Between 1988 and 1990, I had the privilege to attend Yale University as a Robert Wood Johnson Clinical Scholar and M.P.H. student. My mentor was the late Dr. Alvan R. Feinstein, a Sterling Professor of Medicine. One of Dr. Feinstein’s key contributions was his emphasis on the importance of “soft data” of human sensations and judgements alongside more statistical or scientific “hard data.”
Dr. Feinstein’s insight is relevant to COVID-19. The “hard” issues, such as public health measures and scientific progress on vaccines, have been paramount and in the foreground. But the pandemic has also demonstrated the fundamental importance of the soft issues, such as equity, governance, leadership and trust.
During 2020, COVID-19 shone a harsh light on pre-existing social and economic inequities. For example, 52% of the population of Toronto, Canada, comes from racialized communities, but 81% of the cases of hospitalized COVID-19 came from these communities.
The defining challenge of 2021 is vaccine equity. My friend and colleague Dr. Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO), has warned that the world is on the brink of a catastrophic moral failure. Indeed, vaccine coverage of total population is 44% in high income countries compared to 9.8% in non-high-income countries, a more than four-fold difference, according to pandem-ic.com as of early May 2021.
The pandemic has also shown the importance of global governance and multilateralism. I feel proud of my colleagues in the WHO. Since the moment we heard of the cluster of pneumonia cases in Wuhan on December 31, 2019, colleagues have worked around the world and around the clock to save as many lives as possible.
After a series of escalating warnings, on January 30, 2020, WHO declared its highest level of global alert under international law, when there were fewer than 100 cases and no deaths outside China.
Those countries that listened to the WHO’s warnings tended to do well. Indeed, there is more than a 50-fold difference in cumulative mortality even among G20 countries, according to Our World in Data.
Some of this variation is no doubt attributable to chance. Some is preparedness capacity. Some is experience with earlier outbreaks, and the contact tracing and public health measures, like mask wearing, that go along with it.
But some of this variation is no doubt attributable to leadership and trust in government on the part of citizens. And this is an important lesson for public health graduates and, indeed, all students.
Equity, governance, leadership, trust. These soft issues turned out to be the foundation of the response to COVID-19, buttressing the unprecedented scientific progress and serious need to sustain public health measures.
Above all, the key lesson of the pandemic is character matters. Perhaps COVID-19 will unleash a pandemic of kindness.
Peter A. Singer, O.C., M.D., M.P.H. ’90, is Special Advisor to the Director General and Assistant Director General of the World Health Organization.
This commentary is part of a series produced by Yale School of Public Health highlighting important issues related to COVID-19 and public health.