Look at UK English and European experience during the COVID-19 pandemic. Successes and failures. Presentation for a meeting of the Centre for Health and Development (CHAD) University of Staffordshire. Centre via recorded lecture, Thursday, 28 October 2021 12:00 211027 4 definitive middleton chad conference final Video presentation also to be available online

1. COVID-19: What went right, what went wrong
and how do we learn from this?
A presentation for Staffordshire University Centre for Health and
Development Meeting October 28th 2021
Professor John Middleton Hon FFPH, FRCP
Hon Professor of Public Health Wolverhampton
President, Association of Schools of Public Health in the
European Region

3. 3
06/11/2021
COVID-19 what went well ?
The digital revolution, in healthcare and work
Big data, availability of health data and clever presentations of data
Decisive actions by East Asia countries, Australia and New Zealand applying
their knowledge and strengthened public health capacity post SARS
Decisive actions by some other nations-‘COVID underdogs’- in accordance with
World Health Organisation’s January 2020 advice
Scientific and technological development of vaccines
Health services responses where universal health care in place
Mutual aid community in many countries
Setting up COVAX the international vaccine distribution facility

4. 4
06/11/2021
The COVID-19 pandemic

6. 6
06/11/2021
The COVID-19 syndemics

8. Race and ethnicity risks Black men 4X
as likely to die from COVID_19
Risks-
• Pre-existing Health risks- long term
conditions, diabetes, obesity
• More likely to be in high risk
occupations-health, food
processing, transport, security,
front-line health and social care
• Institutional racism- not being
listened to when concerned on
risks (Kevin Fenton PHE report )
▲Journal
American Medical
Association, May
2020
◀︎ UK
Office of
National
Statistics,
April 2020

9. 9
06/11/2021

10. 06/11/2021 10

11. 06/11/2021 11

13. Public mask wearing
mandated early on-
Czechia, Slovakia,
Slovenia, Poland

15. Vaccinations: saving lives in millions

17. 17
06/11/2021
The COVID-19 infodemic

18. Infodemics:
misappropriating
personal information
to sway opinion and
behaviour – in this
example in elections

19. Infodemics: misappropriating social media - to sway
opinion and behaviour – in this example in vaccine
hesitancy

20. Vaccinations: saving lives in millions
Proportion of the population who would refuse COVIOD_19 vaccine if offered it now. Institute of Health
Metrics and Evaluation, March 2021

21. Vaccinations: saving lives in millions

22. Vaccinations: saving lives in millions
https://www.sorryantivaxxer.com

25. John Middleton [lecture title]
[date]
Global governance
for health

28. 28
06/11/2021
The COVID-19 what went well UK ?
Initial efforts on social welfare/furlough/ increased universal credit/ hotels for
the homeless?
Vaccine development, commitment global collaboration of science and
Technology, commitments to shared intelligence, research and delivery ‘COVAX’
Vaccination policy and delivery ‘December 2020-April 2021’
Clinical research: rapid assessment of effective and ineffective treatments
including the Recovery Trial
Rapid set up of major prospective studies REACT, ONS community infection,
ZOE
Genetic sequencing of virus and development of Genomic Surveillance

29. 29
06/11/2021
The COVID-19 what went (well) UK ?
Not ‘well’- but ‘heroic’, ‘admirable’, ‘selfless’, ‘professional’,
‘caring’, ‘compassionate’
NHS services response
Social care unsupported and unprotected
Local public health services – undervalued, unrecognized, snubbed
Community responses: volunteering, ‘mutual aid’, in food delivery,
in the vaccine delivery programme
National public health professional organisations working together

35. 35
06/11/2021
The COVID-19 what badly UK ?
Political leadership: failure to act, policy U turns, failure of Public
messaging
Procurement-incompetence and corruption
Test and trace
Nightingale hospitals
Care and protection of our children in schools and outside
Neglect of local public health services and director of public health
Neglect of social care
Border controls

51. What needs to be done?
Planning for an outbreak of health

53. Vaccinations: saving lives in millions

54. Vaccinations: saving lives in millions

55. https://www.forbes.co
m/sites/niallmccarthy/2
021/05/06/which-
companies-received-
the-most-covid-19-
vaccine-rd-funding-
infographic/?sh=eef64e
a4333d

56. Vaccinations: saving lives in millions
There is no place for intellectual property protection
during a humanitarian crisis
But there must be fair assessment of how industry
should be properly paid for their work and their
products and to protect and ensure investment for
future new life-saving products

57. Vaccine
TRIPS
Waiver
needed
now

58. Planning for an outbreak of
health:
The public health system,
services and profession
https://www.aspher.org/co
vid-19-task-force.html

59. https://epha.org/public-
health-must-be-
strengthened-for-a-
healthy-post-covid-world/
Global governance for health

61. John Middleton:Planning for an outbreak of health
Renew the mandate of the UN and
WHO in global health governance
The new Treaty for pandemic
preparedness
Governance
Transparency and information
sharing
Resources and capacity
New continental/WHO regional
structures with response capacity

63. https://s3.amazonaws.com/ASPPH_Media_Files/Docs/
GNAPH_Global+governance+for+health.pdf

64. John Middleton: Planning for an outbreak of health
Planning for an
outbreak of health:
The public’s health
https://www.aspher.org/covid-
19-task-force.html

65. John Middleton: Planning for an outbreak of health

66. John Middleton [lecture title]
[date]
Upsides
of
lockdown
1 :
Decline in
air
pollution

67. Upsides in
lockdown 2:
interest in
more active
travel

68. Build back
better?

69. ‘Build back’ ?
Working practices and relationships ?
Reducing inequalities? Minorities?
Vulnerable groups? Women? Older
people?

70. John Middleton: Planning for an outbreak of health
https://www.health.org.uk/sites/default/files/upl
oad/publications/2020/Build-back-fairer-the-
COVID-19-Marmot-review.pdf
Build back
Fairer?

71. John Middleton:Planning for an outbreak of health
Build back
Fairer?
The richest billionaires could
give $139,300,000,000 away
and still be as rich as they
were in 2020. These
billionaires could end global
hunger for about $300 billion.
A fraction of their overall
wealth.

72. ‘Build
back’?

73. ‘Build back’ ?

74. ‘Build back’ ?

75. ‘Build back’ ?

76. ‘Build back’ ?
To what austerity, poverty and
unfairness? Environmental squalor and
health and wealth for some?
Plan for an outbreak of health….

77. William Beveridge designed a welfare state
for the UK in the deepest point of the
Second World War.
‘We should regard want,
idleness , ignorance, squalor
and disease as enemies of us
all. That is the meaning of a
social conscience; that we
refuse to make our separate
peace with evil.’

78. Thank you
John Middleton,
President
Association of Schools of Public Health
In the European Region
John.middleton@aspher.org

79. What is ASPHER ?
The Association of Schools of Public Health in the European Region
(ASPHER) is the key independent European organisation dedicated to
strengthening the role of public health by improving education and
training of public health professionals for both practice and research.
We have 120 member schools of public health in Europe and
associates globally.
We are developing our partnerships with sister public health
organisations in America, Africa, Asia, Australasia and the Arab
world