What is planetary health and how can it fight pandemics such as the coronavirus outbreak?

More than 80% of the world's countries are now registering cases of COVID-19, the illness caused by the SARS-CoV-2 coronavirus. The multiplication of cases outside China, epicentre of the outbreak, led the World Health Organization (WHO) to declare a pandemic and to stress that this is therefore a global health problem, and not only a problem of the countries with the highest number of cases.

However, there is no strategy to fight the spread of the disease, and every country has opted to take its own measures. "We don't have a sole criterion for defining protection measures or when they should be applied," explained Salvador Macip, professor at the UOC Faculty of Health Sciences. According to Professor Macip, "WHO could be the body that dictates protocols on health strategies to be followed worldwide, but right now such decisions are left to individual states, which do not act in coordination."

So, there are countries that have chosen a strict lockdown, like China, where authorities banned movement in the city of Wuhan, the centre of the outbreak, and the entire Hubei province, which has a population of 50 million. Other countries, like Italy and Spain, adopted a more progressive confinement of the population, and yet others, such as the United Kingdom, where at first the Government was not going to give orders for schools to close or for people to self-isolate.

Such differences in criteria make containing the virus very difficult, as we have an extremely globalized economic and social system and a high level of mobility of people between countries.

"We need established global strategies to address today's planetary health problems. This is especially important in regard to infectious diseases, which, as we're seeing with this coronavirus pandemic, can have a huge impact on populations that lack the resources to deal with them," said Macip.

In the current situation, while scientists work to find a vaccine and antiviral drugs that may prove effective, the only form of protection against the spread is to make people aware, according to an article on the Faculty of Health Sciences blog by Salvador Macip and epidemiologist and fellow professor at the Faculty, Cristina O'Callaghan-Gordo.

But there are a further two crucial aspects: analysing the causes of this crisis and taking steps to prevent it ever happening again.

Analysis of the genome of this coronavirus has led the scientific community to think that the virus originated in bats and that it jumped to humans in a seafood and animal market in Wuhan, according to the article published in The Lancet, "2019-nCoV in context: lessons learned?", by Richard A. Kock, researcher at the Royal Veterinary College, and other scientists.

As the authors of the article explain, recent epidemics such as SARS, MERS and Ebola have been caused by viruses originating in animals. In this respect, Professor O'Callaghan-Gordo considers that "ecosystem disruption and changes in food production that facilitate contact between wild animals and humans in highly populated areas favour the appearance of new infectious diseases that spread quickly in a globalized world".

The current health crisis "highlights the urgent need to foster the study of planetary health, which analyses how ecosystem disruption and overexploitation can lead to health problems, and seeks solutions based on the interaction of natural, social and economic systems," explained Ramon Gomis, director of the UOC's Faculty of Health Sciences.

Gomis considers that we need to be aware that "our behaviour has an impact that can affect the health of people living in far flung parts of the world", as he explained in an interview published in UOC News.

In the words of O'Callaghan-Gordo, we need to "foster research and provide training in planetary health not only for doctors, but also for professionals in areas such as natural sciences, politics, economics and technology, as today's challenges require urgent, interdisciplinary solutions".

Learning from past mistakes

The Lancet's article and Professor Macip agree that we have not learned from past epidemics. "We missed our chance to learn for the next pandemic, which, as we feared, has had far greater impact than previous ones," said Macip.

"It's important that we don't make the same mistake this time. We need to train professionals who can analyse which factors favour the appearance of new viruses and who are able to design contingency plans against such epidemics," he went on to explain.

These plans should include environmental, healthcare, economic and social factors, "in the same way that we have standard plans for nuclear and petrochemical accidents," said Macip.

Pandemics are just one of the challenges facing planetary health, and according to Salvador Macip, "without a body to coordinate action on a global scale, the governments and healthcare systems of each country must have the basic knowledge and ability to interact and learn from each other, unlike what's happening at the moment".

Despite the gravity of this health crisis, "this is not the worst pandemic we can imagine; it's not unthinkable that more aggressive or infectious viruses than SARS-CoV-2 could come along, so maybe next time we'll have to act more quickly to prevent many people from falling victim," said Macip.

The formula to avoid this, according to the expert, is to "take this opportunity to train professionals from various disciplines who know exactly how to act the next time we have an epidemic; they should study what we did right and what we did wrong in previous viral pandemics".