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The World Health Organisation has begun drafting a ‘pandemic treaty’, intended to be a global agreement on how better to prepare for, prevent and respond to future pandemics
Cholera outbreaks in the 1800s and the realisation that its bacterium spread in water resulted in the development of sewage treatment and water purification in European cities.
Historian of science and medicine Helen Bynum believes Covid-19 offers a similar opportunity for transformation in the treatment of air. The pandemic has produced a preponderance of evidence that Covid-19 spreads through shared air, a trait it likely shares with many respiratory viruses.
“The whole way that we engage with the air could radically change, if people want to make that change,” says Bynum.
“Governments could legislate that buildings must come up to certain air quality standards. You could have better filters in public transport, better filters in public buildings, like schools.”
It goes beyond viruses. Stale, polluted air inside buildings causes tiredness, reduces concentration, and in the long term can contribute to major health problems.
Then there is outdoor pollution. According to the European Environment Agency, air pollution causes 307,000 premature deaths each year in Europe, mainly in urban areas. Those with lungs already weakened by pollution were more vulnerable to Covid-19, among other health challenges.
“Exposure to particulate matter, nitrous oxide and sulphur emissions – people living in those circumstances do much worse,” Bynum says. “If we want a more egalitarian society moving forward, we need to address those kinds of health inequalities.”
In the initial stages of the pandemic, caution and stay-at-home orders caused traffic to disappear. Suddenly, in many cities, residents noticed they could see the horizon.
“When the lockdowns came in and the air got clear, it was one of the great social opportunities of that early period of the pandemic,” Bynum says.
“Whether we’ve learned something positive from it, I think will depend very much on how national governments value the overall health of their population.”
Several Asian countries coped better with Covid-19, avoiding drastic lockdowns while keeping deaths much lower than in the West, helped by what they had learned from previous outbreaks of respiratory viruses.
Past studies had indicated how MERS and SARS spread through the air, such as from one apartment to another through building ventilation systems.
Once Covid-19 proved able to move between the cabins of the Diamond Princess cruise ship, spreading between passengers without physical contact back in early February 2020, the virus was approached as airborne.
The existing societal norm of wearing a face mask when suffering a cold, and as a preventative measure during the winter months, came in useful.
As did the understanding of the need for quarantine facilities to separate infectious people from the rest of the population, and the contact-tracing public health infrastructure that was the legacy of past epidemics.
Could Western countries also retain such prevention and mitigation approaches for the future?
So far, as soon as infections abated many EU countries have been quick to dismantle any new public health infrastructure they were forced to put together to curb the crisis.
Across Europe, states have preferred to rely on public awareness and individual responsibility to combat the pandemic, rather than a structural response.
An equivalent fire risk mitigation strategy might equate to forgoing fire safety regulations, in favour of public advice on how to avoid fires. And then, when fires run out of control, “locking down” the gas and electricity grids until they burn out.
Yet in the background, some governance changes are already under way.
The World Health Organisation has begun drafting a “pandemic treaty”, intended to be a global agreement on how better to prepare for, prevent, and respond to future pandemics.
In the European Union, the central executive body, the European Commission, has asked member states to consider granting it extraordinary powers during pandemics, that would allow it to re-shore manufacturing capacities, source raw materials and medicines, and negotiate directly with manufacturers in an emergency.
It’s an attempt to avoid shortages of vital health products and ensure access to medicines in any future scenario.
The urgency of the pandemic also broke several EU taboos. Its 27 members agreed to a massive joint borrowing programme to counteract the economic damage of Covid-19 that was previously unthinkable.
“It’s the first time that we actually have created common debt. That is quite revolutionary,” says Jim Cloos, a former long-time senior EU official and current Secretary General at the Trans European Policy Studies Association.
“If you had suggested the recovery fund or something like it in 2018 or 2019, people would have said: are you out of your mind?”
The cash is linked to still grander ambitions. As a condition of receiving it, governments must commit to spending it on projects to increase digitalisation and stave off climate change. The availability of this investment to build car-charging networks helped embolden the EU to propose the end of the era of the internal combustion engine by 2025.
The recovery fund has served as a step in integrating the public finances of the EU member states, and tying their financial fortunes together until at least the repayment deadline of 2058.
Even the countries that were most hesitant about joint borrowing and agreed to it only on the condition that it was a one-off are aware that if it works, and the reform programmes the money is tied to are effective, there will be calls to use the tool again.
Another precedent was set in the joint negotiation for vaccine contracts, which after a rocky start, is considered among EU countries to have been a success. Prior to the pandemic, there had been calls for the EU to use its size and clout collectively to negotiate the price of medicines with pharmaceutical companies.
Now that the way has been forged, some see in the technique a way to stop fossil fuel exporters using prices to put political pressure on member states.
“There are at least three member countries I know of who have explicitly made reference to the precedent of procurement for vaccines to plead for joint procurement of gas,” Cloos says. “Now that would be a game-changer.”
