The Lancet has published a hard-hitting piece on lessons learned from the COVID-19 pandemic. The report includes a blow-by-blow account of the pandemic and the lessons that have emerged, and some important recommendations from a global public health viewpoint. Unsurprisingly, this piece has generated a lot of interest and people are talking about it, which is no bad thing!

The Lancet Commission is comprised of about 30 experts in public health and some other related disciplines. The key findings of the commissioners are:

• The origin of SARS-CoV-2 is not yet known, and we can’t yet rule out a “straightforward” epizoonosis from the involvement of a lab-associated escape. I thought the “lab-escape” theory had been pretty much ruled out? But I guess these commissioners are better informed than I am (interesting review article here)!
• WHO are criticised for acting too slow, and for not recognising the role of airborne spread of SARS-CoV-2. Unsurprisingly, WHO have issued a robust response to this charge!
• Governments are also in line for criticism about being too slow to respond at the start of the pandemic.
• There was limited collaboration between governments to create a coordinated regional approach (e.g. the mess around travel restrictions).
• Control measures were hampered by public opposition. Governments could have done better in addressing this, especially by embracing behavioural and social sciences to inform interventions. Disinformation was not tackled effectively enough.
• Public policies didn’t adequately address health inequalities. This is a tough one, because health inequalities run deep and there’s no quick fix. But it’s a fair point!
• Countries with strong and resilient public and national health systems did better than those without. Although under-reporting of cases and outcomes made this difficult to judge.
• Rapid development and implementation of COVID-19 vaccination was a success of science. However, lack of international co-ordination has meant that vaccination coverage has been unequal and not as effective as it could be in halting the pandemic.
• Economic recovery depends on global vaccination.
• Global sustainability aims have been set back by the impact of the pandemic.

I recently posted my own reflections on pandemic-related learnings. Some of the themes are similar (PPE, transmission dynamics, vaccination) but others are quite different (organisational transformation, hospital outbreaks, antimicrobial stewardship). I guess the difference comes from the perspective taken: the Lancet commission from a global health, and mine from an acute healthcare provider in London.

The Lancet article is well-worth a read – and has some important recommendations to get us out of this pandemic, and set us up better for the next!