English writer Aldous Huxley once said, “Experience is not what happens to you; it’s what you do with what happens to you.”
The EU was caught off guard by the sudden shock of the COVID-19 pandemic and had to adapt rapidly to a new reality. Healthcare facilities were initially overwhelmed, creating panic. The closure of many businesses caused inflation and contributed to economic distress. However, the pandemic also elicited some inspiring responses, such as healthcare workers' tireless efforts, the pharmaceutical industry's accelerated development and testing of vaccines, and public health systems' ability to orchestrate the administration of these vaccines to billions of people.
Now, the European Centre for Disease Prevention and Control (ECDC) has released a report titled “Lessons from the COVID-19 pandemic.” The report, based on discussions with EU country representatives and an internal exercise involving ECDC staff, calls for thorough scrutiny of the COVID-19 response and discusses actions to help improve Europe's pandemic preparedness.
Unlocking the power of data
Most surveillance systems in EU Member States shared good quality data with the ECDC during the pandemic to reliably monitor trends, severity and risk factors. However, according to Bruno Ciancio, head of surveillance at the ECDC, the collection of more extensive hospital data was “challenging” due to resource limitations, unequal digitalisation and automation of health information systems, and uncertainties surrounding data protection.
Robust, scalable and adaptable surveillance systems are essential for monitoring outbreaks. Together with the European Commission, the ECDC has been working to support Member States in digitalising their surveillance systems and integrating the surveillance process into health information systems.
“There are already 15 countries working with us on automating surveillance of severe acute respiratory infections due to SARS-CoV-2, influenza and respiratory syncytial virus, and more countries are joining soon,” Ciancio told Univadis.com, adding that, “we are also planning to support countries organising national training on data protection and data sharing.”
Looking ahead, “complementary surveillance systems should be developed, such as wastewater monitoring and crowdsourcing surveillance. Such systems require much less public health and healthcare resources to operate and are likely to be sustainable during a pandemic,” said Ciancio.
The EU4Health programme, which focuses on pandemic preparedness and response, has increased its budget to strengthen Member State surveillance systems in 2023.
From chaos to cohesion
The EU was criticised for its slow and fragmented response and is working to improve coordination and communication among Member States during a future pandemic. It is creating a European One Health network for animal and human health, which will facilitate the sharing of information and collaboration between Member States.
A European Health Emergency Preparedness and Response Authority (HERA) has also been established, which will serve as a single point of contact for Member States during health emergencies and will coordinate the development and deployment of medical countermeasures, such as vaccines and treatments. It will also focus on strengthening genomic sequencing capacity and surveillance and early warning systems. Additionally, a European Health Union is being built, where the member countries will collaborate to detect, prepare for and respond to health crises together.
Building a stronger frontline
The shortage of healthcare workers has been a significant issue since the pandemic, with many healthcare systems stretched beyond their capacity. To address these challenges, the EU has established the Recovery and Resilience Facility, which seeks to increase the number of healthcare workers through various measures, including training programs and financial incentives to attract new, young healthcare professionals to the field.
Poor communication, especially regarding measures and vaccination strategies, was also identified as a significant issue. The changing regulations, varying measures across countries and different strategies created difficulties in communicating with the public or hard-to-reach populations.
The ECDC report stresses the need for public health organisations to train their staff in advance to effectively deliver messages that are developed by multidisciplinary teams during press conferences and to the media, as well as taking advantage of new communication technologies (videos, infographics, social media messaging, etc.).
EU's pandemic battle plan
The previous pandemic preparedness and response plans were inflexible and inadequate in addressing the severity, duration and uncertainties of COVID-19.
“Member States should be able to monitor, on an ongoing basis, indicators of health system utilisation and capacity at a very granular geographical level. Such data in conjunction with surveillance data would enable the prompt and targeted implementation of public health interventions,” said Ciancio.
According to the report, public health experts must have a more significant role in decision-making and crisis management structures, along with segregation of political decisions from expert opinions. It also emphasises the importance of including non-health sectors in pandemic preparedness planning. It is also recommended to address legislation, a variety of diseases, non-pharmaceutical interventions, travel restrictions and resource issues such as strengthening IT, reinforcing public health staff, developing robust surveillance systems and stockpiling personal protective equipment and pharmaceuticals in future preparedness plans.