Should local governments be responsible for pandemic response? Lessons learned so far

Are public institutions nimble enough to pivot quickly to save lives, should the world face another pandemic in the near future?

Nearly a year and a half into the COVID-19 global health crisis, the resounding answer from multiple infectious disease experts is “no.”

Speaking one-on-one with CityNews, the former assistant director of California’s Department of Public Health, Charity Dean, says the writing has been on the wall for more than a year. “We can no longer, as a society, say we are going to transfer the risk of infectious disease onto local government officials. Assuming that government can come to save us didn’t work.”

Two months before the COVID-19 outbreak was declared a pandemic, Dr. Dean was sounding the alarm in the most populous state in the United States.

“Every morning I would look to see if there was anything new coming out of China, to see what kind of scattered intelligence might be out there. Watching the social media reports seemed to indicate that China was behaving as if this was the perfect pathogen. ‘This has to be airborne; this has to be spreading quickly person to person’,” she thought to herself.

With daily flights from China landing in California each day, Dr. Dean began compiling numbers. She quickly came to the conclusion that “exponential growth of the virus” was already underway in California and it was going undetected.

Though her warning to officials became entangled in the slow churning wheels of bureaucracy and public office.

“I think it’s really important in looking back at how the system failed, that we not blame people and that we look at what type of systems were in place that enabled that to happen,” noted Dr. Dean. “What system solutions need to exist so when this happens again, we are better prepared to detect it and contain it fast?”

According to University of Toronto bioethicist, Dr. Kerry Bowman, “We have to rebuild the whole system.”

As part of his years of research, Dr. Bowman has visited wet markets, where wild animals are slaughtered for human consumption, around the world. One year before the pandemic, he visited the Wuhan market which is currently being debated as the location tied to the first reported case of COVID-19.

“When I was in the Wuhan market, I counted 57 species of animals and almost two thirds of those species were wild animals,” said Bowman. “They had high power hoses blasting urine and feces and blood all over the place. You couldn’t do more to create lab conditions for the potential for recombination of viruses and zoonotic outbreak. I was really amazed to see all of this considering SARS-1 emerged from China.”

Dr. Bowman was exposed to SARS in 2003 while battling the disease on the front lines of a Toronto hospital.

“I myself was at the beginning of this pandemic saying publicly that we’ve learned all sorts of lessons from SARS. What I didn’t realize is that we didn’t implement any of these things,” Bowman confessed, “From PPE to allowing the people looking at global surveillance to speak freely, we really didn’t do any of it.”

From her office in California, Dr. Dean was watching Toronto to see how it would respond to COVID-19 based on the city’s and country’s previous experience with SARS. She was hopeful the authorities had learned their lesson but admits “we all got to see that clearly something didn’t work.”

After giving it much thought, Dr. Dean has left her job as a public servant. She’s started a business dubbed “The Public Health Company,” which aims at assisting both governments and the private sector in preventing, detecting and containing communicable disease threats.

“We can no longer afford to move at the speed of fax machines. We now understand our entire economy depends on it. So, solutions have to involve innovative technology, it has to involve the private sector, it has to involve a type of biosecurity system wide approach, so that everyone is part of it, so no one is left out,” said Dr. Dean.

The World Health Organization has recently been called on to establish a global health council.

Dr. Dean believes if a new organization is formed in an effort to prevent a similar health disaster in the future, it must be a “multi-sector approach, that includes private sector leadership, and most importantly including public health officials who are working on the ground. It cannot be done by government alone.”