giving hope a sporting chance covid 19 as a beneficial epidemic CORD-Papers-2022-06-02 (Version 1)

Title: Giving hope a sporting chance: COVID-19 as a beneficial epidemic?
Published: 2021-04-12
Journal: BMJ Glob Health
DOI: 10.1136/bmjgh-2021-005784
DOI_URL: http://doi.org/10.1136/bmjgh-2021-005784
Author Name: van de Pas Remco
Author link: https://covid19-data.nist.gov/pid/rest/local/author/van_de_pas_remco
Author Name: Ooms Gorik
Author link: https://covid19-data.nist.gov/pid/rest/local/author/ooms_gorik
sha: 566e08841060bcb799981481a4c213b0d455db9e
license: cc-by-nc
license_url: https://creativecommons.org/licenses/by-nc/4.0/
source_x: Medline; PMC
source_x_url: https://www.medline.com/https://www.ncbi.nlm.nih.gov/pubmed/
pubmed_id: 33846146
pubmed_id_url: https://www.ncbi.nlm.nih.gov/pubmed/33846146
pmcid: PMC8047549
pmcid_url: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8047549
url: https://www.ncbi.nlm.nih.gov/pubmed/33846146/ https://doi.org/10.1136/bmjgh-2021-005784
has_full_text: TRUE
Keywords Extracted from Text Content: lethal challenge-and Swaan anarchy'-that IntellectualProperty Rights face Swaan's Bollyky COVID-19 pandemic prod broadly-are everyone-while nuclear UK Sociologist Abram cynical-anyone COVID-19 AT Gostin, 7 herd Oye Grotesque Remco pandemics-a green TRIPS lines 1 coronavirus COVID-19 vaccines COVID-19 Vaccine Global Access Facility (COVAX people Swaan
Extracted Text Content in Record: First 5000 Characters:In 1998, the Dutch sociologist Abram de Swaan wrote these lines 1 : Sometimes it takes a disaster to prod people into action which they had refrained from taking until then out of ignorance, indifference or lack of confidence in their peers. Thus, preventive measures are usually adopted only when the catastrophe they are supposed to prevent has already occurred, once. Usually, the discussion centres about the question of what should be done to make sure that disaster will not strike again. Here, I will ask the reverse question: what kind of catastrophe does it take before people will adopt the policies that would have been feasible and beneficial all along. With that reverse question in mind, de Swaan wrote a 'Project for a Beneficial Epidemic'. What would it take to prod 'concerted action by the wealthy countries to eradicate the conditions of poverty that caused the spread of a disease on a world scale?' According to de Swaan, an infectious disease that is airborne, very harmful, if not lethal, and that would 'continue for some years so as to allow governments and international organisations the time to overcome their dilemmas and effectively coordinate their actions'. Abram de Swaan may not be a household name for the readers of BMJ Global Health. However, his study of the emergence of welfare systems in Europe and the USA 2 is of relevance to the study of global health. The kind of solidarity on which public healthcare and welfare systems are built has few altruistic spores. Common and overlapping interests by key actors are the foundations of such systems. As you will have guessed, the question we want to raise is whether COVID-19 may turn out being the beneficial epidemic de Swaan had in mind. While it may sound cynical-anyone with global health concerns would prefer that COVID-19 never occurred-we believe it is of utmost importance and urgency to raise the question. Spiriting COVID-19 away is not one of the options we have. Let us try to use the opportunities. AT FIRST SIGHT, AN UNLIKELY CANDIDATE COVID-19 is airborne, lethal (for many people) and obviously very harmful. It ticks at least two out of de Swaan's three boxes. But will it continue long enough for governments and international organisations to get their act together? The unprecedented speed at which effective COVID-19 vaccines were first announced and later also developed may have turned this epidemic into an unlikely candidate to become a beneficial epidemic. Even before the first vaccines went into clinical trials, vaccine nationalism emerged-or re-emerged. 3 Although we wholeheartedly agree with the Director General of the WHO decrying vaccine nationalism as a 'catastrophic moral failure', 4 Oye warned us a long time ago that 'cooperation under anarchy'-that is, in the absence of a global government-typically occurs in 'the absence of gains from defection', 5 like trade, climate and nuclear agreements. This warning actually predicted rapid defection from the COVID-19 Vaccine Global Access Facility (COVAX). 6 Wealthier states seemed to have a lot to gain from defecting from COVAX: Summary box ► Sociologist Abram de Swaan wrote in the 1990s about a 'Project for a Beneficial Epidemic'. ► Could the COVID-19 pandemic prod 'concerted action by the wealthy countries to eradicate the conditions of poverty that caused the spread of a disease on a world scale?' ► COVID-19 seems likely to become an endemic, and governments will need to switch from emergency measures to policies that are economically and socially sustainable. ► We are not optimistic, but we remain hopeful, that the COVID-19 pandemic prompts states to effectively take international responsibility and collective action. negotiating priority delivery with pharmaceutical companies while keeping the vaccines they pay for to their own people, thus being able to open up their own economies faster than other states could. Furthermore, COVAX alone would not be enough to free the world from COVID-19: some of the poorer states would need additional forms of international cooperation to strengthen their health systems to be able to vaccinate everyone-while keeping the system running for other health priorities. On that issue too, defection from earlier commitmentsfor example, continuing to actively recruit health workers from poorer states-may seem to come with gains for wealthier states. If COVAX cannot work because states think they will gain from defecting from it, hoping that COVID-19 will prompt all states into creating some kind of international health systems fund, as suggested by Gostin, 7 seems grossly optimistic. Defecting saves them their financial contribution. However, the assumptions on which rapid defection from COVAX was based may be wrong. In July 2020 already, Bollyky and Bown warned, It is not clear yet whether achieving herd immunity will be possible with this coronavirus. A COVID-19 vaccine may prove to be more like the vaccines that protect against influenza: a critical
