TOWARD A
POST-PANDEMIC WORLD
Lessons from COVID-19 for Now and the Future
PROCEEDINGS OF A WORKSHOP
Elizabeth Ashby, Claire Biffl, and Megan Snair, Rapporteurs
Forum on Microbial Threats
Board on Global Health
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
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This activity was supported by contracts between the National Academy of Sciences and the Burroughs Wellcome Fund (1021631, 1022390), Johnson & Johnson (C2021020002), the New Venture Fund (NVF-NGDF-NAT10-Subgrant-013446-2021-01-01), the U.S. Agency for International Development (7200AA18GR00003), the U.S. Department of Defense (HU00012110002, HU00012210001), the U.S. Department of Health and Human Services (75A50119C00031, 200-2011-38807/75D30120F00084, 200-2011-38807/75D30121F00095, 1R13FD006897-01, HHSN263201800029I/HHSN26300011), the U.S. Department of Homeland Security (70RSAT21G 00000003/70RSAT21FR0000029), and the U.S. Department of Veterans Affairs (64836C25020P1830, 36C24518D0171/36C25021N0648). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
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Digital Object Identifier: https://doi.org/10.17226/26556
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2022. Toward a post-pandemic world: Lessons from COVID-19 for now and the future: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/26556.
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COMMITTEE ON TOWARD A POST-PANDEMIC WORLD: LESSONS FROM COVID-19 FOR NOW AND THE FUTURE1
ELIZABETH D. HERMSEN (Co-Chair), Head, Global Antimicrobial Stewardship and Health Equity in Infectious Diseases, Merck & Co., Inc.
RAFAEL OBREGON (Co-Chair), Country Representative, UNICEF Paraguay
WILLIAM K. HALLMAN, Department Chair, Professor, Department of Human Ecology, Bloustein School of Planning and Public Policy, Rutgers University
CHANDY C. JOHN, Director, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine
KENT E. KESTER, Professor of Medicine, Uniformed Services University of the Health Sciences School of Medicine
RIMA F. KHABBAZ, Director, National Center for Emerging Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention
KUMANAN RASANATHAN, Unit Head for Equity and Health, Department of Social Determinants of Health, World Health Organization
STEPHEN J. THOMAS, Chief, Division of Infectious Diseases, Director, Institute for Global Health and Translational Science, State University of New York Upstate Medical University
MATTHEW ZAHN, Medical Director, Division of Epidemiology and Assessment, Orange County Health Care Agency (California)
National Academies Staff
JULIE LIAO, Director, Forum on Microbial Threats
ELIZABETH ASHBY, Associate Program Officer
CHARLES MINICUCCI, Research Assistant
CLAIRE BIFFL, Research Assistant
JUSTIN HAMMERBERG, Senior Program Assistant
JULIE PAVLIN, Senior Board Director
___________________
1 The planning committee’s role was limited to planning the workshop, and the Proceedings of a Workshop was prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants and are not necessarily endorsed or verified by the National Academies of Sciences, Engineering, and Medicine, and they should not be construed as reflecting any group consensus.
FORUM ON MICROBIAL THREATS1
PETER DASZAK (Chair), President, EcoHealth Alliance
KENT E. KESTER (Vice Chair), Professor of Medicine, Uniformed Services University of the Health Sciences School of Medicine
RIMA F. KHABBAZ (Vice Chair), Director, National Center for Emerging Zoonotic Infectious Diseases, U.S. Centers for Disease Control and Prevention
EMILY ABRAHAM, Director, External Affairs and Policy, Global Public Health at Johnson & Johnson
KEVIN ANDERSON, Senior Program Manager, Science and Technology Directorate, U.S. Department of Homeland Security
CRISTINA CASSETTI, Deputy Division Director, Division of Microbiology and Infectious Diseases (DMID), National Institute of Allergy and Infectious Diseases
ANDREW CLEMENTS, Senior Scientific Advisor, Emerging Threats Division, Bureau for Global Health, U.S. Agency for International Development
SCOTT F. DOWELL, Deputy Director for Surveillance and Epidemiology, Bill & Melinda Gates Foundation
MARCOS A. ESPINAL, Director, Communicable Diseases and Environmental Determinants of Health, Pan American Health Organization
EVA HARRIS, Professor, Division of Infectious Diseases and Vaccinology; Director, Center for Global Public Health, University of California, Berkeley School of Public Health
ELIZABETH D. HERMSEN, Head, Global Antimicrobial Stewardship and Health Equity in Infectious Diseases, Merck & Co., Inc.
