toll on already disadvantaged and marginalised groups, COVID-19 has worsened and exacerbated inequalities. These injustices have various manifestations, all of them worrying: COVID has, together with the effects of the Ukraine War and inflation, pushed millions more people into poverty; the world’s poorest are finding it hardest to restore their incomes to pre-pandemic levels; those from ethnic minority groups have died from COVID at higher rates than white people; data suggest that violence against women may have increased during the pandemic.
Another vulnerable group that has borne the full brunt of the pandemic have been children,particularly those in developing countries or from marginalised communities. Kailash Satyarthi has devoted his life to safeguarding children and ensuring that cruelty to children and child labour become things of the past. He was awarded the Nobel Peace Prize in 2014 together with Malala Yousafzai, “for their struggle against the suppression of children and young people and for the right of all children to education.” In these two excerpts from his lecture at the Lindau Nobel Laureate Meeting in 2021, he talks about why children were particularly at risk of the negative impact of the pandemic and what must be done to protect them, with a particular emphasis on child labour.
Sir Angus Deaton is interested in the role of education and employment in equality. Having begun his lecture in 2020 by outlining the so-called deaths of despair that have been on the rise in the US for some time in people without college degrees, in the excerpt below he goes on to show how risk of unemployment due to the pandemic was much higher in the earlier months of the pandemic for those without a BA degree.
Alongside the inequalities experienced by children and those without higher education, one other consequence of the COVID-19 pandemic was a revealing of many different types of discrimination and racism. As Nobel Laureate Aaron Ciechanover points out in his Agora Talk from 2022, these are issues that concern society as a whole, but also specifically science and scientists.
The Lessons for Economics and Financial Policy
COVID-19 was not only a health emergency. Indeed, for many around the world, the impact of the pandemic was primarily economic in nature. As countries and regions went into lockdowns, economic activity was severely curtailed, and livelihoods were threatened. What are some of lessons that can be learned in terms of mitigating the effects of livelihoods and incomes? Many governments across the world acted quickly with stimulus packages that took the form of direct payments to individuals and businesses as well as investment in vaccine research. However, what is the fairest way to allocate such funds, and who should have precedence? Here, Kailash Satyarthi makes his case for why children should be near the top of the queue.
Direct payments and monetary payments can of course alleviate much of the suffering associated with COVID-19 and similar crises. However, governments can also act in more systematic, joined-up ways to ensure that those countries and groups who are most at risk do not always bear the brunt in such situations. In a discussion from 2020, Economics Laureate Robert J. Shiller argued for a more equitable way to face such crises in the future, a theme which was then also picked up by his fellow Economics Laureates Peter A. Diamond and Jean Tirole:
As in any crisis, COVID-19 was also an opportunity to think about what changes should be made to governance, the practice of economics and to economic institutions. To their credit, this was also a topic which was comprehensively dealt with by the Laureates and colleagues in their discussions. Here, Peter Diamond talks about how the emergency prompted a realisation that many critical institutions have to change and shift their foci if they are to remain fit for purpose.
One conclusion that came up in different contexts was the how COVID-19 has made it clear that economics must be opened up to incorporate different ethnic groups and different disciplines. In these next clips from the sessions on mitigating the COVID-19 crisis and from the developing-country and international perspectives on the pandemic, Jürgen Willems, and Economics Prize recipients Esther Duflo and Robert J. Shiller share their thoughts on how economics needs to become more diverse and outward-looking.
Finally, Nobel Laureate Jean Tirole notes that the pandemic caught many economists by surprise, something which in itself he finds unexpected. His exhortation to his fellow economists is that they should anticipate more eventualities, a practice which he calls “social science fiction”.
What can Governments and Public Health Authorities Do Better Next Time?
Of course, one of the major areas of discussion when talking about lessons from COVID-19 is what public health authorities could do better if and when a next pandemic hits. The participants in the Corona and Emerging Pandemics Discussion devoted much of their deliberations to precisely these questions and considered many aspects of national and international responses to COVID-19. To plan for next time, it is first necessary to dispassionately dissect what went right – but also wrong – this time. Françoise Barré-Sinoussi, who received her Nobel Prize for characterizing the HIV virus and Harvey J. Alter who was awarded for the discovery of hepatitis C virus, were admirably clear-eyed in identifying the issues with the early responses to the pandemic, particularly in Europe and the US.
So, if these were the issues with the initial responses to COVID-19, what do we need to do next time to save lives and livelihoods? Here, again, the participants in this discussion made very specific recommendations for how we can be better prepared for future pandemics and what success stories we should take with us for the next emergency.
What Can Science and Economics Learn in General From This Crisis?
In the preceding section, Harvey J. Alter talked about the pandemic as being a triumph for medical science but a failure for social science. What are some of the lessons that science and scientists can learn from the COVID-19 emergency? One unifying theme to emerge from discussions on this topic in Lindau centred on the importance of communication, transparency and openness. This importance for communication stemmed in no small part from scientists being thrust into the limelight and being looked to for guidance. “We’re following the science”, was the mantra of politicians the world over. Welcome for sure, but this also meant that scientists were put under considerable pressure to come up with answers, as outlined in this Mini Lecture about the COVID-19 pandemic.
Openness, transparency and effective communication were identified as important to ensure that facts but also uncertainty are properly communicated to decision-makers and the public. This openness will improve trust in science and scientists and will serve to combat the widespread anti-vaccine and sometimes simply anti-science disinformation which was an unfortunate hallmark of the pandemic in many countries, as identified here by Nobel Laureate Aaron Ciechanover.
What exactly does openness and transparency mean in these contexts and how can they improve trust in science? The Laureates advise us not to gloss over the uncertainty that is inherent to scientific endeavours and to not try and hide the difficult conversations that must be had. Such an approach may also serve us well for future crises. Here, Young Scientists and Laureates detail what they feel should change and improve around the communication of science, and specifically uncertainty, and how this could improve trust in science and scientists.
Just as COVID-19 was like a tide going out exposing inequalities in the world at large, so too did the pandemic shine a light on the need for more diversity in the scientific enterprise, most notably in ensuring that women and those from diverse ethnic backgrounds are properly represented in scientific research. Diversity is not a goal in itself, however. Rather, more diversity in science and in decision-making leads to more diverse results, which in turn allows us to better tackle huge challenges such as COVID-19. Here, this problem is portrayed by two Young Scientists and is outlined in a Mini Lecture on COVID-19.
The pandemic has undoubtedly had a sizeable and likely lasting impact on the way science and economics is done. A few themes emerged from discussions on this point at Lindau. Firstly, there was a consensus that open, collaborative science and economics is of great benefit to all, and that much more of it is needed. The ease with which scientists and economists could gather together online was a certainly a boon and videoconferencing will definitely be maintained as we emerge from the pandemic. However, this does not replace face-to-face meetings. Further, the speed with which new results could be shared in the form of prep-prints was also identified as a highly positive development overall. However, this deluge of information also posed a number of challenges as identified by Nobel Laureate Saul Perlmutter and Young Scientist Jana Huisman in these excerpts below. Firstly, quality control of these vast amounts of data was often lacking, and that is something that must be considered for the future. Another issue was the constantly changing scientific guidance and state-of-the-art. More could have been done to educate societies on the iterative process of science.
Opportunity in Crisis
Alongside the lessons for current and future crises and for science and economics in general the COVID-19 global health emergency also offered opportunities to young and established scientists to work on something of critical importance that would have lasting impact on the real world. In this final excerpt, Economics Laureate Abhijit Banerjee explains why he believes that while COVID-19 represented a huge opportunity, Young Economists shouldn’t limit themselves to only COVID-related research.