In the US, the government under Trump removed some of that early surveillance capacity in the last couple of years – we effectively dismantled part of the early warning systems.
Second, we have learned that even though this is a devilish virus, it is controllable. Around two billion people live in countries that have substantially suppressed the virus. They’ve been able to do that, primarily because of public health means and especially non pharmaceutical interventions.
If we look at the UK, the US, Western Europe – we failed to put such policies in place, basically until now. In the US we still don’t have an effective control system.
This second area is crucial. We have a lot of emphasis on hospitals, but far far less on public health. I think that’s a basic point here.
Do you have other early observations you can share?
What I have found notable about this pandemic from the start is the incredible variation in the response to it across the world, with the best response being in the Asia Pacific region.
Perhaps that’s because they were much more tuned to Sars and other epidemics. Perhaps because face mask wearing came earlier and was more familiar. Perhaps because governments have more capacity to put in place politics on an urgent basis.
For whatever reason, the variation of the global response has been huge and countries like ours, the UK and the US, have done quite badly in this, in relative terms.
I think there are also lessons that still need to be drawn about how safer land use practices might prevent zoonotic events, or at least reduce their frequency.
How do you see vaccine development working out?
The extraordinary speed at which the process has been rolled out compared to previous vaccines is very positive. But there are also weak points to do with how it’s getting done. It’s been a mad dash with a lot of potential dangers. I think there’s going to be a lot of lessons to be drawn.
Which side of the suppression versus mitigation debate do you fall on?
I think in general we should be aiming to get the number of infectious cases down to very very low levels. It’s not possible, most likely, to eliminate the virus anyplace because even if domestic transmission were eliminated, which is very hard, countries cannot be completely isolated from the rest of the world, so there will be continued new introductions.