Pandemic Preparedness: Past, Present, and Future

Posted on behalf of Kathleen Chen and Skylar Price

Although it has been more than two years since the pandemic began, COVID-19 transmission and new outbreaks are still occurring throughout the world. Only months ago, China was confronting the country’s largest coronavirus outbreak since the pandemic began. In the United States, summer brought a wave of COVID-19 outbreaks throughout the country, including in California, marking the state’s third highest case peak of the pandemic. Additionally, scientific and public health information is still being gathered and assessed, leading to a better understanding of SARS-CoV-2 (the virus that causes COVID-19) and its variants and mutations. This newfound insight and collected data are continuing to help develop and deploy optimized treatments and controls (e.g., vaccines).  While the world continues to adapt to life in the face of this pandemic, responding to COVID-19 moving forward will require continuous effort and adaptability.

The COVID-19 pandemic has highlighted the critical importance of public health as a science, and created a newfound emphasis on pandemic preparedness. Although pandemic preparedness and response plans may seem novel to many, these practices have previously been implemented during historic health crises (e.g., the 1918 influenza pandemic), and still today comprise an key part of any school of public health curriculum. Pandemic Preparedness frameworks and approaches will continue to be used by public health scientists, health authorities, and workplaces for years to come. When reflecting on the past two years and the policy variations adopted by governments around the world, the approaches that have been particularly effective at mitigating COVID-19 transmission, such as proactive case detection, quarantine/isolation, contact tracing, and proper use of personal protective equipment (PPE) are the ones that stand out. This pandemic, however, also experienced (and continues to battle) risk and factual science communication setbacks that previous pandemics never anticipated. The lessons we have learned today will therefore continue to evolve as we study the virus and subsequent diseases. These lessons will be integral for helping the world to protect human health, minimize disruptions, and support a communal desire to return to “normalcy”.

In addition to posing a newfound morbidity and mortality threat, COVID-19 has also disrupted our way of life in profound ways. When COVID-19 was declared a pandemic, government organizations, healthcare systems, schools and universities, transportation companies, retailers, and businesses alike were overwhelmed, and not fully prepared for the disruption that the pandemic caused. As a result, a disorganized and inequitable response at both a systemic and local level occurred, along with secondary and tertiary consequences from such a disjointed response.  Mental health impacts are just one example of how an improper COVID-19 response has affected society at large. Within the United States, school closings and transitions to remote and hybrid schooling have had significant effects on adolescents.  The CDC’s 2009-2019 Youth Risk Behavior Survey, for example, indicates an increasing and concerning declining mental health status trend across high school students, particularly among minority students. With healthcare systems overburdened by the demand for services, a CDC survey from March to April of 2021 reported that over half of respondents reported at least one symptom of the following mental health conditions: depression, anxiety, or post-traumatic stress disorder. On a global scale, frontline workers in Spain, including healthcare and grocery workers, also reported greater psychological impacts due to the concerns and stress caused by working in the frontline during the COVID-19 pandemic. COVID-19 effects on mental health have indeed been profound, yet the pandemic’s impacts have not been limited just to this issue. Other interrelated impacts include altered economic demands, equitable healthcare, and medical treatment and technology access issues.

Moving forward, entities such as those mentioned and those desiring to transition back to an in-person or hybrid structure, need to prepare flexible and equitable pandemic response plans for ongoing COVID-19 transmission, as well as any future pandemics. In the case of another future major public health event, organizational leaders should invest in updated and thoughtful pandemic preparedness strategies. As described by Parker et al. (2020), these strategies could include developing and implementing a comprehensive and bespoke framework for return-to-work/return-to-normal practices based on governmental guidance, scientific evidence, health equity recommendations, and organization-specific considerations and risks. Intermediary stages of risk and response can be developed as well to allow a level of flexibility for responding to future scenarios in order to minimize disruptions. Preparing a pandemic response plan beforehand will minimize worker risk and business operation and economic disruptions in the face of COVID-19 or another emerging disease(s).

Unfortunately, the threat of an outbreak, endemic, epidemic, or pandemic will always remain on the horizon. During the 2014 West Africa Ebola epidemic (the largest in history), the Unites States narrowly escaped a national health disaster with only eleven cases and one death. More recently, the WHO has declared monkeypox a global health emergency, positive cases across 39 countries, including 32 countries with no prior monkeypox case history. Additionally, New York state public health officials  recently alerted the public to a case of paralytic polio in Rockland County, the first confirmed case in New York since 1990. Shortly thereafter, the polio virus was detected in Rockland and Orange county wastewater. These samples were genetically linked to the individual paralytic polio case, indicating potential community transmission. These recent monkeypox and polio surges of confirm the need for investing in pandemic preparedness and response planning, so as to ensure that our communities and organizations are always well equipped to quickly and appropriately respond to such public health threats. In addition, organizations should thoughtfully consider designing their pandemic plans to be flexible and equitable for all stakeholders and the communities they impact.

Cardno ChemRisk, now Stantec is experienced at developing and assisting with workplace health and safety strategies and support. To learn more about the ways ChemRisk can support occupational health and safety-related matters specific to COVID-19, please contact Justine Parker or Corey Boles, or visit our company website, and Practice Area webpage on Occupational and Environmental Health and Safety.