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Shaping a Healthier World After COVID-19

We must make deep, structural progress to prevent another pandemic.

Key points

  • The pandemic revealed our capacity for coming together to care for each other and for making dramatic changes to our world in the name of health
  • Racism, poverty, economic inequality, and deepening political divides were fuel to COVID-19’s fire.
  • We let our justifiable pride in scientific advances like vaccines distract us from investing in improving the foundational drivers of health.

In last week’s column, I introduced my new book, The Contagion Next Time, in advance of its November 1 release. In that column, I wrote about why I felt compelled to write a book about a pandemic during a pandemic. I have since had a chance to engage with friends and colleagues who are in the process of reading the book and engaging with its ideas. In a way, these conversations have been consistent with the spirit in which the book was written. While the act of writing is a solitary endeavor, producing a book — shaping its ideas and thinking through its structure — is a collaborative process. The thoughts in the book emerged from countless conversations with friends and colleagues, from reading the work of authors and journalists I admire, and from the unique academic setting in which I am privileged to work.

Now that the book is out, I have much enjoyed starting to discuss its ideas in a range of settings, toward the goal of informing the conversation about health. As I have talked with readers, three key themes have emerged that are worth sharing, I think, for their intersection with the broader aims of the book.

The Power of Health as a Universal Aspiration

First, my experience of writing the book and engaging with readers has made me even firmer in my belief that the world is a fundamentally good place. This may seem strange to say, given what we went through during COVID-19. It may seem even stranger to say given that the book is, in large part, a tour of the many ways in which we fell short in our response to the pandemic. Yet the pandemic moment also revealed our enormous capacity for coming together to care for each other, and for making dramatic changes to our world in the name of health.

I have long argued that we need to make deep, structural progress in order to create a healthier world. When I make this case, I occasionally encounter the objection that such progress would be too hard to implement — that we are incapable of making changes at a scale necessary for building the kind of world we wish to see. The COVID-19 moment showed that this is not the case. Once we understood that our health was threatened, we changed the world, seemingly overnight. This suggests the power of health as a universal aspiration capable of bringing us together in shared endeavor. This is indeed to the good. It is now up to us to understand that our health remains at stake, that the structures that allowed COVID-19 to take hold remain in place. Once we realize this, we can follow through on the work we began during the pandemic and truly shape a world where contagion cannot take hold. It has been encouraging to see how many readers share this view and are receptive to a message that calls on us to double down on what is good about the world, to make it even better.

A Broken Status Quo Around Health in Our Society

Second, the things we got wrong during the pandemic were things that we should have fixed before contagion struck. COVID-19 was a novel threat, unprecedented in our lifetimes. Yet the conditions that allowed it to take hold were familiar, long known to us. They were the conditions that characterized a broken status quo around health in our society. Racism, poverty, economic inequality, deepening political divides — these were fuel to COVID-19’s fire, and none of them are new. They are all challenges we should have addressed years ago. Yet we allowed them to become tolerable, even acceptable. We dragged our feet until finally a contagion came and exploited our failure, to catastrophic effect.

We cannot afford to let this happen again. Just as our vulnerabilities were not hidden before the pandemic, they are not hidden now — because they are the same. Our response to them, however, must not be the same. This has been a core takeaway from speaking with those who have been engaged in the work of trying to address fundamental challenges to our health. Long before COVID-19, they saw what needed to be done and how far we were from doing it. Speaking to them both before and after the launch of the book has only sharpened in my mind the urgency of engaging with the foundational drivers of health, while there is still time.

Science Can Do Better

Finally, COVID-19 showed us that our science can do better. We have at times let our justifiable pride in scientific advances like vaccines distract us from investing in improving the foundational drivers of health. A healthier state of affairs would be for science to work in tandem with this broader engagement, informing a more comprehensive approach to health. Doing so will take humility and an understanding that no scientific advance, no matter how sophisticated, has more influence on health than the larger forces discussed in my book. Science has an important role to play in shoring up the foundations of health, but it can only do so when it has fully accepted the importance of these forces and engages with them with an eye toward supporting health. Hearing the personal stories of those who lived through the pandemic — family, friends, colleagues, and readers — was a reminder of the degree to which health is shaped by the context of our lives. It is about the world around us, all of it, and whether or not that world is maximized for health. Science is part of that world, but it is not the whole world, and it is by realizing this that science can maximize its own influence on our collective well-being.

These preliminary reflections mark the start, I hope, of an ongoing conversation around the core themes of the book. I look forward to hearing from many of you in the weeks and months to come. Thank you for your continued engagement with ideas that shape a healthier world. It is a privilege to connect with you, to learn from you.

This piece was first posted on Substack.