International study on COVID-19 offers practical recommendations to end this threat against public health

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More than 350 multidisciplinary experts from over 100 countries reach a consensu

More than 350 multidisciplinary experts from over 100 countries reach a consensus on how to end COVID-19 as a public health threat.

SARS-CoV-2 is still around us. Although some governments have turned this page, a study published today in the journal Nature states that efforts and specific resources are still necessary to save lives. This is one of the six main action ideas identified by a broad group of experts from different disciplines and from more than 100 countries to recommend actions that end COVID-19 as a threat to public health. The conclusions of this study, coordinated by Jeffrey V. Lazarus, lecturer at the Faculty of Medicine and Health Sciences of the UB and researcher at the Barcelona Institute for Global Health ( ISGlobal ) —centre driven by La Caixa Foundation— received the support of more than 150 world organizations.

COVID-19 is still a threat to global health

To date (October 2022), more than 630 million cases of COVID-19 and more than 6.5 deaths (although the real figures of deaths have been estimated at more than 20 million) have been reported. Moreover, millions of patients with cancer and chronic diseases have suffered dangerous delays in their medical care, and Long COVID is still eluding a definite treatment, which is a constant threat to the survivors. Also, the virus is accumulating mutations that can improve their ability to avoid immunity. This is why many public health leaders, including the authors of the study, regard COVID-19 as a dangerous threat to global health.

Despite the notable scientific and medical advances, the global health to COVID-19 has been hindered by political, social and behavioural factors, such as false information, vaccine hesitancy, a lack of global coordination and the inequitable distribution of equipment, vaccines and treatments. "Every country has responded in a different way, and offen inadequately, which is partly due to a serious lack of coordination and clear goals", says Jeffrey V Lazarus, member of the Department of Medicine of the UB, ISGlobal and the Hospital Clínic de Barcelona.

Priority recommendations in health and social policies

In order to reach a global consensus on how to address these questions in the future, Lazarus and his team carried out a Delphi study, a research methodology that invites experts to reach a consensus on complex research questions. A multidisciplinary panel formed by 386 experts from the academic, health, governmental, and NGO fields, among others —from 112 countries— took part in three rounds of structured consultation. The result was a set of 41 statements and 57 recommendations in six main areas: communication; health systems; vaccination; prevention; treatment and care, and inequity.

Among the top priority recommendations are, for instance, adopting a whole-of-society approach involving multiple disciplines, sectors and actors to avoid fragmented efforts; government approaches (such as coordination between ministries) to identify, review and address resilience in health systems and make them more responsive to people’s needs; and to maintain a vaccine-plus approach, which includes a combination of COVID-19 vaccination, other structural and behavioural prevention measures, treatment, and financial support measures. The members of the panel prioritised recommendations for developing technologies as well (vaccines, therapies and services) that can reach target populations.

Other recommendations that reached a 99% agreement were: communicating effectively with the public; getting back the public trust and promoting community participation in the management of the pandemic response.

Only six recommendations had more than 5% of disagreement, including that which considers further economic incentives to address vaccine hesitancy or symptoms approaches to diagnose COVID-19 in places with low access to testing.

The 57 recommendations are aimed at the governments, health systems, industry and other key stakeholders. "Our results place emphasis on health and social policy recommendations that can be implemented in months, not years, to help bring this public health threat to an end", says Quique Bassat, co-author of the study, lecturer at the Faculty of Medicine and Health Sciences, ICREA professor at ISGlobal and member of the Hospital Clínic de Barcelona.

"Our study echoes some earlier recommendations, such as the Independent Panel for Pandemic Preparedness and Response and the WHO COVID-19 Strategic Preparedness and Response Plan 2022", says Lazarus, "but what makes this work unique is the very large number of experts consulted, the wide geographical representation, and the study design, which emphasises consensus building and identifies areas of disagreement. It may prove to be a model for developing responses to future global health emergencies", concludes the researcher.

Reference article:

Lazarus, J. V.; Romero, D.; Kopka, C. J.; Karim, S. A.; Abu Raddad, L. J.; Almeida, G. et al. ’ A multinational Delphi consensus to end the COVID-19 public health threat ’. Nature, November 2022. DOI: 10.1038/s41586’022 -05398-2


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