Historians of previous pandemics and crises offered lessons on how to deal with COVID-19, write Linda Hantrais (LSE) and Susanne MacGregor (LSHTM), though they were not always heeded

Hantrais, Linda

MacGregor, Susanne

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LSE Research Online

Containing	COVID,	part	3	|	Learning	(or	not)	from	pastcrisesHistorians	of	previous	pandemics	and	crises	offered	lessons	on	how	to	deal	with	COVID-19,	write	Linda	Hantrais(LSE)	and	Susanne	MacGregor	(LSHTM),	though	they	were	not	always	heeded.Read	the	first	and	second	posts	in	this	seriesCrises	test	social	institutions,	including	health	systems.	Even	before	countries	were	in	a	position	to	draw	lessonsfrom	their	own	experience	of	the	COVID	pandemic	or	from	countries	elsewhere	in	the	world	that	seemed	to	befaring	better,	historians	proffered	lessons	from	other	global	events	about	how	to	deal	with	crises	and	theiraftermaths.In	2020,	much	of	the	public	discussion	about	the	epidemiology	of	COVID	focused	initially	on	the	post-World	War	ISpanish	flu	pandemic.	Experience	with	other	diseases,	such	as	smallpox,	polio,	HIV/AIDS,	BSE,	foot	and	mouth,swine	flu,	Ebola	and	SARS,	also	informed	the	debate.	Common	defining	characteristics	of	pandemics	were	knownto	be	their	sudden	emergence;	the	initial	absence	of	cure;	a	high	burden	of	illness	and	death;	and	gradualawareness	of	long-term	effects	such	as	disability.	Historical	studies	have	demonstrated	that	pandemics	changehow	societies	function,	with	consequences	for	both	health	and	economies.	Faced	with	crises,	whether	institutionssurvived	or	collapsed	has	depended	on	their	resilience	and	their	ability	to	adapt	to	new	conditions.	Whether	lessonswould	be	learnt	from	experience	depended	on	pre-existing	institutional	arrangements	and	dominant	sets	of	ideas,as	well	as	the	balance	of	political	forces.The	history	of	pandemics,	and	public	health	knowledge	and	experience,	has	shownthe	importance	of	global	preparedness	and	adequate	public	spendingthe	need	for	infrastructures	of	surveillance	and	rapid	outbreak	responsethe	value	of	the	standard	public	health	strategy	of	tracing	contacts	and	ensuring	isolationthe	requirement	for	surge	capacity	in	hospitals	and	healthcare	servicesand	the	need	for	both	national	and	community	involvement	as	well	as	responses	that	are	global.Evidence	from	the	most	recent	epidemics	of	SARS	and	MERS	showed	that	the	wearing	of	face	coverings,	physicaldistancing,	hand	hygiene	and	good	ventilation	can	be	effective	public	health	measures	in	limiting	transmission	andthat	quick,	short,	and	strict	lockdowns	can	be	most	effective	in	containing	the	spread	of	the	disease.	While	thesemeasures	were	generally	accepted	in	China	and	other	Asian	countries,	they	were	not	uniformly	accepted	andapplied	elsewhere.Another	feature	identified	in	historical	studies	of	pandemics	has	been	the	moralising	of	debate.	Pandemics	arefound	to	be	deeply	political.	Scientists	cannot	avoid	being	drawn	into	debates	in	the	policy	arena	and	incontroversies	about	effective	public	health	responses:	the	public	as	a	whole,	however	defined,	has	to	be	involved.Experience	has	shown	that	the	implementation	of	policies	to	deal	with	pandemics	is	complex,	making	coordinationand	partnership	critical;	a	strong	central	state	response	is	required,	combined	with	active	local	involvement	andgood	communication	between	different	levels	of	governance	and	with	the	public	at	large.Western-centrism	may	partly	explain	Western	unpreparedness	in	the	face	of	the	pandemicTeams	of	political	scientists	drew	similar	lessons	to	those	of	public	health	scholars	from	analysis	of	the	long-termimpact	of	another	crisis:	the	2008−09	global	financial	shock	as	experienced	in	Europe.	