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How can we end COVID-19 as a public health threat?

Nancy Lee explains the role that Wilton Park has played in bringing together experts to tackle COVID-19.

Despite many countries having lifted COVID-19 restrictions and many aspects of life having ‘returned to normal’, COVID-19 is not over.  Around the world 6.59 million have died of the disease and the number of new cases per day around the world is around 421,000.

Over the past year, Wilton Park has been part of a process that has brought together hundreds of experts from around the world to reach a consensus on how to end Covid-19 as a public health threat.  The result of this process is the publication ‘A multinational Delphi consensus to end the COVID-19 public health threat’, which is out in print today in Nature.

This paper provides a number of recommendations to different stakeholders around how to end COVID-19 as a public health threat.  One of its key recommendations is a ‘whole of society’, ‘whole of government’ ‘vaccine plus’ approach.

The paper is the result of a rigorous research methodology known as a Delphi process which brought together 386 multidisciplinary experts from 112 countries and territories in the world.  As part of the Delphi process, Wilton Park hosted a dialogue of multidisciplinary experts in March to clarify which areas still needed to reach consensus, and last week we hosted a conversation to mark the paper’s online launch.

Since being launched online, the Delphi consensus is already one of the most shared research papers of all time and rates in the top 5% of all research outputs scored according to Altmetric, a data service which tracks published papers and mentions in on line news.

Why is this study important?

Reduced COVID-19 vaccination rates risk waning immunity; highly transmissible variants continue to emerge and spread – and for many people- long COVID has emerged as a serious chronic condition which lacks understanding and appropriate treatments.

Everyone wants to see COVID-19 contained and no longer a threat to lives and livelihoods.  Yet the data and information on the disease and understanding the best way to prevent, treat and contain COVID-19 has been overwhelming.

Additionally, broader political, socioeconomic and behavioural factors continue to challenge responses to COVID-19.  This has made it harder for policy makers to decide what strategies to implement.

The Delphi consensus study makes 41 statements and 57 key actionable recommendations which are focused on ending COVID-19 as a public health threat. Broadly these focus on 6 key recommendations:

  1. SARS-CoV-2 still moves among us – despite some governments and many individuals saying it’s over – and requires continued and better coordinated efforts and resources to save lives.
  2. Vaccines are an effective tool against COVID-19 but will not alone end COVID-19 as a public health threat.
  3. Multisectoral collaboration that centres on communities and fosters trust is needed.
  4. Responsive health systems are crucial for responding to the COVID-19 pandemic and require coordinated government support.
  5. Adverse forces challenge our efforts to communicate effectively in order to end the COVID-19 public health threat.
  6. None of us are safe until everyone is safe.

Further details of the recommendations can be found in the Nature paper.

Collaboration in emergencies is possible and crucial

Beyond the specific recommendations in the study, a critical outcome resulting from the Delphi process is that collaboration across multidisciplinary fields and across countries is possible.

The size, scope, and disciplined process behind the Consensus Statement panel recommendations distinguishes them as unique, practical proposals to end COVID-19 as a public health threat now and lays a solid foundation to address large-scale outbreaks of infectious disease, reducing the burden on society, especially vulnerable populations, over time.  Indeed, the feat of finding consensus across such a large number of multidisciplinary experts highlights the capabilities of collaborative approaches for future health emergencies.

Co-Chairs of the expert panel, Professor Adeeba Kamarulzaman and Professor Ayman Professor El Mohandes commented they were surprised at the level of consensus that was reached across so many multidisciplinary experts from so many different countries.

As Professor Jeffrey Lazarus noted:

“We have demonstrated that staying clear-eyed and level-headed in the middle of a politically unpopular pandemic is not only possible, but crucial.  Further, we have demonstrated that voluntary, non-partisan efforts can address key areas of risk that decisionmakers must continue to confront and address. These include communications, health systems, vaccination, prevention, treatment and care – and, of course, correcting the many pandemic inequities that remain.”

Supporting stakeholders to address areas of risk where there is lack of consensus is a key part of Wilton Park’s work, as is bringing better understanding to some of our greatest global challenges. We are proud to have been part of the Covid consensus process and of what all the co-authors of the study have achieved.

We hope the wide-ranging recommendations of the study will be widely read and actioned so that we can end COVID-19 as a public health threat once and for all.

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