strangers-B-880x300.jpgLessons learned from the COVID-19 pandemic: the crucial role of epidemiology and public health in health care systems

By Dr. Saverio Stranges
Chair, Epidemiology and Biostatistics

As an epidemiologist and public health physician, I have been watching the COVID-19 pandemic unfold across the globe. And I have been exploring the best scientific and epidemiological evidence to help understand why some countries have succeeded at controlling the outbreak of COVID-19, and others have not.

I feel there are several lessons to be learned from this unprecedented health crisis.

We have fully appreciated the crucial role of public health and epidemiology in health care systems. Specifically, the COVID-19 pandemic has exposed several intrinsic structural limitations of national public health care systems across several western countries. These include a lack of coordinated and timely response mechanisms for enabling rapid actions, like those deployed by some Asian countries, and a lack of adequate community response, which is critical for epidemic containment.

While the health systems of most western countries have prioritized hospital-centered management of non-communicable diseases, during the past few decades, their capacity to prevent and control emerging infectious diseases has not been given adequate attention. Additionally, there has been relatively limited public investment to strengthen epidemiological surveillance systems in the community.

Countries like South Korea, Vietnam, Hong Kong, Taiwan and Japan have been able to curb the spread of the virus at very early stages; compared to countries like Italy, Spain, France, Belgium, Sweden, the United Kingdom and the United States (US), where there has been a rapid surge in the number of infected cases, with a relatively large toll in terms of COVID-19 related deaths. Overall, a lack of pandemic preparedness in western countries has emphasized the need to strengthen early responses and community-centered public health systems, which are in place in some of the East Asian countries.

Another lesson to be learned is around the important role played by public health information and communication systems that reach the broader society.

The COVID-19 pandemic has revealed huge variations across countries in terms of public health messages and recommendations provided by both political leaders and experts.

I believe that overall in Canada, there has been a good degree of consistency in the communication flow between the political leadership, public health officials and scientists. This has certainly helped in fostering responsible behaviours among the general public in terms of adherence to public health recommendations, such as physical distancing and facemask usage.

Finally, we learned about the importance of public health education in the population at large, which helps individuals make better health choices, allows health professionals to engage in evidence-based practices, and helps societies protect and promote population health through policy initiatives.

The COVID-19 pandemic has further emphasized the need to strengthen public health education throughout the lifespan, from school settings to workplaces and community organizations. The prevention and control of epidemics are not solely the responsibility of governments and health professionals, but they necessarily rely on participation and engagement of individual citizens, who all play a critical role with their behaviours in protecting their own and other people’s health and wellbeing.

As an epidemiologist and public health physician, I hope this pandemic has drawn attention to the importance of reallocating resources in terms of public health capacity and epidemiological surveillance systems in the community.

I think in Canada, we preserved our public health infrastructure because of the lessons learned from SARS, and I believe that has played a role in mitigating the impact here in Canada as compared, for example, with the US or even with some Western European countries.