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Nobody told us what to expect (except health professionals and our own simulations)

Most languages and cultures have a saying with the same message as the English proverb “a stitch in time saves nine”. Like a lot of good advice, you only appreciate it after the event, as you stab your finger with the needle trying to do that ninth stitch, for instance. The COVID-19 pandemic is no exception. The Global Preparedness Monitoring Board calculated that preparing for a pandemic would have cost the world 5 dollars per person, compared to the USD 16 trillion the IMF estimates the world had spent on pandemic responses by the end of 2021.

The usual excuse, very popular regarding the 2008 financial crisis, is that nobody saw it coming. And that despite multiple warnings from experts saying it was coming. John Llewellyn, Lehman Brothers’ chief global economist at the time of the crash, told an OECD conference in 2018 that their models had predicted a major meltdown, but since the models couldn’t say when it would happen, the board ignored advice to reduce risk, on the basis that would mean losing money and market share. Llewellyn said he heard similar stories from colleagues in other big financial institutions.

And so with the pandemic. In January 2019, the US Department of Health launched a major simulation called “Crimson contagion”. The scenario was that a traveller returning from China to Chicago had caught a respiratory virus. In less than two months, the virus had infected 110 million Americans; 7.7 million patients would require hospitalisation, and 586,000 people would die. Three years earlier, “Exercise Cygnus” in the UK simulated the situation at week 7 into a major pandemic provoked by an H2N2-type virus. A vaccine had been developed but was not yet available. The exercise warned of the dangers of systemic collapse in the health system due to a lack of resources, for example, ventilators.

Other examples show that you don’t need a big, state-funded exercise to provide valuable lessons. In 2019, Steven Taylor, from the Department of Psychiatry at the University of British Columbia, compiled the findings of his research into how people reacted during previous pandemics. The motivation behind his work was that “public health agencies have devoted few resources for specifically dealing with the psychological factors that influence pandemic-related emotional reactions (e.g., fear, anxiety, distress) and behavioral problems (e.g., nonadherence, avoidance, stigmatization of out-groups)”.

In The Psychology of Pandemics: Preparing for the Next Global Outbreak of Infectious Disease, he describes the mental health and behavioural implications of “severe disruptions of routines, separation from family and friends, shortages of food and medicine, wage loss, social isolation due to quarantine or other social distancing programs, and school closure”. The book covers topics that have become familiar to most of us over the past two years, including vaccine hesitancy, conspiracy theories, and fake cures, as well as other concepts that would have been familiar only to specialists before the pandemic, like social distancing.

One of the main psychological factors at play in the lack of preparation is found across a range of human activities, from climate policy to eating habits. It goes under various names, including short-termism and the very technical “hyperbolic discounting”, but the mechanism is broadly the same – the present counts for more than the future. Benefits that are perceived as real and immediate outweigh possible negative consequences in the future.

Governments can draw several applicable lessons from the research conducted by the COVINFORM project. The project explores how different groups react to and have been affected by the pandemic physically, economically, socially, and psychologically. Additionally, the research aims to improve the preparedness for the next major health emergency. The approach used means that the findings should be usable across a range of potential situations. The theoretical foundations lie in complexity and intersectionality theories. Combining these provides a framework to explore the interactions among different systems and how these interactions affect lives.

And as to conclude this blog, evidently, there are far better and cheaper ways of dealing with problems than waiting until they cause devastation and then spending trillions repairing the damage.

Author: Patrick Love



Taylor, S. (2019). The psychology of pandemics: Preparing for the next global outbreak of infectious disease. Cambridge scholars publishing.