As is probably the case for many of us, this past weekend of self-isolation in a Belgium in lockdown-mode has been spent thinking almost incessantly about the unprecedented situation that we are facing across the world. I found myself reflecting on what could have or could still be done differently as well as on any lessons for the future, with a particular eye on Europe.
While the full scale of this crisis is still uncertain, we can already assume that it will define 2020, the decade and quite possibly the century.
In opining about the political and policy response and implications, we must recognise that we do not yet know the endgame
Fundamental questions remain unanswered: how many people will suffer from the virus, and what will the social, economic and political implications be?
Although we can make assumptions about the answers to these questions at this point in time, the truth is we simply do not know for certain at this relatively early stage.
The first depends on three main factors: the geographical spread of the virus, how many people will be infected, and, of those, how many will die. We know that the spread is now global in scope resulting in a declaration from the WHO that as of 11 March, COVID-19 should be characterized as a pandemic.
On the second, expert views differ, but there seems to be an expectation that a very significant proportion of the population will be infected – and quite possibly the majority. Considering that COVID-19 is now a global phenomenon, this would translate into billions of people becoming infected. It certainly puts the current figures of 150,000 confirmed cases as of mid-March into perspective!
The evidence suggests that COVID-19 is a mild illness in the majority of cases, but in a minority serious illness is experienced, imposing extraordinary burdens on healthcare systems and – tragically – some deaths too.
Europe’s reaction so far has been disappointing on multiple levels
What we can say, regardless of our limited knowledge at this point in time, is that aspects of the policy response have so far been disappointing. The European institutions seem to have been caught by surprise and their lack of reactivity has made the EU’s limited competence in health policy in times of emergency sadly tangible to all. Awareness of the need for a coordinated health crisis mechanism has also increased.
The EU has unfortunately also missed the opportunity to act where it could have, for example through Member State coordination at Council level and exchanges of best practices. The European Commission could have leveraged these exceptional times as an opportunity to express solidarity to the most affected countries and therefore make Europeans feel its presence. And, of course, the European Central Bank did not live up to expectations that it would cut interest rates as the Eurozone heads toward recession.
But there will be important initial lessons that can inform future policy activity
On a more optimistic note, in the months ahead we will learn valuable lessons about how future global pandemics can be mitigated. This will stand us in stronger stead for the future.
There are also a number of initial considerations that we should start reflecting on to positively inform and shape future policy activity.
The lack of a truly unified response from the EU once COVID-19 appeared in the economic heart of one of its founding nations has been evident to all. We know that there will inevitably be other epidemics and pandemics and we must ensure that, next time, Europe is equipped to step up with a coordinated health response and that adequate investments are made to put in place an epidemic response system at EU level. We should have already been warned through previous epidemics and pandemics such as SARS, the swine and avian flu and even Ebola, but we now know that this can no longer wait.
Another obvious lesson should be that citizens’ health education – health literacy – is an essential element for achieving satisfactory outcomes in health. COVID-19 has already made clear why we all have a duty to adopt responsible behaviour for the common good. Health education is a feat that can be tackled through broad multi-stakeholder partnerships at EU and national level, including with policy makers, medical and scientific communities, patients/citizens organisations, the media and business.
A final learning should be around whether anything can be done to structurally reform health systems to be able to cope with such once-in-a-generation health crises. It is now clear that most health systems are not prepared to cope with the scale of a pandemic such as COVID-19. We should take stock of this experience once the months ahead have passed to engage in a constructive debate on whether healthcare systems should be equipped with a residual level of preparedness, reflect on the centrality of health in our lives and what we can do to better coordinate future responses at European level.
by Francesca Scassellati-Sforzolini