Having been a part of the team that developed a leading COVID-19 vaccine, I am often invited to speak or write about the successes of our work—work that led to the fastest vaccine development in history.
But, more than three years into the COVID-19 pandemic and with America’s public health emergency expiring on May 11th, it has become increasingly clear that this moment is not only an opportunity to reflect on successes but also grapple with the setbacks, pitfalls, and failures that defined our response to COVID-19.
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The responsibility to improve our response to future global health crises, I think, lies in correcting our less-than-perfect actions. There are countless opportunities to tweak, iterate, or outright overhaul our pandemic response—but as I review our fight against the virus, particularly from the front row of the frontline, three paths of action stand out.
First, the federal government needs to change the paradigm that defines our federal research focuses, with an emphasis on being proactive instead of reactive.
There are 23 families of viruses associated with human infection, and the state of the research into each of these families varies significantly. In my specialty of coronaviruses, we had made significant strides before the pandemic struck. The strides we made were not because of any extraordinary funding streams, but merely because we were interested in closing gaps in scientific understanding—particularly in light of the recent threats posed by SARS-1 and MERS in prior years, which showed the pandemic potential of coronaviruses.
It is often deemed “miraculous” that our COVID-19 vaccine progressed to phase 1 clinical trial in merely 66 days, but I imagine the vaccine development process could have been even more efficient had our technology gone into phase 1 clinical trial prior to the pandemic. Such an advance beyond our 2017 manuscript to the clinic would have required more financial investment and intellectual resources, but we could have been better positioned to move even faster when COVID-19 struck.
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Basking in our successes means also admitting that we were dealt a lucky hand; the pandemic response could have been way worse. Our understanding of many of these viral families lags far behind our understanding of coronaviruses. If a pathogen from one of those families ever takes off, our wait to clinical trial might be 600 days, not 66. The harm inflicted, both economically and in terms of lives lost, would be devastating.
I’d like to see us invest in each of the 23 viral families that infect humans. The National Institutes of Health (NIH) should lay out checkpoints: key scientific milestones we need to hit for each viral family, so we’re ready to move rapidly in case a pathogen emerges and begins to spread. The investment would be significant, to be sure. But the total cost would be far smaller than COVID-19’s estimated $16 trillion drag on America’s economy and the enormous toll of lives lost.
Secondly, public health practitioners need to recognize that our research is only as strong as our communication. Even our strongest peer-reviewed, evidence-driven findings won’t have their full impact if we cannot clearly and effectively communicate them to the public.
Unfortunately, effectively disseminating complex information is more difficult now than ever before. Public health communicators must project both their humanity and their expertise, which can be a difficult tightrope—especially in a highly polarized political environment that harms public trust. Clarity, conciseness, honesty, and empathy go a long way with the public, especially in moments of uncertainty.
Public health leaders must also recognize that sometimes the messenger is just as important as the message. Instead of relying heavily on leadership in D.C., we must tap into trusted voices in communities across this country, from physicians to community health workers to pharmacists. Once appropriately empowered, these community leaders made a big difference during the pandemic.
Imagine my surprise – and embarrassment – when, in April 2020, I announced to America on CNN that we had a vaccine under development that was backed by years of research, only to find that almost no one had ever heard of said research. How had we allowed the disconnect between our publications and public knowledge to grow so large? Repairing that disconnect is a continuous feat.
I’d like to see us build a strong network that lets officials at the White House and the Centers for Disease Control and Prevention promptly share relevant public health information with local leaders — on a regular basis, not just during a crisis. In turn, those trusted voices should be encouraged to regularly share those updates with their communities, which will help them build up their credibility.
We should fund ongoing training as well, so these local leaders can stay up to date on best practices for communication, as well as the best platforms – for example, it shouldn’t have taken so long for federal officials to begin using Instagram and TikTok to reach younger populations with messaging on COVID-19. By the time the White House featured me on Snapchat, my 15-year-old niece exclaimed that no one even used Snapchat anymore. We were not meeting people where they were, because we hadn’t been walking with them to those destinations prior to the pandemic. It’d be sad to see us go back to the status quo, only to have to catch up again in the next crisis.
We also need to recognize the value of training a diverse group of public health leaders. As one of the few Black researchers involved in creating the COVID vaccine, I saw how much my words resonated with communities of color—and I also know just how often the deck is stacked against young scientists from marginalized communities, making it more difficult for them to break into our field. To create more trusted ambassadors, we must build the pipeline of diverse scientists and public health leaders. We cannot afford to leave them behind.
Finally, we must understand that health leaders cannot solve these crises alone; we have to work in partnership with the public. As a result, we must step up our efforts to teach critical thinking in schools and workplaces so when people do their own research, they come to reasonable conclusions.
This problem has become more challenging in recent years with the flood of content on social media. Some of this information is correct—but much is misinformed, and some is maliciously and knowingly false. We need to help people learn how to separate fact from fiction. That will help us triumph over the snake oil salesmen who use confusion to spread misinformation.
These changes aren’t easy; on the contrary, each would be expensive, time-consuming, and difficult to implement.
But that doesn’t mean they’re not worth doing.
We have seen the consequences of a pandemic under the previous status quo, and we cannot allow ourselves to settle back into that flawed approach. It is vital that we learn our lessons and make the hard choices that will save lives and strengthen our society for future crises. Investing today will yield benefits tomorrow—but if we choose inaction, we’re doomed to repeat our mistakes again and again.
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