Covid-19 has been a public health and governance challenge of dimensions not seen since the Second World War. Millions of lives have been lost around the world and governments have been pushed to the very limits of their capabilities. Much of the policymaking on Covid has had to be undertaken in real time, carefully adjusting the plan as the situation changes. We are not yet out of the woods, but we have learned many lessons. Codifying this knowledge is an urgent priority.
The threat of another pandemic is one of when not if – and it could even be a more transmissible, deadlier strain of Covid-19 that is resistant to antibodies. We should prepare for a near-term threat, developing public health infrastructure more akin to a national security service than the traditional governmental organisations that develop and deliver anti-obesity or smoking-cessation campaigns. This should be the guiding principle for the National Institute for Health Protection (NIHP) due to launch in April.
Drawing on best practice and expert input, the Tony Blair Institute for Global Change has released "The New Necessary", which sets out what we believe the UK must do to prepare for the next pandemic, with clear read-across for countries around the world. It is grounded in something sorely absent over the last year: global cooperation. There is a void internationally, and the UK must use its G7 presidency to fill it.
The capability required is multifaceted. We need an improved surveillance system to identify threats sooner, enabling us to act faster. This should make the most of military-grade hardware and data monitoring, where increased hospitalisations in a defined area or certain purchasing habits could then trigger a series of interventions – including rapid genomic sequencing of any new virus.
We will need to develop vaccines faster and unlock surge capacity to manufacture millions – the aim should be a vaccine within 100 days, rather than the 300+ we saw with Covid. This necessitates setting up new bioreactor capacity in the UK, while also having a pre-set repurposing strategy – one that takes account of the 16 million litres of biological manufacturing capacity around the world and can quickly shift production lines to vital drugs and vaccines.
When it comes to therapeutics, we propose shifting random control trials to be “opt-out”, whereby every hospitalised patient is automatically enrolled. Manufacturing of trialled drugs should be underwritten and commence in-sync with trials: As soon as safety and a base level of efficacy are shown, drugs should become available to all. We must also acknowledge the very real threat of a virus resistant to antibodies and give antiviral development the same focus as we’ve given vaccines.
The new necessary will mean deploying the right kind of tests in the right settings quickly, cheaply and at scale. ‘Test, test, test’ is an enduring principle for any pandemic and should be split into two streams: screening for people with the virus and tests to enable people to be fully active. The former requires a blueprint and rapid testing capacity, while the later focuses on lab capacity and significant R&D money to stimulate the development of a rapid test with PCR-level accuracy.
On PPE, voters will demand a clear strategy that ensures we are not reliant on other countries for supply and are able to readily distribute stockpiles during a crisis.
Finally, we need to up our game on data. We must have in place capabilities to capture, store and access data in responding to the next virus. We will only be able to act faster and more strategically if we are armed with the fullest possible information.
This is a comprehensive but achievable checklist of steps the government needs to put in place to deliver the pandemic preparedness we need. Through its presidency of the G7 this year, the UK has the chance to take a global lead on this issue – something we know is necessary.