As the world reflects on 2 years of the COVID-19 pandemic, we need to change how to tackle the enormous challenges of the future. The good news is that the past 2 years of the COVID-19 pandemic have shown that change is possible.
Mitigating the impact of COVID-19 forced rapid change everywhere. Countries built new testing and contact-tracing infrastructure. Many instituted lengthy stay-at-home orders. Major institutions moved operations online. Entire health systems were rapidly redesigned. Millions learned to work and learn from home. Meanwhile, vaccines were produced on record time scales, and countries undertook the largest mass vaccination programs of the modern era. Governments passed stimulus and relief packages to provide unprecedented financial support for workers and businesses. Necessity was indeed the mother of invention. Some problems, however, remain unsolved, such as ensuring global vaccine equity or reducing health inequalities.
The past 2 years should prompt everyone to revisit the long-standing problems considered too difficult to solve because traditional practice is too sticky, or because people “will never go for it,” or because it’s just too expensive, or it will cost the next election. We need to ask: Are these problems really too difficult? Or do we just not consider solving them necessary? Who decides what is necessary? Government is about balancing trade-offs, and not all problems will be solved—but honesty is needed about which solutions are deemed necessary and why.
Then there are the problems so ingrained that they are not even recognized as solvable. Consider annual hospitalizations and deaths from influenza and other pneumonias. These have been treated as a known winter burden of ill health, although many public health experts argue that surges in winter deaths are not inevitable and are mainly due to poverty and health inequalities. So accepted, however, is the annual burden from influenza and pneumonias, that their average annual numbers of hospitalization and deaths have been used as a benchmark for COVID-19—a signal for when “we can go back to normal.”
But measures taken against one infectious disease can be effective against others, as proven with COVID-19 mitigations. Influenza almost disappeared from the world in the first year of the pandemic. This winter, many were expecting a comeback, but in England, for instance, some pandemic measures remained, such as mask wearing, remote working, and a reduction in social contacts. Since October 2021, England has had just over 2000 influenza admissions—10% of equivalent periods in the 2 years prepandemic. The annual winter burden of respiratory diseases is clearly not inevitable. Rather, the question is how far society wants to go to reduce them. Instead of calling for a return to normal, we should be asking if normal can’t be better.
For many countries, it was mostly the threat of COVID-19 overwhelming health care systems, and the thousands of potential deaths, that created support for large-scale change. But the time scales of infection and the nature of exponential growth are such that hospitalizations and deaths only reached the threshold that changed perception from “it’s fine” to “we must do something” weeks after transmission was already out of control. This doomed many countries to acting late and needing to impose harsher measures for longer periods—and not just once but repeatedly.
Humans have evolved to perceive urgency on the order of hours and days, not years or decades. This tendency already delayed action on COVID-19, which works on a time scale of weeks. We can see it playing out now in the unparalleled and rapid global unified response to the invasion of Ukraine. A sense of immediacy combined with necessity has enabled a response there unimaginable even a few weeks ago. But the biggest global crisis—the climate emergency—struggles to provoke such a response because catastrophes are fully experienced only decades after they became inevitable. The Intergovernmental Panel on Climate Change issued a stark warning last month: “Any further delay in concerted global action will miss a brief and rapidly closing window to secure a liveable future.” The climate emergency requires solutions far greater in their scope than those for COVID-19, and it requires them now. It is imperative that the world uses science to inject that sense of immediacy for tackling the greatest challenges. The last 2 years have shown that together we can do great things, if we decide they are necessary. The old normal is no longer enough.


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Volume 375 | Issue 6585
11 March 2022

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Published in print: 11 March 2022


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Christina Pagel [email protected]
Christina Pagel is a professor of Operational Research and director of the Clinical Operational Research Unit, Department of Mathematics, University College London, London, UK.


[email protected]; @chrischirp

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  1. Science Should Push Us Forward, Not Back, to a “New Normal”, American Journal on Intellectual and Developmental Disabilities, 127, 4, (269-269), (2022).

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