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Still a long way to go with a vaccine
If approved, COVID-19 vaccines will take 6-12 months to become widely available and even longer to create herd immunity.
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Will a vaccine end the COVID-19 pandemic?

Despite the promising news on vaccine development, investment in pandemic resilience remains crucial in the years to come, according to Mott MacDonald’s health security and epidemiology experts.

News that one or more successful COVID-19 vaccines may be authorized for emergency use by the end of 2020 has raised hopes that we may soon turn the corner of the pandemic and end the disruption experienced during 2020. While the prospect of a vaccine certainly invites optimism, it is important to be realistic and maintain vigilance and patience.

If and when approved for use, vaccines will take at least six months to a year (until the middle to end of 2021 at the earliest) to become widely available, and even longer to bring about an effective level of herd immunity — the maintenance of which will be heavily dependent on the duration of immunity provided by a vaccine, which is currently unknown.

For some vaccine candidates, the need for ultra-low-temperature storage and the likelihood that more than one dose will be required represent a huge logistical challenge. It is also not known whether approved vaccines will protect against transmission of the virus, or reduce the severity of disease but still allow transmission. These two scenarios have differing implications for herd immunity and the protection of unvaccinated people. Depending on how long immunity lasts, seasonal booster vaccines may be required to reduce the impact or likelihood of future outbreaks.

Plan for disruption in 2021

With so many unknowns at this time, governments and infrastructure organizations need to proactively prepare for more economic and social disruption from subsequent waves of COVID-19. At the same time, they must become more resilient to future infectious disease threats, strengthening the weak spots exposed during the current pandemic.

It will be difficult to do this against the widespread societal fatigue that follows months of disruption and the temptation to embrace a vaccine as the way back to our pre-COVID lives. Yet unless we analyze and determinedly implement the lessons learned from successes and failures in the global response to COVID-19, we risk the next epidemic catching us just as unprepared as we were less than one year ago.

Even once vaccines are made widely available, it is probable that the virus that causes COVID-19 will circulate for years to come, so it is prudent to plan on this basis. The total lifting of COVID-related restrictions may take years, during which time we will still need to protect the most vulnerable in our societies and help our national health systems cope with the challenges of more COVID-19 cases, a large backlog of delayed appointments and treatments for other conditions, the well-being of overworked healthcare staff, and more.

Prepare for future infectious disease threats

Each year, the World Health Organization tracks approximately 200 epidemic events globally. Many of these are controlled locally — but through a combination of their characteristics and an increasingly interconnected world, some infectious pathogens pose a pandemic threat. When diseases do spread, the costs are heavy, both in terms of human life and economic impact.

The Ebola epidemic of 2014-16, which was concentrated in three African nations, is estimated by some to have led to over 11,000 deaths and cost $53 billion. The global reach of COVID-19 will mean that its cost will undoubtedly be far higher. As is now painfully apparent, epidemics and pandemics have substantial and quantifiable financial risks, and organizations will need to provide confidence to investors, political leaders, and the public that they can manage and mitigate those risks in the future. Investments in pandemic preparedness should be considered as offering extraordinarily high potential return.

Build resilience into infrastructure systems

To deliver efficient and safe services in the coming months and years, infrastructure clients need to address the systemic vulnerabilities that still exist. As a leading global engineering, management, and development firm, Mott MacDonald can help clients do this through high-quality, innovative solutions to pandemic preparedness and resilience. A continued focus on pandemic resilience should enable us and our clients to do the following:

  • Reduce risks of pathogen transmission in crucial infrastructures, enabling continuity of services during an epidemic, prioritizing safety of users and staff while maintaining public confidence.
  • Manage risks more intelligently by developing preparedness and contingency plans, including operating procedures for possible scenarios, anticipating and mitigating economic challenges before they happen.
  • Incorporate pandemic resilience in the design or technical specifications of new infrastructure such as railway lines, airports, and education or sports facilities.
  • Normalize infection risk mapping as part of the broader health and safety assessment process for an infrastructure.
  • Incorporate pandemic resilience principles into existing and future industry standards.

Our infectious disease epidemiologists can advise insurance providers on what measures would confer changes in transmission risk. Similar to managing risks posed by fires or floods, we can help commercial businesses that may be subjected to increasing insurance premiums, helping them comply with regulations and global best practice.

Amid the focused attention on a global pandemic, we must not lose sight of other important health issues. One of these is the increasing challenge of antimicrobial resistance (AMR), an area in which Mott MacDonald has been involved in vital recent international work. The global health security measures to reduce exposure to and monitor drug-resistant bacteria — such as disease surveillance, strengthened laboratories, and infection prevention and control (IPC) measures — are often similar to the ones required to prevent and manage an epidemic.

It is time to stop relying on reacting to outcomes and to start thinking proactively and strategically about building a pandemic-resilient future. Let us help you work through what this means for your organization and understand how you can build greater resilience. Contact us today.

Dr Anthony Huszar

Mott MacDonald global health security lead

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