Introduction by Croakey: Australian public health leaders have warned that COVID-19 is not over as a public health threat, even if it’s no longer an official state of emergency, and have questioned the World Health Organization’s communications on the landmark declaration.
WHO Director-General Dr Tedros Adhanom Ghebreyesus announced last Friday that the Emergency Committee convened under International Health Regulations had met and recommended he declare an end to the ‘public health emergency of international concern over the global outbreak of COVID-19’ – the highest level of alarm under international law.
“It is therefore with great hope that I declare COVID-19 over as a global health emergency,” he said, before adding: “However, that does not mean COVID-19 is over as a global health threat.
“The worst thing any country could do now to use this news as a reason to let down its guard, to dismantle the systems it has built, or to send the message to its people that COVID-19 is nothing to worry about,” he said.
The post below, by Dr Simon Nicholas Williams, Lecturer in Psychology at Swansea University in the United Kingdom, explains the significance of the declaration and what has been learnt about human behaviour during the pandemic. It was originally published at The Conversation UK under the headline: “COVID is officially no longer a global health emergency – here’s what that means (and what we’ve learned along the way)”.
Leading health broadcaster and journalist Dr Norman Swan told RN Breakfast yesterday the important distinction is that “it’s not the end of the pandemic, it’s the end of the emergency response,” adding that while politicians are hoping it means COVID-19 has gone, “it hasn’t gone”.
UNSW Adjunct Professor Kathy Eager, former Foundation Director of the Australian Health Services Research Institute, was critical of the way the announcement was made. She tweeted:
She later told Croakey it was the order of the messaging that is the problem.
“The WHO headline is that the ‘COVID emergency is over’. Which it is. But the problem is that those few words are all people read. The COVID pandemic is not over. The real headline should have been ‘COVID now classified as an ongoing global health threat’ with a subheading that COVID management has now moved from the emergency phase to an ongoing health threat,” she said.
Eagar said she appreciated that WHO has to juggle complex politics and relationships between its member states, but it has “a critical role in shaping the international narrative about COVID”.
“While I don’t think it was what WHO intended, the effect of its headline was to suggest to a lay person that the pandemic is over. It is not.”
Also via Twitter Professor Brendan Crabb, Director and CEO of the Burnet Institute, said that while the WHO announcement “sends the wrong message”, he suspected it will mean little.
“What WHO was doing in the emergency response was no longer making a difference in most places. The battle to take COVID as seriously as it deserves to be was lost a long time ago.”
See these and other tweets at the bottom of the post.
Simon Nicholas Williams writes:
World Health Organization (WHO) experts have officially declared that COVID no longer constitutes a public health emergency of international concern (PHEIC). This coincides with the WHO’s new strategy to transition from an emergency response to longer-term sustained COVID disease management.
This may not change too much practically. COVID will still have pandemic status, and countries will continue to have their own authority as to whether to treat COVID as an emergency within their territories (some countries, including the US, have already declared an end to the national emergency).
For the global public health community, however, this is an event of monumental importance, drawing to a close the emergency response period which commenced on January 30 2020.
At the same time, for a large portion of the general public, it may well pass by relatively unnoticed. For many people, it’s been a long time since they viewed COVID as an emergency. In the UK for example, COVID no longer features in the regular Office for National Statistics public opinion survey that asks people what they think the key issues facing the country are. Even a year ago, only two in five Britons were very or somewhat worried about COVID, according to the survey.
Along with other behavioural scientists, I have been following public experiences of the pandemic for the past three years. The results have yet to be peer reviewed but by summer 2022, many participants in our research described the pandemic as being like “a distant memory” or like it “never happened”.
As we move into this next phase, it’s time to consider what we’ve learned about human behaviour during the pandemic, and what happens next.
Old habits die hard
In the early days of the pandemic, many behavioural scientists, myself included, wondered whether some of our pandemic habits were here to stay. Would face masks become a regular wardrobe staple? Would people stop “soldiering on” and going into work when unwell?
It turned out that for most people, the pandemic hasn’t permanently changed our behaviour and habits or created a “new normal”. Looking again at the UK, face mask use has consistently declined, with figures from last month suggesting that fewer than one in six adults had worn a face mask recently. Regular use is likely much less common.
Social distancing has long since disappeared, except for a relatively small proportion of the public, in particular those most vulnerable to COVID.
Read more: Long social distancing: how young adults’ habits have changed since COVID
The COVID pandemic has taught us how adaptive behaviour can be, in particular how much people were willing to change their behaviour to keep themselves and others safe. Most people followed the rules during the height of the pandemic, no matter how difficult. COVID has reminded us how resilient we humans can be.
These pandemic adaptions, and the fact that our pre-pandemic behaviour bounced back so quickly, shows how important social cues and social norms are to behaviour. Putting on a mask or keeping our distance from others were habits – actions triggered automatically in response to contextual cues, such as seeing signs with pictures of people socially distancing.
Social norms – what we think others are doing – were key to vaccine uptake and to our uptake of preventative measures in general. As these contextual cues disappeared and the social norms started to change, and as vaccine coverage increased and the risk to the majority decreased, our behaviour changed.
The pandemic has also demonstrated how important social connections and social, especially physical, contact can be. This is something we have already argued COVID couldn’t keep at bay forever. According to social safety theory, which sees stress and wellbeing as a product of biological, psychological and social factors, COVID posed a threat to the “social fabric that makes humans resilient and keeps us alive and well”.
It’s unsurprising that life satisfaction and happiness were lowest during lockdowns, and recovered as people started to mix socially again.
The emergency isn’t over for everyone
As we mark the end of the emergency phase it’s important to remember the nearly seven million lives lost due to COVID since 2020.
And of course, we must consider that for some, especially those who are clinically vulnerable, the emergency is not yet over, and may never be.
Although it’s no longer a PHEIC, as the WHO reminds us, COVID is still responsible for millions of infections and thousands of deaths each week around the world. Also, thanks to long COVID, hundreds of millions of people are in need of longer-term care.
Read more: COVID pandemic: three years on and nobody wants to talk about it – here’s why we should
In the future, we need to move from relying on the resilience of individuals to building resilience in our institutions. We can all take measures to continue to protect ourselves and those around us from COVID and other respiratory viruses (such as by hand washing and keeping up to date with vaccinations). But responsibility for preventing public health emergencies shouldn’t rest solely in the hands of the public.
Actions that governments, employers and health authorities can take now could protect against future public health emergencies.
Systematically tackling misinformation, improving ventilation in schools, workplaces and other public indoor spaces, and making longer-term improvements to paid sick leave are all good ways to start building more resilient societies in preparation for the next pandemic. Hopefully this is something we will never see in our lifetimes.
Responses via Twitter
See Croakey’s archive of stories on COVID-19