It has now been three years since the world became fully aware that it was facing a pandemic caused by the COVID-19 virus, since when there have been 6.9 million deaths due to the virus according to official figures, but more than 20 million deaths overall, according to “excess deaths” estimates calculated by The Economist. In 2020-21 COVID-19 ranked as the third-highest cause of death in the United States, after heart disease and cancer.
That is ample reason to try to draw lessons from this extraordinary pandemic before they fade from memory, but there is an added one: climate change and population density make it virtually certain that more viruses will threaten new pandemics in the future, making our 2020-22 episode unfortunately not unusual, even if hopefully not exactly ordinary. It is good, therefore, that many countries will now hold public inquiries into the lessons of the pandemic, but in too many cases these reviews risk becoming exercises in recrimination and blame-allocation rather than assessments of what can and should be done to prepare for the next viral threat.
Scientists will surely draw the most sophisticated and specialised lessons about issues such as viral detection, medical treatment and vaccination technology. But for the rest of us there are general lessons from 2020-22 about public policy, politics and social behaviour. Some of these will differ from country to country, but some general principles still do apply.
The first of those principles can be drawn from East Asia. The whole pandemic experience has combined tragedy and peculiarity, with one of the most peculiar aspects being that two of the countries that were among the first to become aware of the virus, China and Japan, have now, in 2023, been among the last to restore their societies to normal life, by reopening borders and finally ending rules or guidelines about masks and other social measures.
During much of 2020, the rest of the world suffered from East Asia Envy. Seeing the far lower infection and death rates in China and Japan than in Europe or North America, we searched hard for explanations, often resorting to exceptionalist notions of cultural acceptance of mask wearing, of social conformity or, in China’s case, of technologically-advanced authoritarianism, in order to avoid too much awkward self-criticism.
Yet by the first half of 2022, as much of Europe and North America abandoned rules and restored normality, the envy had ceased and been replaced by bafflement mixed with annoyance at the continued need for travel visas for Japan and strange spit tests at Haneda Airport.
For ultimately the East Asian lesson is a simpler one: once a virus has achieved global pandemic status, it cannot be suppressed forever. It will eventually find its way into a population. Border closures and other forms of suppression are exercises in delay, not prevention.
A second, related, lesson is that delay is an important tool if it buys time to develop effective treatments against the virus and the real solution of vaccination. But delay also brings consequences and costs, which need to be weighed in the balance. This can be seen in Japan’s mortality figures for the period to March 2023. The official COVID death rate of 73,000 is a lot worse than looked likely a year earlier, yet is still better overall than most European countries or the United States. Nonetheless, estimates of excess deaths in Japan during this period are now much higher, with The Economist reckoning 170,000-210,000 in all. The main explanation is probably delayed treatments for other diseases, while fear was high and access to hospitals restricted.
Similar phenomena can be seen in other countries. COVID-19, like other viruses, has been a kind of leveller, bringing some convergence of outcomes over time. However, public policy responses still made a big difference.
The third lesson draws on those differences. It is about the converse of delay: speed. The early weeks of the pandemic were filled with huge uncertainties about what was happening and how dangerous it was. In response to that uncertainty, some countries took longer than others to take the pandemic seriously. Donald Trump’s United States and Boris Johnson’s Britain both responded to the uncertainty by playing down the dangers and postponing action, suffering high early death rates as a result.
The lesson is that the right response to an uncertain viral threat is to impose swift restrictions while the scientists work out what is going on, rather than waiting for fuller knowledge before acting. Arguably, social acceptance of those initial swift restrictions is likelier when the uncertainty and fear are at their highest.
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That is what China and Japan got right, and much of Europe and the US got wrong. Yet having made that early mistake, the Americans and Europeans then moved with greater vigour, financial commitment and political determination to get vaccines developed and manufactured quickly, and then to distribute them swiftly to their populations.
China was swift to make vaccines, but was too politically stubborn to adjust once it became clear that the Chinese vaccines are much less effective than the western ones. Japan wisely bought western vaccines but was very slow to administer them thanks to regulatory rigidity. For all of us, greater investment in vaccine manufacturing capacity would have brought clear benefits in terms of reduced mortality and faster economic recovery.
Pandemics, it is now plain, cannot be predicted but they can be prepared for by setting up early-warning detection systems and maintaining stocks of masks and other protections. And above all, responses to them can be rapid if scientists and pharmaceutical firms are allowed to move swiftly and given help and financial support by government. What is also plain, however, is that even though a virus is the quintessentially common and global threat, countries are not willing to collaborate very much in response to them.
Institutions of global governance and collaboration, such as the World Health Organisation and the International Monetary Fund, were in effect marginalised during 2020-22. Far from diminishing in the face of this global threat, superpower rivalry intensified, making those institutions impotent. And from the point of view of middle and smaller powers, especially the developing countries, the key lesson was that none of the superpowers can be relied upon to help in a global emergency. There is no hegemon, nor any true friend to smaller countries. Three years into the pandemic only 30% of Africans have been fully vaccinated against COVID-19. That figure compares with 70% in the United States, 73% in the European Union and 83% in Japan. This vaccine inequity is an important background to the division of attitudes to Russia’s invasion of Ukraine between what is now known as the Global South and the rich West.
This article was originally published in Bill Emmott’s Global View substack. Subscribe here.
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