Being in a constant state of high alert and uncertainty is exhausting. But health officials warn that we can’t let our guard down yet and that resisting living with the ‘new normal’ could threaten our health.
23 September 2020
The COVID-19 pandemic has meant that as a species we have collectively gone into a form of flight-or-fight mode, an evolutionary self-defence mechanism that can kick in when faced with a crisis. But what happens when that crisis lasts for months with no end in sight? For many, this protracted emergency is resulting in pandemic fatigue. But what does that mean exactly, and could it breed a form of complacency that could spell trouble for the fight against COVID-19 in 2021?
Many people who have had even mild cases of COVID-19 can have post-viral fatigue that can last for months or even years. This can include feeling constantly tired, with aching muscles and brain fog. Instead, pandemic fatigue refers to feeling overwhelmed with still having to maintain a state of constant vigilance, in this case six months after the pandemic started, and a weariness to abide by restrictions.
COVID-19 has infected more than 30 million people and killed nearly one million. These numbers seemed unthinkable at the start of the pandemic, but we are now having to accept that the numbers are likely to continue to rise especially as some countries start to enter their second wave of infections. This alone will exert a huge toll on human health. But the collateral damage is devastating too; the loss of incomes, the closure of entire swathes of community services and a lack of access to non-COVID-19 health services, including routine immunisation, is causing widespread insecurity and uncertainty about both the present and the future.
This emotional overwhelm can understandably lead to or exacerbate mental health problems, such as depression and anxiety. Health experts around the world have warned of a rise in the need for mental health services, which in the UK has been estimated at a 20% increase. A study in April this year looking at mental distress in more than 2,000 Americans indicated that 28% showed signs of serious mental illness compared with 3.4 in a similar survey in 2018. Young adults (18-44 years) showed the biggest downward change, and they were ten times more likely to have mental health issues.
Even for people who have not developed mental health problems, the weeks of lockdown and restrictions that millions went through brought emotional and psychological challenges that few had ever experienced. For many, those stresses may have lifted when lockdown eased, with schools and offices re-opening along with restaurants and gyms. Yet countries, such as Spain and the UK, are potentially facing new restrictions that might include another lockdown. Israel just went back into its second lockdown as it has one of the highest COVID-19 infection rates in the world. It’s unclear how people will cope with a second lockdown. In many low- and middle-income countries lockdown has proven disastrous. In India, 400 million workers in the informal sector - 80% of India’s non-agricultural workforce - are now at risk of falling into poverty as a result of the crisis.
Although face-coverings and physical distancing is still mandatory in public spaces in most countries, there are many reports of people either not wearing masks or wearing them ineffectively. Equally, despite pavements and floors in shops and airports painted to indicate the distance that people should keep apart, often they are not heeded. Yet masks are unlikely to go away as a disease prevention tool for COVID-19, and moreover there is evidence that countries that introduced masks early on had milder epidemics. People in countries where the pandemic has yet to fully take-off, may also be complacent in continuing to comply with restrictions, in the believe that the threat is over.
People who have had COVID-19 and have antibodies may feel that they are fairly well protected as they may have natural immunity to further infections. Yet natural immunity may not last long and there are documented cases of re-infection, sometimes leading to asymptomatic disease, but occasionally sending the person into intensive care. Some scientists believe that when a person is re-infected, they are protected by their antibodies from severe disease. But so far, it’s not clear how long antibodies last for, which also has implications for vaccine development.
Some pandemic fatigue seems to be caused by conflicting public health messaging in many countries. During lockdown, the rules in some countries were so strict that they were fairly unambiguous. Now, after the easing of lockdowns in many places, some countries are reintroducing restrictions of varying levels following rising numbers of cases. These constantly changing measures can cause confusion over what people should and shouldn’t do, for example, how schools should respond to students testing positive for COVID-19 or differences in messaging between local and national governments.
