Building back better, fairer, greener

The challenge is to build back better, preferably to build back fairer. As some semblance of normality begins to return after a year of lockdowns, we are beginning to appreciate how complex those challenges are and how deeply disparities divide society.

Another challenge is to understand how we might do better next time there is a major surge, perhaps caused by a new SARS-CoV-2 variant of concern, or a new pandemic with a different pathogen.

One thing is clear: too many modern day policy makers find changing course or admitting to mistakes an impossibility or political suicide. Yet, would it be as consequential if owning mistakes and learning from errors were routine? By making such admissions scarce, their magnitude is amplified.

The UK is not alone in this. No major nation is yet to hold a meaningful inquiry into the pandemic response, which is a tragedy since changing course and U-turns require more bravery than seeing a mistake as a weakness.¹

Indeed, would vaccine policy even be the same second time around? Might staff vaccination be mandatory? Should it be now²? Or would ethnic minorities be specifically prioritised³? Would the dosing strategy deviate from clinical trials, especially as people will be more aware of the medicolegal consequences⁴? Would we do better with people’s wishes to die at home⁵? Might the English National Opera be placed in charge of long-term recovery⁶?

Another thing is clear: building back better or building back fairer is also building back greener. And on that front, our demand for personal protective equipment, for masks and gloves and gowns, has created a plastic ‘pandemic’ for our planet. This month’s issue includes new research on the projected environmental impact.⁷ As with attempting to answer most questions, or planning to do better next time, the best discussions begin with helpful data.