The COVID-19 pandemic in 2020

In this year’s final episode of The Lancet Voice podcast, senior members of the editorial team reflected upon the impact of COVID-19 in the past year, in the context of five key COVID-19 papers.

The first COVID-19 paper published in the Lancet on January 24, 2020 by Wang et al, not only described clinical features of infected patients, but also the importance of personal protective equipment, testing, and the pandemic potential of the virus, before it was officially declared a global public health emergency. Dr. Richard Horton, Editor-in-Chief of the Lancet, commented on the intensity, speed, and effectiveness of China’s early response, primed by its experience with the previous SARS and avian influenza outbreaks. He emphasised the importance of suppressing prevalence sufficiently to eliminate community transmission and enable re-opening of the economy.

Dr. Zoe Mullan, Editor-in-Chief of the Lancet Global Health, discussed the impact of the pandemic on low- and middle-income countries surrounding a study published on May 12, 2020 by Roberton et al. Thinking in advance about how an emergency response can be integrated into existing healthcare systems and not displacing them, is crucial in protecting these countries. Communication between the government and its citizens are also key to general public health. Dr. Mullan commented that early, aggressive strategies, active surveillance and quarantine mandates were taken very seriously in low- and middle- countries such as Vietnam and Mongolia, which helped to bring the pandemic under control.

A UK longitudinal study published on July 21, 2020 by Pierce et al, showed that the pandemic had caused clinically significant mental distress, particularly in the younger population, those with young children and those employed before the pandemic. Regarding the potential effects of COVID-19 on mental health, Dr. Niall Boyce, Editor-in-Chief of the Lancet Psychiatry, explained that there has been a surge in digital delivery of mental health services which is likely to be a permanent change e.g. for people who live in geographically remote areas.

Frontline workers face a significantly increased risk of COVID-19 infection, as demonstrated by an observational study published on July 31, 2020 by Nguyen et al, involving UK and US communities. Dr. John Carson, Senior Editor of the Lancet Public Health, explained that although the study used self-reported data from a COVID symptoms smartphone application, it enabled fast data collection and a large sample size. He commented that future retrospective analyses of all data collected in the course of the pandemic will reveal underlying vulnerabilities to COVID-19 more clearly. Social science is also important in improving responses to infectious diseases as it identifies inequalities in health and exposure to risk in society.

Finally, Dr. Horton discussed lessons learnt from 2020 based on a paper published on September 24, 2020 by Han et al that compared approaches adopted in Asia Pacific and Europe. He emphasised the need to build a resilient healthcare system which has capacity to handle emergencies, as COVID-19 has highlighted the importance of healthcare to economic security. Part of this may involve wider public duty from scientific institutions such as improved dissemination of scientific information and research.

Source: The Lancet Voice (Season 1, Episode 28)