In contrast, the pandemic has profoundly challenged one of the EU’s most treasured achievements: free movement. Travel rules were a patchwork across the continent prior to the introduction of the digital Covid certificate, and the introduction of border restrictions has broken a taboo. Some countries have suggested they may be prepared to hinder border crossings again for another reason: migration control.
From income support schemes, to mass vaccination campaigns, to lockdowns and mandatory quarantines, the pandemic has reintroduced the interventionist state to Europe.
Citizens now understand that states can act ambitiously and sweepingly when they wish, and may have expectations for action in other areas. In the eyes of some, this may be useful in achieving the profound changes needed to curb the worst of climate change.
But it has also provoked a counter-reaction. Tens of thousands have taken to the streets repeatedly in European capitals in protest at Covid measures. In a minority, being asked to follow health advice has brought out a libertarian streak.
“People who don’t want to wear masks in public in public spaces, who kind of tout their libertarian credentials . . . right-wing parties might seize upon this as a way of pulling in votes,” Bynum says. “A lot of people resist vaccination, not because they really are worried about what’s being put into their body, but because they don’t like being told what to do.”
Throughout Europe, the vast majority of people who can be have already been vaccinated. The norm has been observance of health measures, not defiance. Across the continent, polls have repeatedly shown strong support for government actions to curb infections.
But the pandemic has undoubtedly caused political polarisation, just as it worsened a longer-term trend that has helped create the conditions for societal strife.
The economic response to the 2008 global financial crisis caused wages to stagnate while assets inflated, particularly the cost of housing, creating steep inequality that deepened during the pandemic.
“The result is increasing political activism, extremism, radicalism, the emergence of more politically extreme parties, we’ve seen more violent protest as well. And that’s likely to continue,” says John Egan, chief executive of foresight company L’Atelier BNP Paribas.
“Outside of climate change, this to me is the issue that’s going to shape Europe more than anything else. Because at the core of both democracy and capitalism is the promise of social mobility. If social mobility disappears, then why engage your political franchise when it’s meaningless, and there’s never an opportunity for prosperity?”
There are other trends, too, that Covid-19 accelerated.
After the pandemic, European societies will be sicker than they were before. It has left vast numbers of people with the enduring illness of Long Covid, a post-viral syndrome.
Waiting lists for medical treatments have lengthened, while delays in getting help has meant that cancers and other conditions are being spotted later, at a time when they need more intervention. The impact on healthcare systems is expected to be felt for the next decade.
Societies will also be older. Divorce rates increased during the pandemic, while marriages were delayed. The number of births fell, while IVF fertility treatments halted, accelerating the ageing of European societies.
Church attendance collapsed at the outset of the pandemic and has not fully recovered, as predominantly older regular mass-goers stayed away. Egan questions whether in time, churches will begin selling off their substantial land holdings, as they face financial challenges as a diminished “political force”.
It is news to no one that the pandemic cemented online shopping, normalised virtual meetings, and embedded remote work. It remains to be seen what impact this will have on cities. Mark Honigsbaum, a writer and medical historian, questions the impact, pointing to a rebound in rents in London and New York.
“Remember the point where everyone thought: everyone wants to move the country, and all these offices can be empty? That’s not happening,” he said. “We’re not seeing the hollowing out of major cities.”
However John Egan – who has relocated himself due to the pandemic – sees it differently.
“In the post-war period, cities have competed for companies to set themselves up in their city. So cities are actually effectively designed as residences for corporations,” he says.
“Cities have never actually competed for residents before. That will require a total overhaul of the way cities design themselves. I think that is going to be very beneficial for people. But it will also mean that cities that are not on top of that will degrade very, very quickly – think of cities like Detroit in the US.”
Digital infrastructure will be key in attracting residents. The OECD has called for tax regulations to be reformed to keep up, to adjust to the reality of cross-border telework, as people live in one place while working for a company based elsewhere.
The new variant Omicron indicates that the Covid-19 pandemic is shaping up to resemble the so-called “Russian flu”, according to Honigsbaum – a pandemic that broke out in 1889 and recurred repeatedly until 1895.
Such an enduring pandemic might embed some hygiene practices in Europe longer-term, such as limiting the size of indoor gatherings in winter, and the retention of face masks.
But there may be limits to the lessons of history, as in many ways the current pandemic is unprecedented.
The rapidity with which international air travel can scatter new seeds of infection and variants has been repeatedly demonstrated. A pandemic has never been experienced so much online. It has made plain the dangerous potential of social media in spreading misinformation, spurring efforts for reform.
This is also a “big data” pandemic. It has produced vast amounts of information about everything to do with the spread of the disease, its impact and its aftermath. Never has a pandemic been so comprehensively recorded.
This sea of data will take years to process, but has the potential to produce breakthroughs in the scientific understanding of infectious disease.
Bynum believes the insights are there for the taking. She says European societies could be divided by the pandemic or realise that collective action is required to confront common threats.
“I think at the moment, that could go either way,” Bynum says. “We can heed lessons, or we can just carry on as before, but the lessons are there to be learned.”
Everything you need to know about the Covid-19 outbreak
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