Health and medicine cannot solve COVID-19
Authors: Amy K McLennan, Anne Katrine Kleberg Hansen, Stanley J Ulijaszek
Journal: The Lancet (2020)

Richard Horton argues that combination prevention and global health collaboration are required to address the COVID-19 pandemic.1Horton R Offline: It's time to convene nations to end this pandemic.Lancet. 2020; 396: 14Summary Full Text Full Text PDF PubMed Scopus (4) Google Scholar We agree and suggest this should incorporate further measures. Thinking closely in terms of medical solutions could create false public expectations of a return to normal, and risks closing out non-health interventions that could lead to substantial improvements. COVID-19 has exposed the complex and interdependent systems of everyday life. Health, politics, economics, technology, environment, education, policing, engineering, transport, food systems, communication, and more all intersect as complex expert systems.2Ulijaszek S Models of obesity: from ecology to complexity in science and policy. Cambridge University Press, Cambridge2017Crossref Scopus (26) Google Scholar Any intervention continually shapes, and is shaped by, other parts of these systems. For example, lockdown-related transport disruption is impeding routine vaccination programmes,3WHOAt least 80 million children under one at risk of diseases such as diphtheria, measles and polio as COVID-19 disrupts routine vaccination efforts, warn. Gavi, WHO and UNICEF, 2020https://www.who.int/news-room/detail/22-05-2020-at-least-80-million-children-under-one-at-risk-of-diseases-such-as-diphtheria-measles-and-polio-as-covid-19-disrupts-routine-vaccination-efforts-warn-gavi-who-and-unicefDate accessed: June 12, 2020Google Scholar reshaping education, and improving air quality.4Chen K Wang M Huang C Kinney PL Anastas PT Air pollution reduction and mortality benefit during the COVID-19 outbreak in China.Lancet Planet Health. 2020; 4: e210-e212Summary Full Text Full Text PDF PubMed Scopus (301) Google Scholar At the same time, health improvements could come from fields well outside of health. An example of this from London's recent past is the radical re-engineering of city landscapes and construction of sewer systems, which substantially reduced infectious disease burden. Collective interventions will create the new normal that we will inhabit in the future.5Latour B Where to land after the pandemic? A paper and now a platform.https://www.bruno-latour.fr/node/852.htmlDate: 2020Date accessed: June 7, 2020Google Scholar Yet, the pandemic is framed primarily as a global health crisis, and so the public expects health interventions—a vaccine, new public health measures and hygiene behaviours, and effective treatments—to end COVID-19 and permit a return to the old normal. We caution against this framing. Medicine is well placed to change the narrative and make space for joined-up thinking about a different future with or without COVID-19. We declare no competing interests. Offline: It's time to convene nations to end this pandemicA historic and calamitous milestone was reached this week. WHO reported more than 10 million cases of COVID-19 and over 500 000 COVID-19 deaths. The world's political leaders have been tested and they have been found wanting. It's hard to recall a more lamentable response to a global emergency. Even the climate crisis had its Kyoto and Paris agreements. But despite the urgency of this continuing human catastrophe, despite the immediacy of the economic collapse we are witnessing, there has still been no moment when nations have been convened to reflect on lessons to be learned, to coordinate actions to protect citizens, and to plan for future spikes or waves of infection. Full-Text PDF