Beyond COVID-19: science, policy, and society joining forces

A dual pandemic raged during the three years of the COVID-19 crisis: a worldwide viral tsunami caused by the new, highly transmittable SARS-CoV-2 pathogen, and a societal infodemic that drowned the world in a constant barrage of images: patients dying from asphyxia and hospitals pushed beyond capacity—all accompanied by waves of wretched fake news. Despite profound scars, four years after the pandemic began the take-home message is now clear: science and medicine, coupled with efficient, informed societal actions, ultimately prevailed. Now that the viral tide is low, what have we collectively learned that could prepare us to face future pandemics or other health emergencies?

Our ultimate success in the fight against COVID-19 was achieved in three key stages. First, the devastating explosion of cases planetwide triggered a beneficial chain reaction within science and medicine. In expeditiously facing this new threat, these two fields paved the way for emergency political decisions, helping stunned democracies to understand and accept exceptional limitations on their liberties including lockdowns, school closures, and work-from-home orders. Thanks to emerging technologies and advances in omics, the unprecedented international scientific response spanned epidemiology and disease modelling, basic research, mRNA vaccine development, and clinical studies assessing new treatments. Following advice of scientists and doctors, policymakers established informal, collaborative models of dialogue at the national and international levels. Such unprecedented coordination launched the exceptionally rapid development and evaluation of new vaccines and medicines through unusually large, comparative clinical trials. Meanwhile, innovative international and European political agreements were established for purchasing vaccines, proclaiming that vaccine access would be shared. Coordinated usage of e-technologies also provided populations with day-to-day updates on their smartphones, including epidemiological data on the positive (though transient) effects of lockdowns.

Then, several windows of relief and hope were opened, including: i) clinical confirmation of lower disease severity in children; ii) the first rigorously evaluated improvements in clinical management of severe SARS; iii) rapid worldwide capacity-building in virological assays, coupled with rapid sharing of results, which contributed to “test and isolate” strategies; iv) the incredible efficiencies of mRNA vaccines and vaccine trials demonstrating the safety of COVID-19 vaccines, fuelling their rapid regulatory authorization. These tangible examples of progress, obtained in a matter of months, stimulated unexpected public curiosity and interest in topics including PCR, point-of-care assays, and epidemiological and statistical data.

Finally, light appeared at the end of the tunnel as mass-vaccination campaigns rapidly confirmed the “real life” efficacy of COVID-19 vaccines. The first positive results of new antiviral therapeutic monoclonal antibody and treatments reinforced the feeling that we had reached the beginning of the end. Meanwhile, while the scientific and medical communities kept up unified efforts—to identify and inform the public about the never-ending waves of viral variants, to fine-tune medicines and vaccines, and to advise and encourage both policymakers and the public to adopt novel advancements.

But what about society? Beyond the initial panic that promoted acceptance of emergency regulations, the most fantastic scientific and medical discoveries would not have been successful without societal involvement. We still need a better social-science understanding of how democracies accepted practices like sharing personal data, the “test, trace, and isolate” doctrine, mass vaccination, or even the prolonged “zero-COVID” campaigns seen in some countries. How did populations react in the face of such an invasive influx of information? Furthermore, we must analyze whether and how policymakers mitigated the huge inequities in exposure—not only to COVID-19 itself and in access to prevention and treatment options, but also to high-quality information. Beyond strict obedience to mandates, how did society tame panic and shock to finally understand and accept the benefits of progress?

We know that SARS-CoV-2 is still lurking, at least transiently tamed by herd immunity. Its continued presence means we must learn to live with it, which involves continually surveying and monitoring viral presence and changes with the most up-to-date technologies. Thus, policymakers must facilitate access to accurate, advanced monitoring methods and interconnected data.

Like all other pandemics, COVID-19 is a zoonosis. Emerging viruses come from the wild, which means that research and surveillance must extend far beyond human communities, to encompass the animal world and numerous ecosystems. We know the COVID-19 crisis was immediately followed by, and will be continuously followed by, many infectious disease outbreaks (e.g., mPox and dengue in the last two years, or possibly avian flu or a yet unidentified disease in the future), the frequency and size of which will increase with climate, environmental, and geopolitical changes. To “fight back,” interconnected surveillance systems within ecosystems must monitor both pathogens and environmental changes.

Based on our learnings from the COVID-19 pandemic, we know that ongoing progress in e-technologies and artificial intelligence will be of tremendous help in preparedness. We also know that highly efficient, specific tools for prevention and treatment can be rapidly developed and scaled up. Moreover, to effectively prevent or prepare for major health emergencies and pandemics, we have learned that collaboration between science, medicine, policymakers, and societies is our only option. Such intense national and international collaborations require the urgent support of ambitious, innovative, interdisciplinary, and intersectoral research programs in a One Health approach to studying the Exposome. Only high-quality research will permit health policy decisions to rest on a solid, documented scientific foundation. Public health professionals and social scientists must be integrated into this interdisciplinary approach, and special attention must be paid to factors contributing to inequities in access to information, prevention, and care across populations and countries. Communities should be fully integrated into the preparedness and research processes, to deepen their understanding and empower societies to effectively face future pandemics and health emergencies.

In conclusion, trust in progress and the sensible use of next-generation technologies is indubitably the gold standard for preparedness, pathogen monitoring, innovative vaccine/drug development, and informed decision making. For policymakers and the public alike to rapidly invest in science and reap its benefits, advanced technologies should also help to provide rational, rigorous, verified, and transparent information on diseases and countermeasures. Robust education at all levels, on both health risks and the indispensable rigor of the scientific process, is unequivocally required in the longer term. Combined, high-quality science and clear, accessible communication are the driving forces behind the improved understanding, prevention, and control of new diseases or health crises. Trust is the key word and, as aptly stated by the Three Musketeers (who were four), “L’union fait la force.”