CHRISTOPHER R. HOUCHENS, Director, Division of Chemical, Biological, Radiological and Nuclear Countermeasures, Biomedical Advanced Research and Development Authority
CHANDY C. JOHN, Director, Ryan White Center for Pediatric Infectious Disease and Global Health, Indiana University School of Medicine and Riley Hospital for Children at IU Health
MARK G. KORTEPETER, Vice President for Research, Professor of Preventive Medicine and Medicine, Uniformed Services University of the Health Sciences
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteurs and the institution.
MICHAEL MAIR, Acting Assistant Commissioner for Counterterrorism Policy; Acting Director, Office of the Chief Scientist, U.S. Food and Drug Administration
JONNA A. K. MAZET, Vice Provost–Grand Challenges; Chancellor’s Leadership Professor of Epidemiology & Disease Ecology, University of California, Davis
VICTORIA MCGOVERN, Senior Program Officer, Burroughs Wellcome Fund
SALLY A. MILLER, Distinguished Professor of Food, Agricultural and Environmental Sciences in Plant Pathology, The Ohio State University, College of Food, Agriculture, and Environmental Sciences
SUERIE MOON, Director of Research, Global Health Centre; Visiting Lecturer, Graduate Institute of International and Development Studies; Adjunct Lecturer, Harvard T.H. Chan School of Public Health
RAFAEL OBREGON, Country Representative, UNICEF Paraguay
KUMANAN RASANATHAN, Unit Head for Equity and Health, Department of Social Determinants of Health, World Health Organization
GARY A. ROSELLE, Executive Director, National Infectious Disease Services Program, Veterans Health Administration, U.S. Department of Veterans Affairs
PETER A. SANDS, Executive Director, the Global Fund to Fight AIDS, Tuberculosis and Malaria
THOMAS W. SCOTT, Distinguished Professor, Department of Entomology and Nematology, University of California, Davis
MATTHEW ZAHN, Medical Director, Division of Epidemiology and Assessment, Orange County Health Care Agency (California)
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Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the contents of this proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by CARLOS E. RODRIGUEZ-DIAZ, The George Washington University, Milken Institute School of Public Health. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with the standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.
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Acknowledgments
The workshop summarized in this proceedings is the product of many valuable contributions. Special thanks go to the presenters and discussants who gave generously of their time and expertise to make the event possible.
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Contents
2 POTENTIAL LONG-TERM EFFECTS OF COVID-19 ON HEALTH EQUITY
Pandemic Inequalities in the United States
Measuring Mental Health and Social Determinants
Disease Mechanisms of Long COVID-19
3 ADDRESSING UNCERTAINTIES IN PANDEMIC COMMUNICATION
4 SYSTEMATIZING RECOVERY EFFORTS TO MITIGATE THE NEXT PANDEMIC
Boxes and Figures
BOXES
1-1 Lessons Learned in Qatar as Presented by H. E. Hanan Al Kuwari
FIGURES
2-1 Rates of uninsurance by poverty and Medicaid expansion status
2-2 Change in symptom scores before and after vaccination
4-1 COVID-19 cases per million inhabitants in Paraguay (2020–2021)
5-2 Key characteristics of the future, as generated by group two
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Acronyms and Abbreviations
| ACA | Affordable Care Act |
| CBPR | community-based participatory research |
| CCHN | Center for Community Health Navigation |
| CDC | Centers for Disease Control and Prevention |
| CEAL | Community Engagement Alliance |
| CHW | community health worker |
| COVID-19 | coronavirus disease 2019 |
| EMR | electronic medical record |
| FEMA | Federal Emergency Management Agency |
| HMC | Hamad Medical Corporation |
| ICS | incident command structure |
| IHR | International Health Regulations |
| IP | independent panel |
| LMIC | low- and middle-income country |
| NCD | noncommunicable disease |
| NCIRD | National Center for Immunization and Respiratory Diseases |
| NIH | National Institutes of Health |
| NIMHD | National Institute on Minority Health and Health Disparities |
| OECD | Organization for Economic Co-operation and Development |
| OR | odds ratio |
| SDG | Sustainable Development Goal |
| SDOH | social determinants of health |
| SNAP | Supplemental Nutrition Assistance Program |
| UHC | universal health coverage |
| WHO | World Health Organization |
