Concerns for the possibility that an emerging infectious disease previously unknown to humankind would pose a serious threat to humanity in the 21st century, have been raised as far back as the 1980s. As we entered the new century, this concern became reality with the successive outbreaks of such infectious diseases as SARS (severe acute respiratory syndrome), MERS (Middle East respiratory syndrome), Ebola virus disease, and Zika virus disease, all of which became a global public health issue.
However, even having experienced these outbreaks, which should have been regarded as nature’s warnings, the world refused to acknowledge the risk that another of these incidences may occur; on the contrary, we have rapidly accelerated our vulnerability towards emerging infectious diseases.
Amid these circumstances, COVID-19 emerged.
While SARS, which appeared in 2002, was successfully contained in about 8 months globally, we are yet to see how and when the COVID-19 pandemic will end. More than a year and a half in, we are still seeing an enormous number of people being infected all over the world every day. The reason why COVID-19 has led to such a devastating pandemic is that, compared to SARS, COVID-19 is a far more difficult infectious disease to control. However, this is not the only reason. The spread of COVID-19 is proving much faster compared to SARS 17 years ago, and we as a civilization cannot compete against the rapidness of this spread. As a result, all actions taken so far in response have been behind the curve. The way in which globalization has been promoted in the interest of economic efficiency is a clear key factor that has allowed COVID-19 to spread so fast.
On the other hand, science and technology have made remarkable progress in the last 17 years since SARS first emerged. The causative virus of COVID-19 was promptly identified, and antiviral drugs and vaccines have been swiftly developed. The speed at which these developments took place could never have been imagined at the time of the earlier SARS outbreak. Antiviral drugs are thought to have certain positive effects, and the newly developed vaccines have been reported to be effective.
However, in the short term, neither antiviral drugs nor vaccines can provide a perfect solution to this problem. Antiviral drugs that could be administered to many infected individuals, including those with mild illness, are not yet available. Likewise, the adequate supply of vaccines is a great challenge that is still yet to be addressed. Above all, the fact that over 5 million lives have already been lost, primarily in high-income countries in Europe and North America, but also in emerging economies, demonstrates the current limitations of science and technology.
COVID-19 has caused a variety of different problems throughout all levels of society. These problems do not solely pertain to medical or public health issues, but instead, require actions to be taken across multiple fields in order to formulate an effective response. In most countries, the question of how to balance social and/or economic activities with measures to combat infection has been a difficult issue to address, and governments have struggled to cope with this challenge from the very beginning.
In Japan, it has been especially difficult to break the chain of infection, particularly in metropolitan areas, and this is thought to have led to the second and third waves of COVID-19. It is also thought that this may have resulted from the formation of “invisible clusters” in which the virus spread through vulnerable individuals of society living primarily in metropolitan areas, and to whom countermeasures were unlikely to have reached. How we can provide adequate supports to these individuals is a critical problem that needs to be addressed moving forward.
Furthermore, in Japan, most of the countermeasures against COVID-19 are fundamentally dependent on voluntary behavioral changes by the citizens. But behavioral changes are impacted by various factors such as psychological attitudes of individuals, and the dissemination of information related to the disease. These factors are extremely difficult to comprehensively quantify and evaluate within the currently available mathematical models. Using a natural scientific approach alone does not always work when addressing the challenging issues associated with COVID-19. In order to find solutions for these problems, an interdisciplinary approach utilizing the humanities and social sciences is warranted.
Moreover, at this point, it is no longer possible to completely contain and eliminate COVID-19 from the world, and we must consider how society can coexist with this virus. Meanwhile, in order to protect all people from this virus, we must also remember to empathize with those having difficulty living in society (i.e. marginalized populations) and not to exclude them when taking measures to control the spread of infection.
COVID-19 may just be a prologue in the history of emerging infectious diseases of the 21st century. It is entirely possible that in the future, there may be even more emerging infectious disease pandemics.
The most impending threat that we possibly face is an influenza pandemic. Estimates have indicated that the Spanish influenza pandemic that occurred about 100 years ago, killed 40 to 50 million people worldwide, including many deaths of young people. Even if COVID-19 no longer continues to be a threat to human beings, returning to our previous type of society in which we were vulnerable to infectious diseases threat, could easily lead to an even worse pandemic in the future resulting in formidable consequences.
Infectious diseases have always been the greatest threat to human beings. In particular, infectious diseases leading to large-scale outbreaks can be considered as one of the problems that have emerged as civilization continued to evolve. Throughout its long history, humans have supposedly learned a variety of different lessons, which should have been passed on from generation to generation as wisdom to mitigate future risks.
However, since the industrial revolution, we have forgotten many of these lessons and have instead, prioritized economic efficiency, thereby increasing our vulnerability towards infectious diseases. This vulnerability can be said to have accelerated rapidly upon entering the 21st century. What we should learn from history is not only to point out that similar things have repeatedly happened in the past but to take a moment to ruminate about why it is that the collective wisdom accumulated from our ancestors has been forgotten.
It may not be a coincidence that high-income countries of Europe and North America which have, to date, driven so much of the world’s economic development, are now also among those being most seriously impacted by COVID-19.
Human beings are now at a crossroads where we are being challenged to reconsider our way of life in which economic efficiency is prioritized above all else and to recreate a new world for ourselves. Tohoku University, as a university constituted of a wide spectrum of disciplines, is responsible for gathering knowledge and expertise through interdisciplinary collaboration, so as to explore synergistic countermeasures against COVID-19 and to further foresee what a post-COVID-19 world should look like. The newly established, “System Design of Inclusive Society with Infectious Diseases (SDGS-ID)”, at Tohoku University will help promote interdisciplinary research to fulfill the above-stated responsibility.