An infodemic of misinformation about COVID-19 has threatened the COVID-19 response since the start of the pandemic. This includes false claims that it would be better to get the virus (in the belief that antibodies would then protect against further infection), that the disease is not as bad as people have been led to believe or even whether or not the virus is real. All of this can not only put people at risk by not following guidance such as wearing masks, but it can also put more vulnerable people in society at risk, as well as encouraging the spread of non-scientific information.
Even when we are past the acute phase of this COVID-19 crisis, pandemic fatigue could threaten future disease prevention. Just three years after the H1N1 flu pandemic, World Health Organization (WHO) officials noted that health experts were unwilling to analyse it anymore to influence future pandemic planning, and were keen to move on. Yet such guidance based on lessons learned can be especially important for low- and middle-income countries that lack the resources to develop their own plans. A failure to plan also tends to mean a waste of resources – global health experts estimate it costs around US$ 4.5 billion a year globally to properly prepare for pandemics. By contrast, responding to the pandemic is costing low-and middle-income countries on average a staggering US$ 52·45 billion every four weeks.
Many people are understandably keen to see the end of 2020, but public health experts are keen to point out that nothing will materially change on 1 January 2021. Comprehensive testing and contact tracing programmes are yet to be successfully rolled out anywhere in the world, even in high-income countries. Scientists have modelled future scenarios of how the pandemic may evolve, none of which include a scenario in which the virus disappears. By the end of 2020, we are unlikely to have a treatment or a vaccine, and when we do get a vaccine, the logistics of manufacturing and distribution are not insignificant.
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Zipline is a California-based automated logistics company that uses autonomous drones to make on-demand, emergency deliveries of high priority products, including emergency and routine vaccines and other health products.
The pandemic will only strengthen our commitment to vaccinate vulnerable communities. On 4 June 2020 Gavi will hold its third donor pledging conference online with the aim to raise vital funds for the next five years.
The COVID-19 pandemic is most often compared to the H1N1 influenza pandemic of 1918, or Spanish flu, even though there have been three other major pandemics since then. So how does this coronavirus pandemic compare to those?
Equitable access to COVID-19 vaccines was a major priority for world leaders attending the virtual meeting
Black, Asian and minority ethnic (BAME) communities in Europe and the USA are overrepresented in COVID-19 deaths. In the bid to slow and, ultimately, stop the spread of COVID-19 it is vital to understand the reasons why, in order to adequately…
Health is not just a human right, it is a prerequisite for development. Through its advocacy programme Global Health, Global Access, Cordaid continually stresses the importance of Health for All.
While the number of COVID-19 cases and deaths stays relatively low across Africa, Asia and Latin America compared with the rest of the world, the economic and social consequences are likely to reverberate for decades to come.
The COVID-19 pandemic is disrupting vaccination programmes across the world, but this could provide an opportunity to hasten the move to digital record-keeping systems.
Altering the ease with which the new coronavirus spreads in the population is critical to controlling the pandemic. The number of people infected by any single case - the R number – will be key. If the virus is able to infect more than one person…
There is no fundamental reason to stop immunization in any situation.
Seventy (out of 73) Gavi-eligible countries have reported 257,996 confirmed cases and 7,547 deaths. These 70 countries account for a small proportion, about 5%, of global COVID-19 cases and 2% of global deaths.
Vietnam became one of the first countries to report a COVID-19 infection and the first to report human-to-human transmission outside of China. One hundred days later, just 270 cases had been confirmed in the country, with no deaths.
It is clear that the search for COVID-19 vaccines is being fast-tracked like never before. In just a few months, we now have over 100 vaccine candidates in development, ten of which are being tested in clinical trials.
Agencies call for joint effort to safely deliver routine immunization and proceed with vaccination campaigns against deadly vaccine-preventable diseases.
Experts are warning that COVID-19 could become an endemic disease. What does this mean and how will it impact our response?
