Preparing for pandemics needs a dose of public health and a booster of “complex thought” (Errare humanum est, perseverare diabolicum)

Abstract

AbstractThe COVID‐19 pandemic has triggered unprecedented governmental responses worldwide, revealing weaknesses in health systems and public health policies due to lack of “complex thought” required to manage complex adaptive systems. Understanding COVID‐19 response strategies' multiple effects is particularly important now that pandemic preparedness and response (PPR) is on top of the global health political agenda. Here, we adopt a complex adaptive systems approach to critically analyze the literature and draw lessons from the COVID‐19 response to inform future PPR strategies. We observe that in many contexts, strategies implemented in response to COVID‐19 were poorly effective, inefficient, and inequitable. We explain the limitations of these prevailing measures and propose approaches and strategies to manage pandemics arising from a “systems thinking” perspective. PPR demands the adoption of an evolving, evidenced‐informed, and context‐specific strategy based on comprehensive approaches reflecting the complexities of health crises. This means moving away from single‐focused health security paradigms to consider the full range of health problems facing populations and adopting a package of interventions chosen via participatory and deliberative processes that are context‐specific and sensitive, as well as evidence‐driven, to ensure a fair balance between various pillars of pandemic responses: health promotion, non‐pharmaceutical interventions, prophylaxis, vaccines, and treatments.