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COVID‑19 Blind Spots: a Consensus Statement on the Importance of Competent Political Leadership and the Need for Public Health Cognizance

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COVID‑19 Blind Spots: a Consensus Statement on the Importance of Competent Political Leadership and the Need for Public Health Cognizance Consensus Paper COVID‑19 Blind Spots: A Consensus Statement on the Importance of Competent Political Leadership and the Need for Public Health Cognizance Thomas J. Papadimos, Samara E. Soghoian, Prabath Nanayakkara, Sarman Singh, Andrew C. Miller, Venkataramanaiah Saddikuti, Achala Upendra Jayatilleke, Siddharth P. Dubhashi, Michael S. Firstenberg, Vibha Dutta, Vivek Chauhan, Pushpa Sharma, Sagar C. Galwankar, Manish Garg, Nicholas Taylor, Stanislaw P. Stawicki On Behalf of the Multidisciplinary ACAIM‑WACEM COVID‑19 Consensus Group, Bethlehem, PA, USA Abstract As the COVID-19 pandemic continues, important discoveries and considerations emerge regarding the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pathogen; its biological and epidemiological characteristics; and the corresponding psychological, societal, and public health (PH) impacts. During the past year, the global community underwent a massive transformation, including the implementation of numerous nonpharmacological interventions; critical diversions or modifications across various spheres of our economic and public domains; and a transition from consumption-driven to conservation-based behaviors. Providing essential necessities such as food, water, health care, financial, and other services has become a formidable challenge, with significant threats to the existing supply chains and the shortage or reduction of workforce across many sectors of the global economy. Food and pharmaceutical supply chains constitute uniquely vulnerable and critically important areas that require high levels of safety and compliance. Many regional health-care systems faced at least one wave of overwhelming COVID-19 case surges, and still face the possibility of a new wave of infections on the horizon, potentially in combination with other endemic diseases such as influenza, dengue, tuberculosis, and malaria. In this context, the need for an effective and scientifically informed leadership to sustain and improve global capacity to ensure international health security is starkly apparent. Public health “blind spotting,” promulgation of pseudoscience, and academic dishonesty emerged as significant threats to population health and stability during the pandemic. The goal of this consensus statement is to provide a focused summary of such “blind spots” identified during an expert group intense analysis of “missed opportunities” during the initial wave of the pandemic. Keywords: Blind spots, COVID-19, international health security, lessons learned, pandemic response, public health, public services, risk management, supply chains Blind spot: An area in which one fails to exercise judgment INTRODUCTION or discrimination As the first “rolling wave” of the COVID-19 pandemic – Merriam Webster Dictionary transitions into subsequent waves, the world is preparing and waiting in anticipation to see if public health (PH) measures Blind spotting: When a situation or an image can be [1,2] interpreted in two different ways, but the participant can only designed to soften the impact are effective. The pandemic see one of the interpretations (primary definition) Address for correspondence: Prof. Stanislaw P. Stawicki, Using someone’s ignorance, or misinformation, in order to Department of Research and Innovation, St. Luke’s University Health manipulate for selfish gain (alternative definition) Network, 801 Ostrum Street, Bethlehem, PA 18015, USA. E‑mail: [email protected] – Urban Dictionary This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. Access this article online For reprints contact: [email protected] Quick Response Code: Website: How to cite this article: Papadimos TJ, Soghoian SE, Nanayakkara P, www.jgid.org Singh S, Miller AC, Saddikuti V, et al. COVID-19 blind spots: A consensus statement on the importance of competent political leadership and the need for public health cognizance. J Global Infect Dis 2020;12:167-90. DOI: 10.4103/jgid.jgid_397_20 Received: 30 October 2020 Revised: 11 November 2020 Accepted: 25 November 2020 Published: 30 November 2020 © 2020 Journal of Global Infectious Diseases | Published by Wolters Kluwer - Medknow 167 Papadimos, et al.: COVID-19 Blind Spots has proven how interdependent the global community is associated with this important phenomenon.[3,17] Those who when facing an international health security (IHS) threat. attend public events with hundreds and possibly thousands It also became clear that, governments around the world of people in relatively close proximity should be aware that need to embrace key leadership qualifications in disaster and it does not take many new cases to re-ignite the outbreak, health security threat education, including a moral and ethical especially when considering that those newly infected will be obligation to rely on established expert resources. Given our asymptomatic and infectious for several days after contracting collective experiences to-date, it has become clear that evident the virus.[3] Therefore, it is important to understand that masks officials may require a “fitness to lead test” (e.g., leadership are very effective, but not a perfect solution. At the population competency) in the area of health security and pandemic level, there appears to be a fine balance between the risks of preparedness. More specifically, those in key leadership “social distancing at in-person events” and the effect of “stay- positions should seek appropriate consultation from established at-home” behavior in terms of net viral transmission.[18] It is content experts/advisors, with curbs to executive power when evident that government leadership and understanding of PH it comes to any proposed deviation(s) from scientifically problems and their consequences is of paramount importance. established, life-saving PH measures. Consequences of The goal of this consensus paper is to provide a high-level incompetence or lack of preparedness in this critical area can overview of potential PH “blind spots” of which political be devastating and far reaching. leaders should be cognizant. In addition, the IHS community Although much has been learned during the global society’s may need to recognize and address these blind spots during initial encounter with the novel coronavirus, a lot remains to be any subsequent waves of the COVID-19 pandemic to assist elucidated. In addition, the collective memory of what worked local, regional, and national governments. The current and did not work during the global response to the first wave manuscript is divided into sections dedicated to specific areas may not be long lasting if experiences with past outbreaks that were felt by our Multidisciplinary American College of and pandemics stay true.[3,4] Furthermore, what is believed to Academic International Medicine-World Academic Council be the “correct” answer as a result of our initial experiences of Emergency Medicine Consensus Group to represent may be easily reversed as new evidence is collected and opportunities for inclusion in a sustainable future pandemic published (e.g., transition from “no mask” to “mandatory management framework. To help the reader navigate this mask” regimes).[3,5,6] Within this very context, we must also extensive manuscript, we provide an executive summary of acknowledge that the world and the reality around us continue the 14 blind spots discussed in Table 1. In addition, Figure 1 to change, and what has worked in the past may not necessarily provides a word cloud reflecting the most common themes of this consensus paper. be equally applicable in the future. Effective leadership in the matters of PH concern is mandatory. Blind spot #1: Politicizing the process It is unacceptable for our political leaders to be ill informed and Public health blind spotting by senior elected political complacent toward political, social, economic, and scientific executives has become a serious problem during the COVID-19 pandemic.[19,20] This type of blind spotting can be political and/ evidence. For instance, in the USA, many COVID-19 outbreaks [21,22] appeared to be contained by early June 2020. By the beginning or cognitive, and can have devastating consequences. For of July, however, the number of new cases skyrocketed to more some, the circumstances of this global event are being used as a means to a political end, to enhance division as a form of than 54,500 per day.[7] Moreover, a number of complacent electioneering; or there may be a cognitive blind spot in some leaders who openly advocated for less strict application of leaders’ ability to process important matters related to PH nonpharmacological interventions (NPIs, e.g., hand washing, and society’s safety.[23,24] Countries that have transformed the universal facial coverage, social distancing, and avoidance of crowds and closed spaces) have themselves contracted the disease.[8-10] As of the writing of this article (November 2020), many countries are experiencing a well-defined second wave of the pandemic. Although many of the factors associated with this resurgence remain to be elucidated, it is increasingly clear that the degree of implementation and compliance with key NPIs may play an important role.[3,11,12] This is not unique to the USA, as other countries have experienced
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