Pregnant women can be more exposed to risk during outbreaks. With 200 million pregnant women in the world, is the global pandemic response adequate to protect them, and not just from the coronavirus?
The country has made strategic investments including supply chain strengthening and technological innovation, all of which have allowed critical immunisation activities to continue during and beyond the quarantine.
Does air travel increase your chances of getting becoming infected by the novel coronavirus and contracting COVID-19?
Controlling the pandemic demands a multi-pronged approach with other key methods like contact tracing to help stop the chain of transmission.
Zenysis is an advanced analytics software company. Their platform helps countries harness the life-saving power of data to improve the delivery of essential health services, like childhood vaccination, and to fight infectious disease outbreaks.…
What our lives will look in the short to medium term future is uncertain, but what does seem clear is we won’t return to a pre-COVID-19 life any time soon. Here are three potential scenarios that infectious disease experts have sketched out for…
The COVID-19 pandemic is putting a strain on health systems worldwide. The increasing demand on health facilities and health care workers has dramatically shifted resources from essential routine health services to COVID-19 response as countries…
Social inequity will put the poorest populations at greater risk from COVID-19
Initially, children seemed to be least affected by the new coronavirus. However, new evidence suggests that a small number might have a rare immune reaction to COVID-19, with some needing intensive care.
As countries rich and poor struggle with challenges in the face of the COVID-19 pandemic, Afghanistan is taking proactive steps to overcome its own.
Personal protective equipment, or PPE, such as masks and gloves are becoming part of our daily lives, but what counts as effective PPE and what doesn’t?
The new coronavirus has killed more than a quarter of a million people in just a few months, but the pandemic’s effect on food, housing and job insecurity will last years.
Will efforts to save lives in cases of severe COVID-19 trigger another global health crisis once the pandemic is over?
Sixty-nine (out of 73) Gavi-eligible countries have reported 123,129 confirmed cases and 3,941 deaths, five more countries than the 64 announced last week. These countries account for about 3% of global COVID-19 cases and deaths.
Tracking who is infected is essential to controlling the transmission of contagious diseases. Could digital technology prove to be a game-changer for the current pandemic?
Because of vaccination, many deadly diseases are now preventable. But we still lack vaccines for other potentially lethal diseases that could spread to become pandemics like COVID-19. Here is a list of 10 diseases to watch.
Even when a COVID-19 vaccine is available, testing can help pinpoint populations who should be prioritised for immunisation.
For the global health community, the implications resulting from COVID-19 could be immense.
How we can ensure that once a COVID-19 vaccine is available, it is accessible to everyone that needs it.
The COVID-19 pandemic has placed a heavy burden on global economies, health care systems and other core sectors. Gavi is helping countries reallocate their health system strengthening grants to provide fast and flexible funding for vital…
Q&A with Dr Vertando Halim, Coordinator of Expanded Programme on Immunization, Jakarta, Indonesia
With so many lives and livelihoods at stake, when will the lockdowns end, and what will they look like across the world?
As part of Gavi’s work supporting lower-income countries’ response to COVID-19, the Alliance is providing US$ 40 million to UNICEF to secure supplies of personal protective equipment (PPE) and diagnostics for 58 countries.
The world is currently on pause, buying time while an effective vaccine against COVID-19 is developed. Already, several vaccines have entered human trials, and discussions have begun about how the most promising candidates might be manufactured…
The COVID-19 pandemic has placed a heavy burden on global economies, healthcare systems and other core sectors. Gavi is helping countries reallocate their health system strengthening grants to provide fast and flexible funding for vital resources…
Goal of new global collaboration is to make COVID-19 diagnostics, therapeutics and vaccines available to everybody that needs them as quickly as possible.
How the 2009 H1N1 influenza pandemic can help us be better prepared for distributing and administering potential COVID-19 vaccines.
Indigenous groups face unique health challenges. How do we mitigate these risks in our COVID response?
How exactly is the COVID-19 virus spread and will a mask protect me?
