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Once, we all respectfully listened to what epidemiologists said. We queued up for vaccines, observed distancing lines and confidently asked unmasked passengers on public transport to cover their faces. A tyrannical virus ruled over us, and we did everything in our power to limit its ravages.
Five years on from the declaration of the Covid-19 pandemic, it’s the masked passenger who is suspect, nobody notices the scuffed distancing lines and trust in vaccines has taken a tumble. A different narrative has invaded the conversation: it wasn’t the virus that ruined our lives, but the response.
This narrative was always there, but for a long time it stayed on the fringes. Now it’s becoming mainstream, turbo-charged by the recent successes of its political champions who typically gravitate towards the populist right. Public health experts have watched its advance with a gathering sense of doom. They know that how we respond to the next pandemic depends on how we understand the last, and that the next one is probably closer than most people think. Mind-bogglingly, many of them worry that Covid-19 has left us more, rather than less, vulnerable to it.
The response was far from perfect, these experts say, but the purveyors of the new narrative have picked the wrong target: science. The mRNA vaccines prevented millions of deaths. The technology for building new, effective vaccines quickly came on in leaps and bounds. Masks worked. And as with every pandemic in recent history, subsequent reviews have found that the advice to go early and hard with containment was correct. Did the scientists make mistakes? Of course, but they were working in conditions of high uncertainty. But they were also often ignored or countered by the politicians they advised, as well as by others in positions of influence – and yet those people aren’t the villains of this piece.
Anyone who doubts the power of narrative need only look at that modern Icarus, Anthony Fauci. Five years ago, the seasoned epidemic warrior and prominent figure in the US Covid-19 response (he was chief medical adviser to the president, 2021-22) was anointed the country’s “most trusted coronavirus expert”, and its “scientific voice of reason”. Then the white-hot heat of public opinion melted his wings. Having accepted a pre-emptive pardon from Joe Biden, he was forced to point out that he had committed no crime. And though he has been subjected to frequent death threats, Donald Trump has withdrawn his federal security detail.
Fauci’s British counterparts, Chris Whitty and Patrick Vallance, have also received death threats. But in allowing these scientists to be treated so shabbily, we undermine ourselves in the long run. Who would take on that thankless task now, if a new pandemic struck? Fauci et al are just the visible face of the backlash. Behind the scenes, infectious disease researchers report their funds are drying up, leaving them less able to predict and prevent the next pandemic. The Trump administration has sown disarray at its medical research agency, the National Institutes of Health (NIH), and ordered US withdrawal from the only global public health agency, the World Health Organization. Negotiations over a pandemic treaty, which would improve disease surveillance and vaccine access globally, have stalled.
Speaking about the NIH in late 2023, Trump’s future health secretary, Robert F Kennedy Jr, reportedly said: “We’re going to give infectious disease a break for about eight years.” Unfortunately it isn’t giving us a break, because our various crises are linked. The rate of emergence of zoonoses – human infections of animal origin – is accelerating, due to factors including deforestation and the human-altered climate. Where viruses are concerned, the chief executive of the Coalition for Epidemic Preparedness Innovations, Richard Hatchett, wrote recently, “the world is on fire”.
A teenage survivor of the 1918 flu could expect to never encounter a pandemic again in their lives. The same is unlikely to be true of today’s teenagers. The most imminent threat is probably posed by “bird flu”, the strains of H5N1 influenza A that are at present circulating in cows and poultry. They haven’t become transmissible between humans yet and they may never do so, but they have spread from animals to humans dozens of times on several continents, causing illness and at least one death. If one of them were to trigger a pandemic, that pandemic would be at least as deadly as Covid-19, which is estimated to have caused upwards of 27 million excess deaths to date.
It’s difficult to know which microbe will cause the next pandemic, because for all scientists’ sophisticated modelling, they can’t predict the change in context that will nudge one from a relatively benign trajectory on to a more dangerous one. Besides studying the causes of the zoonotic threat, our best hope for protecting tomorrow’s teenagers is to make our societies more resilient. We saw this clearly at the height of the emergency, but we’ve forgotten it. Remember the shortlived calls to reduce gaping inequalities, shore up our health systems and work forces, and “build back better”?
Interviewing people from 70 countries in a global listening project launched in 2021, a team led by anthropologist Heidi Larson found that many felt uncared for – their daily challenges lost in talk of case rates and “unflattened curves”. The sick-pay issue was emblematic: plenty couldn’t afford to stay at home when ill. Their desire to help others was stymied, too, by – among other things – the disastrous insistence on social distancing. This became a shorthand for physical distancing, which was essential, but it undermined efforts towards social cohesion, which is also vital in a pandemic.
“In a real crisis, the state can’t look after you,” psychologist Stephen Reicher of the University of St Andrews told me. “It can’t put food on your table, or walk your dog. We do it for each other.” Up to 14 million Britons participated in mutual aid groups at Covid-19’s peak, and Larson’s feedback suggests that the number would have been higher had the government supported those efforts.
Five years after the start of the worst health crisis in living memory, there is a national conversation waiting to be had about the roles of the individual, society and the state in such a crisis. What is my responsibility to myself and to my community, and what is the responsibility of the state towards us? At each level there is room for improvement, but we’re not addressing it. Let’s hope we can have that conversation before we’re tested again, but first the more strident – and misguided – voices have to pipe down.
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Laura Spinney is a science journalist and the author of Pale Rider: The Spanish Flu of 1918 and How it Changed the World
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