This blog is published ahead of our International Health Lecture 2020, taking place on Monday 2 November at 10.30am.
You can register for the free webinar here.
As countries around the world experience resurgences of the COVID-19 pandemic, the Academy of Medical Sciences and The Lancet International Health Lecture 2020 will explore what we have learnt so far. Here, the three speakers, Professors Ilona Kickbusch, Gabriel Leung and Robin Shattock FMedSci give us a taste of the talks they will deliver.
“There are two lessons we need to take from the pandemic,” says Professor Kickbusch, from the Graduate Institute of International and Development Studies in Geneva, Switzerland. “The first is to recognise that it cannot be seen in isolation, it is but one component of a larger pattern of risk.” In her talk about the interface of politics and science, she will explain that this pattern also encompasses ecological, financial and social risks, among others.
“The second lesson is to understand the unambiguous relationship between risk and power: who defines the risks, who takes the political decisions and who suffers the consequences.” For example, Professor Kickbusch points out that the spread and the impact of the pandemic in ‘populist and divisive societies’ has been defined by high death rates, high inequalities and a disregard of scientific evidence.
According to Professor Gabriel Leung, from the University of Hong Kong: “False choices between health protection, economic preservation and public acceptance of population interventions have misguided policy decisions.”
He has reviewed the lessons learned so far in public health and will discuss evidence on two controversial interventions: the use of face masks and school closures. “Whether to don a face masks to prevent community spread has perhaps been one of the most argued and divisive issues, initially between East Asia and the West and later along partisan fissures within western countries.
“There are clear gaps in the evidence on modes of transmission, and on masks as an intervention in mitigation. Nevertheless, given that there is very little possibility of harm from wearing a face mask, public guidance should be strongly recommending the practice in all settings.”
On schools, Professor Leung says: “There continues to be intense debate over whether face-to-face classes should be suspended to reduce SARS-CoV-2 circulation within the school setting and transmission spillover into the general community.” Here too, he says there are gaps in the evidence, in terms of differences between older and younger children and in the exact timing of closures. He adds: “The urgency of addressing these knowledge gaps cannot be overemphasised. A recent World Bank study has projected that learning discontinuity due to class suspension for five months during COVID-19 could sacrifice 16% of total public investment in students’ basic education worldwide. This burden would be inequitably borne by those who are already disadvantaged.”
Looking ahead, Professor Leung concludes: “The question of whether repeated cycles of lockdowns would eventually turn out to be preferred over a ‘herd immunity’ approach in terms of both health and economic protection, deserves careful analysis after COVID-19 eventually settles.”
Professor Robin Shattock FMedSci, from Imperial College London, UK, will explain how COVID-19 and the vaccine race has ‘driven an explosion of effort’, with 100 vaccines in early development and nearly 50 in clinical trials. He says: “One of the greatest and often unlauded successes was the rapid online sharing of the SARS CoV-2 genome.
“While the development of prototype vaccines has moved at unprecedented speed, the major rate-limiting step remains the demonstration of efficacy and safety in large clinical trials.” Professor Shattock also comments that technology readiness, speed of production, access to scale up capacity, and governmental support are all factors: “The latter is highly influenced by undertones of vaccine nationalism and prestige.”
He adds: “Media attention is obsessively focused on when and who will be first past the post in demonstrating efficacy. However, as hopefully more candidates cross the finishing line, multiple criteria will rapidly come into play over eventual use and commercial longevity of any candidate.” These will include global context access, affordability, scale up and ease of distribution.
Professor Kickbusch will also discuss the role of vaccines: “We must learn to see that the greatest risk lies not with the virus but vaccine nationalism und the unwillingness to cooperate.” She believes that equitable and fair access to a COVID-19 vaccine, will be the ultimate test case for society's ability to come together to tackle the pandemic. “Right now, there is some ground for optimism: a new dynamic in relation to common goods and collective action is emerging.
“The make and break for this new dynamic lies with the Covax facility – the new global risk-sharing mechanism for pooled procurement and equitable distribution of eventual COVID-19 vaccine; the ambitious goal is to distribute two billion doses of COVID-19 vaccines before the end of 2021.”
She concludes: “For pandemics, as well as the other incalculable risks our way of living has generated, we need to prepare with a new mind frame; by being responsible for one another and for the planet on which we live.”
The 2020 Academy of Medical Sciences & The Lancet International Health Lecture will take place virtually as a webinar at 10.30 - 12.00 (GMT) on Monday 2 November and is free to attend and open to all. Please register here to join.
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