COVID-19 could have brought out the best in humanity. Instead, public health programs have fallen short, exposing us to a resurgence of diseases.
A baby is vaccinated against malaria in Malawi. (WHO/Mark Nieuwenhof)
COVID-19 has shut down vaccination programs around the world. It has stifled aid efforts and emptied coffers of money meant to help prevent and treat diseases from tuberculosis to HIV.
In a perfect world, the coronavirus pandemic would have brought out the best humanity had to offer. As scientists raced to develop vaccines and treatments, governments would have poured trillions into beefing up public health systems in rich and poor countries alike.
They would have pooled resources to make sure no community was too poor or too remote or too unimportant to miss out on the opportunity to build new clinics, train new healthcare professionals and set up the infrastructure needed to roll out tests, vaccines and treatments.
This is obviously not a perfect world.
Not only has public health fallen apart in underdeveloped nations, but even the richest nations of the world have failed spectacularly to rise to the challenge.
While vaccine development has been lightning fast — and the new vaccines are stunningly effective — development of tests, of protocols to control the spread of the virus and of treatments has trailed behind. Vaccine distribution is slow and heavily weighted towards a few wealthy nations.
Worse, the confusion and expense of the pandemic have damaged other public health efforts, decimated the ranks of health workers and emptied the coffers of the World Health Organization (WHO) and other groups that had already been struggling to boost public health.
Millions of children have missed routine immunizations.
What does that mean for the future?
Many experts are predicting a new pandemic — one a little less obvious but spawned directly by COVID-19. It’s a pandemic of infectious diseases that the world had controlled, if not conquered, through sustained vaccination efforts.
In July, the WHO reported that 23 million children around the world had missed their routine immunizations against infections such as measles, polio and diphtheria because of the pandemic.
As many as 17 million children did not get a single shot in 2020, and 2021 is not looking much better. A team led by the Institute of Health Metrics and Evaluation at the University of Washington reached similar conclusions in August.
COVID-19 has put the goal of eradicating polio in peril.
What could that mean?
Before widespread vaccination against measles, according to the WHO, the virus caused major epidemics every other year or so and killed about 2.6 million people a year.
Children get their first measles shot when they are still babies and need a series of jabs to be fully protected. The first shots of this vaccine series reached 86% of the world’s babies by 2018, and vaccination programs reduced measles deaths by 73% between 2000 and 2018. The same cannot be said for 2020 and 2021.
“Even as countries clamor to get their hands on COVID-19 vaccines, we have gone backwards on other vaccinations, leaving children at risk from devastating but preventable diseases like measles, polio or meningitis,” WHO Director-General Tedros Adhanom Ghebreyesus said.
“Multiple disease outbreaks would be catastrophic for communities and health systems already battling COVID-19, making it more urgent than ever to invest in childhood vaccination and ensure every child is reached.”
The world has been on the cusp of eradicating polio for a few tantalizing years. Now, between the pandemic and the breakdown of the government in Afghanistan, this goal is in peril.
Afghanistan has been one of the last two to three countries where wild polio still circulates, and the Taliban have blocked polio vaccination efforts in regions it controls for years.
“This evidence should be a clear warning – the COVID-19 pandemic and related disruptions cost us valuable ground we cannot afford to lose – and the consequences will be paid in the lives and wellbeing of the most vulnerable,” UNICEF Executive Director Henrietta Fore said.
In the U.S., the lag in vaccinations could pose a serious public health risk.
This isn’t just happening in the developing world. The United States also lost ground on childhood vaccinations over the past two years.
A U.S. Centers for Disease Control and Prevention analysis of 10 states and cities shows that between March and May of 2020, vaccinations against diphtheria, tetanus and whooping cough fell by almost 16% for infants and toddlers, and by 60% for kids aged 2 to 6.
“This lag in catch-up vaccination might pose a serious public health threat that would result in vaccine-preventable disease outbreaks, especially in schools that have reopened for in-person learning,” the CDC-led team of researchers wrote in a report last June.
Some states are catching kids up now, but none of the 10 jurisdictions studied by the CDC team managed to get vaccination rates to even pre-pandemic levels, let alone to levels that would make up the deficit.
COVID will spawn other epidemics.
It’s hard to predict what exactly this means, as so many different infectious diseases are covered by routine childhood vaccines. But a computer modeling study published last January by a team at Cambridge University and Imperial College London found vaccines against 10 major diseases – including measles, rotavirus, human papillomavirus or HPV and hepatitis B – prevented 37 million deaths between 2000 and 2019.
Even before the pandemic, outbreaks of measles in unvaccinated and undervaccinated populations still killed an estimated 140,000 people a year, according to the WHO.
It could take years to make up the ground that has been lost, especially as many parts of the world will be struggling for the next two years or more to even begin vaccination programs against COVID-19.
The coronavirus pandemic will spawn a series of other epidemics caused by infectious diseases that could, and should, have long been in humanity’s rear-view mirror.
Three questions to consider:
- How has the pandemic disrupted public health efforts?
- What effects has vaccination had on human health over the past two decades?
- How did the world fail to step up to the challenge of the coronavirus pandemic?
Maggie Fox has been reporting on health and science for more than 20 years and is currently a consulting editor to Medscape and WebMD and a consultant on health and science news. She has covered conflict, politics and other international events from London, Hong Kong and Beirut. She has covered the cloning of Dolly the sheep, Ebola epidemics, stem cell technology, vaccine controversies and other stories for Reuters, CNN, National Journal and NBC News. She lives in Washington, DC.