The Impossible Triangle Model of Pandemic Prevention and Control

Dear Editor

Every major pandemic has forcefully changed the direction of human history. It is the preference of nations and people to balance bioethics with the needs of the economy, society, politics, and so on, but without a way to simultaneously obtain these objectives in all areas, the balance of bioethics with other social demands needs to be weighed and balanced based on the most human basic ethics and morality. In more direct terms, it is difficult to balance the three sides of an impossible triangle: health protection, social consensus, and economic development.

These choices have been decisive factors in human history. For example, in 541 AD, a plague swept through Rome, and when it reached the beautiful and prosperous city of Constantinople, the city suddenly fell into hell on earth. From then on, the Roman Empire was economically depressed, and its influence on European civilization also declined. In the 1420s, the Black Death swept through Europe, killing tens of millions and reducing the continent’s population by a third. In the view of many historians, the plague gave birth to modern Western civilization (McNeill 1998; Tian 2020). COVID-19 is the most serious pandemic in the past century. In the face of this big test of history and under international and domestic pressure, what decisions would governments all over the world make when facing the impossible triangle?

Facing COVID-19, countries all over the world have undertaken various prevention and control measures in accordance with their specific conditions, including economic, social, cultural, religious, institutional, and national considerations. Because risks can come at any time, we need to maintain these measures for a long time (Ashby 2022). The Chinese government and people have based their response on principles that include the notion of a community with a shared future for humankind, the paramountcy of the people, the paramountcy of life, the need for fair and just decision-making, and the responsibilities of a major country. They have led by example with prudent decision-making and a firm belief in the success of their strategies, uniting all forces that could be united, coordinating international and domestic platforms, and making use of the global industrial supply chains. China launched a people’s war for COVID-19 pandemic prevention and control, which brought together the wisdom and strength of all humankind, and won a series of major battles, and achieved to a certain extent the “three victories” of health protection, social consensus, and economic development based on bioethics. China's approach to balancing the impossible triangle model may only be a special case and does not necessarily apply to other countries. There is no single best, suitable solution. We cannot universally politicize and ideologize anti-pandemic measures; they conform to the conditions and basic social ethics of particular nations. China does not comment on the pandemic prevention policies of other countries but only shares its own experience and provides timely help and guidance to countries in need.

China’s anti-pandemic strategy is applicable to diseases with strong infectivity and lethality, especially in countries with a large population and insufficient medical resources. Adherence to the concepts of people first and life first aim to better balance the relationship between pandemic prevention and control and economic and social development. With this strategy, the pandemic can be contained quickly, saving lives and restoring economic production and daily life. Of course, a strong capacity for organizational mobilization and implementation are also needed. As the virus continues to mutate, becoming more and more infectious and less lethal, this balance strategy will become more and more difficult to implement, and there will be an increasing number of factors to be considered, such as balancing the choice between public health measures that decrease the threat to life and the risk of the people's economic income continuing to decrease and the risk of increasing unemployment. The medical and bioethical dilemma caused by increasing infection rates after the liberalization of public safety measures needs more time and practice to resolve. COVID-19, albeit mutated, remains with us, changing our lives, forcing us to face the impossible triangle. The cost is inevitable, and the outcome is different. Different pandemic prevention and control measures in different countries do not need to be evaluated ideologically. What is more important is to respect the choices made by countries according to their actual situation and characteristics. Different prevention and control measures have different application scenarios and preconditions; there is still a long way to go, and the merits and demerits are best assessed by future historians.

Declarations

Conflicts of Interest

The authors declare no personal or financial conflicts of interest of relevance to this topic.