The West should be on a war footing for the next pandemic

Posted on May 22, 2024

By Airfinity's CEO and founder Rasmus Bech Hansen

People have been quick to forget how bad the pandemic was, but it's important to remember the scale of the crisis. It’s estimated that 25 million people worldwide lost their lives. 

We have had very few global events in human history that come anywhere near that. It really puts it in perspective if you look at the economic damage, it goes toward $15 trillion and we're still suffering from. It puts the pandemic in between the First World War and the Second World War, in terms of negative impact on humanity.

Now the emergency has passed, policy makers are keen to move on. I hear time and again that we now have 100 years until the next pandemic because before Covid it was the Spanish flu which happened in 1918. But of course it doesn’t work like that. 

With climate change, globalisation, a growing global population - and the increased capacity for man made bioterror through the combination of synthetic biology and AI, the risk of a new pandemic has actually increased. Our risk modelling estimates there is a 27.5% chance of a COVID like pandemic in the next 10 years. That is in line with other estimates and the assessments of the insurance industry.

And however unreal it might sound, 2020 was actually a mild pandemic. A very bad pandemic could kill 1% or more of the entire global population. For instance, we calculated that had the original COVID-19 wild type virus been as transmissible as Omicron, more than 300.000 thousand people would have died in the UK alone, nearly three times more than was the case. Now in the US we have H5N1 avian flu which is spreading in cows for the first time. If bird flu mutates and the virus gains the transmission properties that can cause a global pandemic, it would be even worse because it has a much higher case fatality rate. It’s for those reasons most countries rank pandemics in the top of risks facing the country. 

Pandemics are an extreme test of any society. So in the West we should ask ourselves how we  democracies fared compared to autocracies. Given that autocracies can take more draconian measures to contain a virus, it may be surprising to some that our analysis shows stronger democracies correlated with fewer excess deaths during the pandemic. This includes factoring in the higher income and better health care in democracies. So why did democracies fare better? One is that democracies developed the best vaccines. The Pfizer/BioNTech and Moderna mRNA as well as Oxford-AstraZeneca vaccines came out of the Western ecosystem’s long term investment in the bio-industry and populations in democracies were the first to have access to these. Another reason is trust in government. People need to trust their government, especially if they’re being asked to have an almost mandated vaccine.

This graph shows the trend that democracies had lower excess deaths, but there are outliers. For instance, the United States had a really bad pandemic, and that was not because it didn't have a good vaccine. But many places in the US there was a huge reluctance to take the vaccines. The uptake was just too low. 

Autocracies China and Saudi Arabia were also key outliers in their approach and outcomes during the pandemic. China which followed a strick ‘zero-COVID policy’ had one of the lowest excess deaths and was also the first country to develop and roll out vaccines.  China was able to scale its vaccine production to supply vaccines beyond its borders before Western producers had enough supply.

One of the constraints on Western nations was the supply chain. It takes around 300 ingredients to produce one vaccine. Contrary to the West, China had control over all aspects of the supply chain which enabled them to produce vaccines very quickly. So for the first year of COVID, China had all the vaccines, and the West had very few. This allowed China to go to Africa, to go to South America and provide vaccines and although they weren't perfect vaccines it was better than having nothing. 

But of course few would argue that China, with its very protracted and damaging lockdowns, is the model to follow. Whilst lower excess deaths and fast vaccine development are good measurements of a government’s ability to minimise the impact of a pandemic on its citizens, avoiding lockdowns in the first place should be the north star. The debate as to whether lockdowns were right or wrong, are to some extent missing the point; fundamentally, lockdowns are at odds with the central tenets of democratic and liberal societies and their implementation is a failure of pandemic preparedness. What is critically required is effective pandemic preparedness that removes the need for a lockdown when the next pandemic hits. 

Although the West is today much better prepared than before COVID, there is still much to be done. The ‘pandemic accord’, if it can be agreed upon, is part of the solution but it won’t be enough. Western allies need to develop a joint pandemic strategy and anchor it clearly in an international institution. NATO could be a good umbrella for coordinating pandemic response with government agencies. If we had a similar sophistication in surveillance, risk assessments, attack simulations and investment similar to defence programs, we would be a long way forward. 

Defence investment, especially in the US, has proven to be an important driver of innovation. Pandemic response goals such as the 100 day mission to develop an effective vaccine for a new outbreak are more likely to be successful with the urgency and logistical capacity of defence. Now the crisis from COVID-19 has passed, it’s time for the West’s pandemic preparedness to reflect the true severity of the risks. The good news is that democracies are better suited for these efforts that any other form of government.

This opinion article was published in The Telegraph on 22nd May. Click here.

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