key: cord-0930382-qts9lcr7
authors: Leeder, Stephen
title: Hello! How are we doing after one year of COVID-19?
date: 2021-04-11
journal: Int J Epidemiol
DOI: 10.1093/ije/dyab071
sha: 1bbe9083066d1f73e3a8cc4f7863c90ebf719592
doc_id: 930382
cord_uid: qts9lcr7

nan

It was inevitable that many papers sent to us were written in haste and, almost always, with incomplete data. We appreciate the authors' goodwill in responding to our requests to make their contributions as robust as possible. Our papers cover the spectrum, from fieldwork reports through to sophisticated modelling. Yet, there remain many epidemiological features of the pandemic to be elucidated.

Siddhartha Mukherjee, a distinguished New York oncologist, geneticist and author, wrote an article in a recent issue of The New Yorker entitled 'The Covid Conundrum'. Mukherjee's conundrum was the huge and puzzling differences in the frequency of COVID-19 among countries. 'Many regions', he noted, 'report a COVID-19 death rate that's a hundredth of the US rate'. 1 Likewise, in The Economist, reference is made to the 160 000 recorded deaths from COVID-19 in India: 'as a share of its nearly 1.4 bn people, the tally is miniscule, despite a huge outbreak. A national survey of blood samples suggests that by December (2020) some 22% of Indians had been exposed to [SARS-CoV-2], 30 times the official tally of around 11 m cases to date. If that estimate is right and if India's fatality rate had been as high as, say, Britain's, there would have been some 10 m deaths'. 2 Beside our incomplete epidemiological understanding of the virus and its behaviour, which deserves our further attention, there are lessons to learn from controlling COVID-19. Francis Collins, Director of the US National Institutes of Health, writing recently in an editorial in Science, pointed to several, among them being the value that comes from technological readiness to respond to future pandemics with even faster vaccine development. This requires long-term investment; Collins writes that 'working out the details of a messenger RNA strategy, for instance, was a 25-year journey'. 3 He is also enthusiastic about enhancing our therapeutic agent development processes and those that underpin rapid diagnostic testing. To this we might add the strengthening of public health services, the better to respond to future epidemics. Dorothy Porter, a distinguished historian of medicine and public health, wrote that 'An epidemic is a sudden disastrous event in the same way as a hurricane, an earthquake or a flood. Such events reveal many facets of the societies with which they collide'. 4 COVID-19 has illuminated strengths, and weaknesses, in many places-for example: the willingness (or not) of politicians to change course, based on scientific advice; the trust people do (or do not) place in political leaders; the importance of simple, consistent and inclusive communications in a time of crisis; and the great advantage enjoyed by countries that invested substantially in pandemic control before the event. 5 So, Thank You! We are immensely grateful to our Editorial Board and reviewers, who enabled us to handle both the COVID-19 surge in papers and the journal's standard workload simultaneously, and to the fellowship of the International Epidemiological Association for their continuing support. This mighty unpaid workforce is, together with those who contribute articles, the backbone of the journal. The reviewers who assisted us in 2020 are acknowledged in the following pages.

We also acknowledge our colleagues who have aided us during this past year, especially the editorial team here in Sydney and our publisher, Oxford University Press. None of us was immune to the stress associated with COVID-19.

Thank you all for your contributions to refining and developing our science of epidemiology. 

The Covid Conundrum. The New Yorker

Getting off Lightly: India Seems to Have Suffered Surprisingly Few Deaths from COVID-19. The Economist 13

COVID-19 lessons for research

Civilization and the State: A History of Public Health from Ancient to Modern Times

The Covid-19 pandemic: lessons for our future