Institutions must adapt and anticipate the response to new pandemics

That people are tired of worrying is not only understandable, but even reasonable, as a form of defense of their sanity. It is therefore understandable that citizens cannot be asked for continuous vigilance and effort, after three years of the pandemic.

However, it is neither understandable nor justifiable that the institutions do not act to make our country more secure.
Sars-cov-2 did not represent a sudden change from an epidemiological point of view: it was rather the expected occurrence of an event, which is a sign of long-term changes that have already occurred, which have led us to a different situation from the one experienced from any great ape, and probably from any vertebrate.

The pandemic has forced us to look at the reality of a now very abundant, hyper-connected species with almost instantaneous movements, which also lives in contact with many other organisms with which it can exchange pathogens: from a Darwinian point of view, we and our domestic species we are an ecological paradise capable of guaranteeing the sustenance of an astonishing number of biological replicators such as viruses, but also other bacterial and eukaryotic parasites.

What’s more, thanks to the constant selection pressure we’ve exerted in all ways to use compounds that should be reserved for human therapy for all sorts of other purposes in farms, we are close to the arrival of pandemics caused by agents resistant to the treatments available todaymost likely capable of sharing resistance codified in the form of genetic information among several different species and distant groups thanks to the numerous mechanisms that allow this exchange.

We know all this well, and not from now on; it is therefore time for the institutions that govern us to act as a result of the knowledge accumulated in recent decades, instead of wanting to believe and make others believe that the epidemiological crises are temporary problems, after which we return to the starting state.

First, epidemiological surveillance, rather than abandoned, must be strengthened. We need broad spectrum testing for the detection of genomes of potential pathogens, and we need farms, wastewater and a variable sample of the population (even at airports) to be constantly screened. The costs for this supervision are reduced, while the economic consequences of not providing it will necessarily be very serious.

We also need an incentive program comparable to that which benefits installations of renewable energy systems, aimed at the air treatment industry inside public buildings and homes. The technology to break down the transmission of respiratory pathogens already exists and is mature; just as cholera was brought under control thanks to the architectural rehabilitation of large cities, today we need to intervene on schools, houses, hospitals and other places of large aggregation, so that the air is renewed and possibly even filtered effectively. If we can boost the home solar and energy retrofit industry, why not the indoor air quality control industry?

It is also necessary to invest in a national district for the development of RNA and other types of medical products based on technologies related to the sequencing of pathogens and the rapid synthesis of appropriate nucleic acids, as well as monoclonal antibodies and other types of targeted and response therapeutic agents rapid, and their clinical formulations. For RNA vaccines and drugs, as well as for the most advanced molecular diagnostics and therapeutics, we cannot depend on individual international suppliers, who are required to supply billions of doses in a very short time: we need to bring together the numerous laboratories and public centers that have the specific skills, connect them to the industry present in our area and thus have a sort of scientific force for rapid intervention, which can satisfy the demand both in times of crisis and, gradually, in ordinary times (we will in fact have more and more vaccines need).

Then there is the need to maintain the type of logistical and operational structure that has allowed the efficient administration of millions of doses in rapid times, where it is necessary to intervene with vaccines or appropriate drugs; as was done for civil protection, it is necessary to have a national force that is not affected by the regionalization of healthcare and that is ready, without having to rediscover the wheel every time.

Finally, I won’t write about public health, because there are too many and there are rapidly worsening problems before everyone’s eyes; it is clear, however, that without it, we will not be saved, because only a nation and its health system – in concert with other nations – can face future health crises on a large scale, and it is ridiculous to think that it can make up for a system private in this sector.

What to do is very clear, and it is there for all to see; but if those eyes close, particularly in government offices, well, future eyes will know very well where and how to look for the responsibilities of avoidable health crises, transformed for convenience into unpredictable accidents of cynical and cheating fate.