The immediate and long-term consequences of the coronavirus pandemic are disproportionately impacting the lives of women and girls, and the most marginalised.
How does the benefit of stopping the spread of coronavirus weigh up against the risks from diseases such as measles?
With COVID-19 spreading in low- and middle-income countries, governments have been imposing strict lockdowns that could pose an even greater threat than the virus itself.
Interview with Emmanuel Lansana, outpatient supervisor at Monrovia’s Redemption Hospital in Liberia, about lessons learned from the Ebola outbreak that can help tackle COVID-19.
Africa is better prepared now to perform research in emerging infections than during the Ebola epidemics in West Africa.
Will new evidence suggesting that the virus is airborne mean we all need to wear masks?
Although there are guidelines on how long people should self-isolate when infected, the data on how long people remain contagious is not yet fully understood.
Could the impact of COVID-19 on routine immunisation be an even bigger threat in low-income countries than the virus itself?
At least 13.5 million people to miss out on vaccinations due to postponement of campaigns and interruptions in routine vaccinations, with millions more likely to follow.
As we continue to encroach on the environment and erode natural habitats, the likelihood of other diseases like COVID-19 emerging to devastate the planet are high.
Large-scale testing for COVID-19 could help solve some of the mysteries surrounding the virus that are still puzzling scientists.
Imperial model of the spread of COVID-19 implies a suppression strategy could be most effective.
With nearly 550,000 people infected, almost 25,000 dead, and hundreds of millions in lockdown across the globe, the coronavirus pandemic has brought the world to a standstill. But what do we know about COVID-19 and what can we do to fight this…
Gavi, the Vaccine Alliance applauds the commitment of the G20 Leaders chaired by Saudi Arabia “to provide immediate resources to the WHO’s…
The idea of herd immunity as the solution to the COVID-19 pandemic has triggered heated debate, but what is herd immunity and how does it work?
Over 1 billion lives are at risk if COVID-19 sweeps through crowded slums. How can we prepare?
With an increasing number of countries around the globe going into lockdown because of the COVID-19 pandemic, many people forced to stay home may be wondering why these measures are necessary, how long they will need to go on for and what it will…
On the most recent issue of The Bio Report podcast, Gavi's Aurélia Nguyen discusses COVID-19 vaccine development, the role of the Vaccine Alliance in stopping the pandemic, and shares lessons learned from the 2014 Ebola outbreak that may prove…
When a COVID-19 vaccine is available, how will we pay for it?
With the COVID-19 pandemic already affecting 47 Gavi-supported countries, Gavi, the Vaccine Alliance has already taken new steps to help strengthen the preparedness of health systems in lower-income countries with the full support of its Board.…
If COVID-19 epidemics are not controlled, 510,000 people could die in the UK and 2.2 million in the USA.
With zero cases of COVID-19 in Mozambique so far, Dr Rosa Marlene, National Director of Public Health of Mozambique, discusses a potential impact that a pandemic of this magnitude could have on the country’s health system.
We touch countless objects every day, from house keys to our mobile phones. The virus that causes COVID-19 can last for anywhere from 30 minutes to several hours in the air (in the form of aerosol droplets) before drifting down onto surfaces,…
Clinical trials for vaccines can take 10-15 years and cost hundreds of millions of dollars, which is why pharmaceutical companies can be reluctant to start down that challenging road without a definite pay-off at the end. As the COVID-19 pandemic…
Africa marks a critical juncture for the coronavirus pandemic.
From travel restrictions to social distancing, what is the best way to stop a pandemic?
We don’t yet know how the COVID-19 pandemic will progress and how long it will take for a vaccine to be developed, but the knowledge and experience gained from past outbreaks can be applied to the global response to coronavirus.
A vaccine against the novel coronavirus is under urgent development as the number of people infected with COVID-19 increases, a process which could also result in a new range of highly innovative vaccine technologies that ushers in a new era in…
