What went wrong? 13 mistakes that plunged the world into the coronavirus crisis

A major review analysing the global response to the coronavirus outbreak has delivered a damning verdict: the international health system was “clearly unfit” to prevent the pandemic, and needs radical reforms to avoid similar mistakes in the future.

In an 86-page report, supported by a raft of supplementary annexes, the Independent Panel for Pandemic Preparedness and Response (IPPPR) – led by two former heads of governments and a host of international experts – sets out a range of recommendations to better prepare for emerging health threats.

They also dissect what went wrong. From complacency to a slow global alert system and geopolitical squabbles, here’s a look at the 13 mistakes that turned a small outbreak into a devastating pandemic:

1. Caught off-guard

The number of zoonotic “spillover” events is accelerating, yet the world was caught off guard despite witnessing SARS, MERS, Ebola, Zika and many other outbreaks in recent years. The report finds that few governments had rigorous pandemic preparedness plans; assessments and simulations of national readiness failed to predict key weaknesses – including political leadership, trust in government and the speed of response; and 16 international reports with important recommendations were largely ignored since 2011.

2. Slow global alert system

The global alert system was too slow when confronted with a fast moving respiratory virus. The current International Health Regulations “constrain rather than facilitate rapid action” and the announcement of a global health emergency by the WHO was delayed by negotiation with China. The precautionary principle - which should have assumed the threat of human-to-human transmission once it seemed likely - was not adopted.

3. A ‘lost month’

February was a “lost month”: even after a global health emergency was announced on January 30, governments were too slow to react. While countries such as Thailand, Vietnam and Singapore did take urgent early action, others did very little until they were hit by rising Covid cases and the WHO declared a pandemic on March 11. By this point it was too late, the virus was spreading globally.

4. Overwhelmed health systems

Health systems were not prepared for an overwhelming surge in cases - in Spain, for instance, ICUs operated at 200-300 per cent of capacity. Health workers lacked adequate PPE and supplies such as oxygen and non-pharmaceutical measures, including remote schooling, had not been planned for. As a result. at least 17,000 health workers died from Covid in the first year of the pandemic and mental health issues are soaring.

5. Scramble for PPE

The world needed more PPE than manufacturers could produce, and without clear international leadership securing supplies descended into chaos. Border closures, hoarding and export controls on medical supplies only made the crisis more acute.

6. Viral misinformation

While the internet helped disseminate vital information, misinformation also spread like wildfire via social media and private messaging services. Key public health interventions – including face masks and lockdowns – became divisive issues in a highly politicised climate. But at the other end of the spectrum, billions of people without access to the internet received no information.

7. Unprecedented speed, but fragmented science

The scientific community jumped to action. The genome was rapidly sequenced and shared; vaccine development has taken place at warp speed; and the unprecedented pace of R&D was backed by a massive infusion of public funds. But still the R&D infrastructure has been inadequate to respond to a pandemic of this size; key vaccine producers – including Russia, China and India – weren’t that involved in the development of initiatives like ACT-A; and clinical trials have been fragmented, with little overarching coordination.

8. International squabbles

Geopolitics has hampered, at times even scuppered, international collaboration – particularly the competition between the two largest economies, China and the United States. But nationalism in general has undermined concerted action – the rhetoric of global solidarity “vanished into hot air” when governments faced domestic pressures.

9. False ‘health v economy’ trade-off

Responses to the pandemic have often been framed as a dichotomy between the economy and public health, but there is no such trade off. While the $22 trillion impact of the pandemic is the biggest shock to the world economy in 75 years, countries where the virus was swiftly contained – such as Vietnam – have seen less economic damage, plus far fewer deaths.

10. Entrenched inequalities

The pandemic has disproportionately affected certain groups, and poor social protection safety nets means inequalities have been entrenched. There’s been a huge rise in poverty rates, especially in middle-income countries, while women make up 39 per cent of the global workforce but account for 54 per cent of overall job losses. The impact on children’s education has also been acute, and refugees, ethnic minorities and some 11 million girls are less likely to return to school post-crisis, driving a future shortfall in “human capital”.

11. Vaccine nationalism

Effective vaccine allocation and distribution based on need “has failed”. While wealthy countries including the UK, US and EU have secured enough jabs to protect more than 200 per cent of their population, few doses have made it to poorer countries. The Covax scheme has been hit by bumpy supply, while progress expanding vaccine manufacturing capacity and sharing production know-how, licensing and intellectual property has been slow.

12. Shaken belief in global collaboration

The pandemic has shaken confidence in the international agenda pushing for sustainable development, and the world’s ability to cope with a major global crisis. But, on a more optimistic note, it has also thrust health to the center stage, and may be an opportunity to promote a “green and healthy recovery”.

13. The threat of variants

Coronavirus variants could herald a new chapter of the pandemic, but in the meantime there is a “need for speed” in the vaccine rollout and how to coexist with Covid-19 should be considered. Will it still be possible to pursue ‘Zero Covid’? Or will the aim be managing the virus as vaccines slowly subdue the pandemic? Shifting from the mindset of fighting to stop a pandemic to acknowledging Covid-19 will linger with us is difficult and presents challenges relating to logistics and equity.

Protect yourself and your family by learning more about Global Health Security