Keywords Extracted from PMC Text: people capital.18 COVID-19 Vaccine Global Access Facility defection',5 nuclear Grotesque face USA2 UK COVID-19 response15 SARS-CoV-2 lethal fund.12 TRIPS Swaan's — lines1 Gostin,7 's COVID-19 commitments— Swaan Bollyky green IntellectualProperty Rights COVID-19 vaccines cooperation11 re-emerged.3
Extracted PMC Text Content in Record: First 5000 Characters:In 1998, the Dutch sociologist Abram de Swaan wrote these lines1: With that reverse question in mind, de Swaan wrote a 'Project for a Beneficial Epidemic'. What would it take to prod 'concerted action by the wealthy countries to eradicate the conditions of poverty that caused the spread of a disease on a world scale?' According to de Swaan, an infectious disease that is airborne, very harmful, if not lethal, and that would 'continue for some years so as to allow governments and international organisations the time to overcome their dilemmas and effectively coordinate their actions'. Abram de Swaan may not be a household name for the readers of BMJ Global Health. However, his study of the emergence of welfare systems in Europe and the USA2 is of relevance to the study of global health. The kind of solidarity on which public healthcare and welfare systems are built has few altruistic spores. Common and overlapping interests by key actors are the foundations of such systems. As you will have guessed, the question we want to raise is whether COVID-19 may turn out being the beneficial epidemic de Swaan had in mind. While it may sound cynical—anyone with global health concerns would prefer that COVID-19 never occurred—we believe it is of utmost importance and urgency to raise the question. Spiriting COVID-19 away is not one of the options we have. Let us try to use the opportunities. COVID-19 is airborne, lethal (for many people) and obviously very harmful. It ticks at least two out of de Swaan's three boxes. But will it continue long enough for governments and international organisations to get their act together? The unprecedented speed at which effective COVID-19 vaccines were first announced and later also developed may have turned this epidemic into an unlikely candidate to become a beneficial epidemic. Even before the first vaccines went into clinical trials, vaccine nationalism emerged—or re-emerged.3 Although we wholeheartedly agree with the Director General of the WHO decrying vaccine nationalism as a 'catastrophic moral failure',4 Oye warned us a long time ago that 'cooperation under anarchy'—that is, in the absence of a global government—typically occurs in 'the absence of gains from defection',5 like trade, climate and nuclear agreements. This warning actually predicted rapid defection from the COVID-19 Vaccine Global Access Facility (COVAX).6 Wealthier states seemed to have a lot to gain from defecting from COVAX: negotiating priority delivery with pharmaceutical companies while keeping the vaccines they pay for to their own people, thus being able to open up their own economies faster than other states could. Furthermore, COVAX alone would not be enough to free the world from COVID-19: some of the poorer states would need additional forms of international cooperation to strengthen their health systems to be able to vaccinate everyone—while keeping the system running for other health priorities. On that issue too, defection from earlier commitments—for example, continuing to actively recruit health workers from poorer states—may seem to come with gains for wealthier states. If COVAX cannot work because states think they will gain from defecting from it, hoping that COVID-19 will prompt all states into creating some kind of international health systems fund, as suggested by Gostin,7 seems grossly optimistic. Defecting saves them their financial contribution. However, the assumptions on which rapid defection from COVAX was based may be wrong. In July 2020 already, Bollyky and Bown warned, Recent findings seem to confirm Bollyky and Bown's concerns. COVID-19 now seems more likely to become endemic, and governments will need to switch from emergency measures to policies that are economically and socially sustainable, and back to emergencies, indefinitely.9 To avoid that, all countries will have to work together to control SARS-CoV-2 mutations, wherever and whenever they occur, while keeping in mind that health systems in most parts of the world are not prepared for that challenge—and have other health issues to deal with. This may be in the form of COVAX, an international health systems fund or a global fund for health10; a deep revision of the International Health Regulations, as well as reforming the Agreement on Trade-Related Aspects of IntellectualProperty Rights (TRIPS), focusing on obligations of doing no harm and international cooperation11; or even—considering how climate change increases the risk of pandemics—a green and social climate fund.12 We may well have to consider all these ideas to engineer a major shift in the global governance of health and its inequities. Optimism and hope are two different things, or so argue Bury et al whose research 'aims to identify the unique nature of hope, suggesting hope is invoked in particular when expectations of positive outcomes are low', while 'with greater probability hope tends to align with optimism'.13 We are not optimistic. But we are hopeful. A qu
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