They	identified	a	deep-seated	problem	in	achieving	political	consensus	and	cooperation,	also	applicable	to	the	COVID	pandemic,	whichwas	due	not	to	technical	obstacles	but	to	the	political	infeasibility	of	adopting	policy	or	institutional	solutions.LSE Covid 19 Blog: Containing COVID, part 3 | Learning (or not) from past crises Page 1 of 2		Date originally posted: 2021-04-29Permalink: https://blogs.lse.ac.uk/covid19/2021/04/29/containing-covid-part-3-learning-or-not-from-past-crises/Blog homepage: https://blogs.lse.ac.uk/covid19/Other	political	scientists	identified	four	modes	of	learning	in	public	policy	in	the	context	of	the	Brexit	negotiations,which	were	ongoing	when	the	public	health	crisis	hit	the	UK.	Learning	through	the	first	three	modes	proved	highlydysfunctional	when	applied	to	Brexit,	and	the	UK	government	was	forced	to	rely	on	bargaining	between	competingfactions,	producing	a	highly	political	form	of	learning	which	stymied	the	development	of	a	coherent	Brexit	strategy.By	analysing	Brexit	‘as	a	policy	process’	rather	than	‘a	political	event’,	policy	dynamics	were	shown	to	play	animportant	role	in	shaping	the	political	context	within	which	they	are	located.	In	the	case	of	the	pandemic	within	theEU,	it	could	be	argued	that	all	four	modes	of	learning	are	relevant,	particularly	from	a	comparative	perspective	if	theanalysis	of	the	policy	process	focuses	on	‘endogenising	accounts	of	macro	political	developments’.Western	countries	were	often	accused	of	not	learning	lessons	from	East	Asian	countries	such	as	South	Korea,Singapore,	Taiwan	or	Vietnam.	These	countries’	relative	success	in	controlling	the	spread	of	COVID	at	its	onsetwas	widely	attributed	to	their	capacity	to	learn	from	previous	experience	of	epidemics,	their	preparedness	to	dealwith	new	threats	to	health,	and	public	acceptance	of	the	need	to	comply	unquestioningly	with	stringent	measures	tocontain	the	virus.	The	crisis	brought	urgent	challenges	that	policymakers	had	to	resolve	under	conditions	of	deepuncertainty:	understanding	the	nature	of	the	virus,	improvising	social	distancing	measures	without	evidence-basedroadmaps,	communicating	with	an	anxious	public,	and	preserving	economic	and	social	wellbeing.	In	2020,	fewWestern	countries	were	economically,	physically	or	politically	as	well	equipped	as	some	East	Asian	countries	tomeet	the	challenges	of	a	public	health	pandemic.	Another	pertinent	lesson	from	previous	public	health	crises	is	that‘we	have	managed	to	deal	with	disease-causing	pathogens	significantly	better	than	with	our	entrenched	prejudices’.A	key	lesson	that	could	have	been	drawn	from	recent	scholarship	is	the	danger	of	Western-centrism,	which	maypartly	explain	Western	unpreparedness	in	the	face	of	the	pandemic.	The	West	was	in	danger	from	highlycommunicable	diseases	such	as	COVID	in	spite	of	its	wealth	and	scientific	knowledge	because	insufficient	attentionwas	paid	to	to	these	risks.	Research	and	policy	had	shifted	to	non-communicable	diseases	such	as	diabetes	andobesity.	As	it	turned	out,	many	of	these	diseases	appeared	to	interact	with	SARS-COV-2	to	increase	vulnerability.This	post	represents	the	views	of	the	authors	and	not	those	of	the	COVID-19	blog,	nor	LSE.LSE Covid 19 Blog: Containing COVID, part 3 | Learning (or not) from past crises Page 2 of 2		Date originally posted: 2021-04-29Permalink: https://blogs.lse.ac.uk/covid19/2021/04/29/containing-covid-part-3-learning-or-not-from-past-crises/Blog homepage: https://blogs.lse.ac.uk/covid19/

Containing COVID, part 3. Learning (or not) from past crises

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Containing COVID, part 3. Learning (or not) from past crises

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