Thinking our way out of the pandemic

With COVID-19, pandemics, and public health emergencies as the main theme of the recently concluded 74th World Health Assembly that gathered all World Health Organization (WHO) member states (including the Philippines), health stakeholders, and leaders the world over to discuss the current state and future of global health security, a clarion call was made to make COVID-19 the last pandemic.

To make that happen, to think of what actions to do from now until the next pandemic, a great deal of strategic foresight is key.

Strategic foresight, according to Hines and Bishop, is the ability to create and sustain a variety of high-quality forward views and to apply the emerging insights in organizationally useful ways to detect adverse conditions, guide policy, shape strategy, and explore new markets, products, and services.

This couldn’t be more relevant to public policy than in the time of the COVID-19 crisis.

We could have seen COVID-19 coming. We could have anticipated its multifaceted and far-reaching consequences. We could have done better and prepared a faster response to arrest its onslaught.

We have to make sense of what’s still unfolding before us. We have to test our strategies and policies. We have to deliver better services. We have to build better systems for pandemic preparedness.

We have to make sure that if we cannot make COVID-19 the last pandemic, we can at the very least be prepared for the next one.

To apply strategic foresight to our crisis response, we must be cognizant of thinking challenges that happen across time when we talk about pandemics. These can be grouped into topics of concern before, during, and after the crisis.

Before any crisis, it is mostly about understanding the situation that can happen based on its probability, magnitude, and consequences. The endpoint here is building preparedness—having the capacity to predict, prevent, and anticipate pandemics and other public health threats, and ensure that our health systems and society can handle these when they happen.

During a crisis, it is about decision-making based on available information and carrying out the necessary interventions to mitigate the consequences of the pandemic to health, the economy, and society, utilizing all the resources at one’s disposal. The ability to execute plans while adapting to the evolution of science in an agile manner, and the skill to manage uncertainties on the fly, are critical success factors in any response to a pandemic.

After a crisis, it is about learning from lessons and turning the response experience into a cornerstone for building better pandemic preparedness. This is when we should use the practical lessons we have imbibed and the theoretical knowledge we have gained to do the task of institutional-building while the memory of the crisis is still fresh.

Since we’re still in the midst of a crisis and new pandemics will have a way of emerging by way of myriad factors, strategic foresight must be embedded into our ways of thinking through the following approaches:

Since pandemics are complex non-linear problems that are dynamic in nature, we need to adopt systems thinking—looking at the problem as a whole, analyzing its parts, and appreciating connections, causality, and cascading reactions.

Because there are still many uncertainties regarding COVID-19, current and proposed strategies and policies need to be subjected to stress-testing and future-proofing to consider future developments and implications. We need to come up with a range of scenarios unraveling in the near and far futures on different fronts—social, economic, technological, environmental, political—and determine the possible trajectories of the pandemic and its outcomes to our society.

For now, COVID-19 cases in Metro Manila and contiguous regions are stabilizing, but infections are rising elsewhere. Vaccination is still underway while quarantine restrictions are being lifted to open the economy. Thus, prevention and mitigation through compliance with minimum public health standards and robust public health response remain crucial.

If we are tackling a crisis, if we are to understand the pandemic better, make more responsive decisions, and learn from lessons more effectively, it is instructive for us to think long, hard, and far, always.

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Ronald Law is a physician, public health emergency practitioner, and academic examining the COVID-19 pandemic from a global health security perspective.