Global Public Health
Briefing document in preparation for The Recovery Summit (Sep 14-17)
• Agenda: www.recoveryproject.org/
• Livestream: https://youtu.be/LIHJRku6-Oc
The COVID-19 Pandemic is the worst global public health emergency in over a century, and described by the United Nations Secretary-General as the “most challenging crisis since World War II.”[1] In less than three months since it was first internationally reported on New Year’s Eve 2019, the virus has rapidly spread to almost every country with varying patterns and waves of infection, contributing to almost a million deaths and 30 million confirmed cases as of September 12, 2020.[2] Its unique epidemiological characteristics and diverse range of clinical manifestations contribute to one reputable study estimating that 1.7 billion people – or 22% of the global population – could be at an increased risk of severe COVID-19 if infected.[3]
As the first waves of infection rapidly swept across Asia, Europe, the Americas and Africa, we are reminded that the second and third waves of the 1918 influenza pandemic killed significantly more people.[4] Limited disease detection and testing capacity, not only in lower income countries but also advanced economies, obscure the true toll of the COVID-19 pandemic, including community spread and deaths. Public health experts and governments have turned to rapid surveillance of excess mortality as a key indicator of overall epidemic impact and trajectory.[5]In Africa, up to 190,000 people could die of COVID-19 by the end of 2020, and an additional 44 million people could be infected.[6]
Beyond the direct effects on morbidity and mortality, COVID-19 also contributes to secondary health impacts. Disruptions in essential care as well as food shortages with self-evident health impacts are projected to contribute to 1.2 million additional under-five deaths, representing the first increase in global childhood mortality since World War II.[7] Immunization campaigns have also been suspended globally, as Médecins Sans Frontières describes the “devil’s choice” that countries and aid organizations face in balancing pandemic response while maintaining vaccination programs.[8] Indirect maternal deaths are likewise expected to rise from 8% to 38%, undermining major gains in Maternal and Child Health over the past decade.[9] Global shortages in personal protective equipment, uncertainties around transmission dynamics as well as weak infection prevention and control measures have also contributed to elevated risks among front-line health workers that make up more than 11% of all cases worldwide.[10]
COVID-19 also threatens plans to eliminate and control infectious diseases, with widespread interruptions to HIV, TB, and malaria care. Many countries are also reporting challenges in maintaining chronic disease care, including 80% of countries in Central and South America, as manageable cases risk becoming active infections.[11] Recent projections indicate public health containment, control and mitigation measures such as hand washing, wearing masks, widespread COVID-19 testing, contact tracing and social distancing, may need to be maintained into 2022, further straining health systems and exacerbating social and economic impacts.[12] The impacts of the pandemic cascade beyond health across all sectors, compounding existing vulnerabilities and emerge as network hyper-risks that ramify across systems and geographies. Like all natural and health hazards, COVID-19 has also shown how marginalized and vulnerable communities are disproportionately impacted, while exacerbating existing inequities and vulnerabilities such as malnutrition, insecurity, gender-based violence and the impacts of natural hazards, among others.