The development of vaccines must not make us complacent in the face of the Covid-19 pandemic, a senior public health official at the World Health Organisation warns.
“The vaccines have brought optimism, but let’s not think it will all be over by tomorrow,” said Dr Rüdiger Krech, the WHO’s director of health promotion, in an exclusive interview for the Livehealthy Festival 2021.
With the arrival of vaccines, the world is now at “a crucial moment” in the pandemic, he added.
“In the history of pandemics, this has always been the last mile, when there was finally light at the end of the tunnel. People thought they were safe, but that’s when we saw the most infections and it all went really wrong.
“People stop taking health measures so seriously because they think they’re not infected. They forget to wash their hands and keeping a distance doesn’t seem so important.
“Do I see a reason for optimism? Yes, but that is a big risk in itself if we discard health measures, just because there is a vaccine.”
The pandemic is at least partly a result of earlier warnings being ignored, said Dr Krech.
“We in public health have warned heads of governments for years that it was not a case of ‘if’ we face a pandemic, but ‘when.’ The world has become so interconnected that the risks of outbreaks are increasing in number and scope.
“Fifteen years ago we had bird flu, 10 years ago, swine flu, five years ago, Ebola and now Covid. After each crisis there were reviews, but the action plans after Ebola were not put in place. That’s why we face this risk now and we will face much bigger risks if we do not fundamentally change how we interact and how we take care of this planet.”
Keeping fit in body and mind is essential to warding off the virus, or at least its worst effects, he said. The WHO and its member states have set a target to reduce physical inactivity by 15 percent by 2030.
“Even before this crisis there was an urgent need for us to be more active. We now have a situation where one in four adults is not active enough and 80 percent of adolescents are not active enough. In that 80 percent, girls are even less active, so there is a gender issue. In the last two decades there has been no particular improvement, particularly in those gender differences, so it’s very important, regardless of Covid, that we all look at changes in lifestyle.
“It’s not easy keeping active when sports clubs and swimming pools are closed, but go for a walk or a bike ride if you can. If you can go to a park or some green space, do so, but keep practising distancing. If you’re running, keep more than two meters apart.
“If you’re not regularly active already, start small and slow with low-impact exercise. Walk for 5 to 10 minutes and build up to 30 minutes over a few weeks. It’s better and safer to be active for short but frequent periods than to do a lot for a longer period, because you don’t want to be landing up in hospital with an injury.”
Though it is a global body headquartered in Geneva, the WHO is more of an umbrella for 150 branches all over the world, all of which deal with different regional, social, cultural and economic differences when formulating guidelines.
“We’re not just sitting around a table thinking about what to do,” said Dr Krech. “We review all the evidence gathered from sports, medical and social sciences and analyzed by different experts and also review regional differences.
“There is actually very little disagreement over what is good for your body and what isn’t, so acceptance levels of WHO guidelines is already very high. National governments are translating those guidelines into national policies and that trickles down to local communities. And any individual can access the information on the WHO website. In 2020, 1.4 billion people used the information and 2.2 billion documents were downloaded.
“It’s all part of ‘health literacy.’ There are huge industries behind sports and physical activity and we are working very closely with them, including the International Olympic Committee, FIFA and others, on how to use sporting events to promote physical activity for everyone, so it’s not just the elites that are supported. Many of our recommendations don’t cost a lot of money.
Dr Krech said the pandemic has served to highlight further the gross inequities in the world.
“Chronic disease care services have not been sustained in many countries. Many people cannot work remotely or stick to physical distancing because of their living environment and because they have to work in the informal sector. All this has aggravated the situation and shows how ill-prepared the world is.
“This crisis is holding up a magnifying glass to many issues we face in public health. It has shown us how resilient some of our health systems are and also where the differences are. We’ve seen that some of the health systems in developing countries are much more resilient than those of industrialized countries.
“Another factor is the discipline of the people and the political implementation of public health measures, and basing those measures on evidence and not on politics. That’s a lesson we can all see because every day we see the infection rates and how public health measures have been implemented.”
All the data emerging from study of the pandemic must now form the basis for building and designing societies for the future, in which good health “does not depend on where you were born,” said Dr Krech.
What is certain, he added, was that there will be another pandemic in the future and continuing urbanization is arguably the biggest risk factor. After Ebola, scientists identified around 30 different pathogens, any of which could cause the next epidemic.
“So the issue is: how could it spread? The risk is in the way we have designed our habitat. If we keep enlarging our cities and encroaching more on wildlife, more wild animals will enter our cities to feed on the waste we produce. It may not be wet markets next time – the next epidemic will come from somewhere else.
Another certainty is the need for collaboration and cooperation between nations, said Dr Krech.
“If you’re only looking at your own population and your own national boundaries, there will always be reinfections coming into your country and it will be very difficult to achieve herd immunity. Only by doing this in solidarity will we get out of this pandemic. Otherwise the virus will be with us much longer and will cost many more lives.”
• Dr Rüdiger Krech is director of health promotion at the World Health Organisation in Geneva and was the keynote guest at the Livehealthy Festival on January 22, 2021.
Anna Pukas has reported from all over the world as a foreign correspondent for British media. She is now an editor based in Abu Dhabi.