Today marks five years since the World Health Organization (WHO) declared COVID-19 a Public Health Emergency of International Concern.
Burnet Chief Health Officer of COVID and Health Emergencies Associate Professor Suman Majumdar shares his thoughts on what we have achieved since the beginning of the pandemic and what we can do to ensure we are better prepared for future pandemics.
The COVID-19 pandemic is one of the greatest global challenges in human history. It has had a profound effect on the health and wellbeing of people, the economy and society - an estimated 28 million excess deaths , disruption to essential health services in low- and middle-income countries and a USD 3.3 trillion hit to the global economy. Most notable, is the exacerbation of health and economic inequities, within and between countries - people have been left behind.
COVID-19 continues to have ongoing impacts, including the burden of Post-Acute Sequelae of COVID-19 (PASC) or long COVID , which currently has no cure. The intersecting global crises of climate change, biodiversity loss, weakened health systems and geopolitical instability have increased the risk and potential consequences of future global health outbreaks developing into pandemics. We were not prepared for COVID-19 and we have a lot of work to do to be better prepared for the next pandemic.
A standout lesson from COVID-19 was the paradigm shift about the airborne transmission of pathogens, and how to effectively respond. Reversing the ' droplet dogma ' and understanding the airborne nature of SARS-CoV-2 and other pathogens, which are transmitted through the air where they are inhaled (rather than via direct or close contact when particles fall to the ground or on a person), has been a huge leap in science and public health policy.
As a results of this knowledge gain, there is the need to adopt alternative interventions to prevent the spread of airborne pathogens in indoor environments, where transmission occurs. These clean indoor air or engineering solutions include ventilation (opening windows or using building systems), air filtration (with HEPA air cleaners) or disinfection (with germicidal UV). These interventions can be coupled with real-time monitoring and performance standards and work 'passively' in the background without the need to change human behaviour. Beyond infections, poor indoor air quality (IAQ) can lead to the accumulation of non-infectious airborne pollutants, including outdoor air pollution, bushfire smoke, carbon dioxide and pollen.
Despite the evidence these interventions work in laboratory settings, there has been limited implementation beyond healthcare settings. But attitudes towards adopting these interventions are changing, with both the Federal and State Governments in Australia developing guidance on indoor air quality and investing in research to understand the best approaches to improving indoor air quality. There has been global momentum in indoor air quality, through the World Health Organization (WHO) and countries around the world, which are captured in a Burnet report on Clean Indoor Air .
Burnet researchers are working to better understand the impact of clean indoor air on the transmission of airborne infections and hazards. The Pathway to Clean Indoor Air project and ELUCIDAR study will provide evidence on the real-world effectiveness of interventions to improve indoor air quality and enhance our preparedness for future airborne pandemics.
