Abstract
Despite notable scientific and medical advances, broader political, socioeconomic and factors continue to undercut the response to the COVID-19 pandemic1,2. Here we convened, as part of this Delphi study, a diverse, multidisciplinary panel of 386 academic, health, non-governmental organization, government and other experts in COVID-19 response from 112 countries and territories to recommend specific actions to end this persistent global threat to public health. The panel developed a set of 41 consensus statements and 57 recommendations to governments, health systems, industry and other key stakeholders across six domains: communication; health systems; vaccination; prevention; treatment and care; and inequities. In the wake of nearly three years of fragmented global and national responses, it is instructive to note that three of the highest-ranked recommendations call for the adoption of whole-of-society and whole-of-government approaches1, while maintaining proven prevention measures using a vaccines-plus approach2 that employs a range of public health and financial support measures to complement vaccination. Other recommendations with at least 99% combined agreement advise governments and other stakeholders to improve communication, rebuild public trust and engage communities3 in the management of pandemic responses. The findings of the study, which have been further endorsed by 184 organizations globally, include points of unanimous agreement, as well as six recommendations with >5% disagreement, that provide health and social policy actions to address inadequacies in the pandemic response and help to bring this public health threat to an end.
Main
Pandemics have disrupted societies and impacted public health throughout human history4. Today, almost 3 years after SARS-CoV-2 was first identified and more than 1.5 years after the first vaccines became available, pandemic fatigue5 threatens to undercut our vigilance and the effectiveness of our responses to ongoing and new pandemic-related challenges. As of September 2022, more than 620 million cases of COVID-19 and over 6.5 million deaths have been reported6, although mortality estimates range as high as 20 million7,8. The healthcare for millions more people has been delayed, often as a result of overwhelmed health systems9,10,11,12. Highly transmissible variants continue to spread globally, while surveillance for variants of concern remains largely inadequate13,14,15. Reinfection risks are not fully understood. Low vaccination rates16 may compound the risk from waning immunity17,18. Long COVID has emerged as a serious chronic condition19,20,21 that represents a considerable burden of disease and still lacks adequate understanding and appropriate preventive or curative solutions. In addition to its direct health consequences, COVID-19 has disrupted economic activity, social interactions and political processes, affected civil liberties and interrupted education at all levels22,23,24,25,26. Although many governments and individuals no longer have the same level of concern as earlier in the pandemic27, many public health leaders, including members of this panel28, continue to regard COVID-19 as a persistent and dangerous health threat29,30,31.
Responses to the COVID-19 pandemic have been hindered by interrelated factors that include false information32, vaccine hesitancy33,34, inconsistent global coordination35, and the inequitable distribution of supplies36, vaccines37,38 and treatments39. Despite increased levels of trust in science during the pandemic23,40, there is information fatigue4 and waning compliance with those public health and social measures41,42,43 that remain in place, particularly those that affect daily lives44. Meanwhile, during periods of high community transmission, needs for services continue to exceed the capacity of many health systems45, which also are challenged by ongoing risks to the health of their workers46,47,48. Furthermore, long-standing social inequities have caused some populations to experience greater risk of COVID-19 infection, severe disease and death37. Many of these populations continue to have less access to COVID-19 vaccines37,49 and treatment39, as well as to resources to mitigate the mental health, social and economic consequences of the pandemic50,51,52.
You must be logged in to post a comment.