The Post-Pandemic Period –

New Challenges and Opportunities for bringing health to the most vulnerable and deprived.

By Dr. med. Klemens Ochel; medmissio

The first cases of a SARS-CoV-2 infection where reported at the end of 2019 from Wuhan, China. The virus has been identified since December 2019. In the first quarter of 2020, the virus then spread to all continents.

From the beginning, the SARS-CoV-2 virus sought its victims among the weak, vulnerable, highly exposed or socially marginalized. But you will agree with me that this is not the only crisis of the present. The war against Ukraine, the many other conflicts in the world or the rise of totalitarian, violent regimes have in common that there is a reversal of the development progress of the last decades. This means, for example according to the World Bank more than 150 million people have been pushed back into absolute poverty. About the same number of increases, 150 million, sum up to the 811 Mio., or in other words, a tenth of the global population, who suffer from hunger, according to the World Food Program. The shortage of basic supplies of food and the increased prices exacerbate poverty. As a result, education, health and social progress are deteriorating. The vulnerable, weak, elderly, disadvantaged, refugees, women and unfortunately, children are affected disproportionately not at least through the Corona Pandemic.

The Corona pandemic could have turned into a much worse catastrophe had it not been for a few lucky factors, all of which can be found in the field of science. The most important appeared to be the genetic analysis, which lead to the rapid development of testing devices, vaccines and pharmaceuticals. Reservations about vaccination are strong in all societies. Since the beginning the health communication about the vaccines suffered in all countries. False information, doubts and harmful because hate cantered news were rapidly spread in social media over the globe, but tragically by some Church leaders. WHO talked about an ‘infodemic’. As a consequence, several 100.000 had to pay for fake news with their lives. Some people have a lack of information or are simply afraid of the vaccine. For others, behind the rejection of the vaccine is much more a rejection of public health measures and a refusal to put the common good before self-interest.

In the sense of systematising the consideration of the effects of the Corona Pandemic, one can distinguish direct effects of the disease on a patient from indirect effects on the health system and broader socio-political effects. Here are some examples. In October 2021 the United Nations reported that up to 180.000 health and care workers may have died from COVID-19 between January of 2020 and May of 2021. In the future, it will be necessary to compensate for this aggravated shortage: through training, but also by upgrading working conditions and better occupational safety measures. This will also be a challenge for the mission of the Camillians. Another impact is the excess mortality due to COVID-19. Excess mortality is a term used in epidemiology and public health that refers to the number of deaths from all causes during a crisis above and beyond what we would have expected to see under ‘normal’ conditions. Human potential that is lost due to COVID-19 is immense. Experts have shown that the global burden of diseases increased by 20% due to COVID-19. In terms of economic impact massive losses of income, jobs and opportunities for social protection have been observed. At the beginning of the pandemic, some politicians and experts spoke of “all people being equal before the virus”. They meant that everyone, rich or poor, in the Global North as well as in the South, was at risk of getting infected. But it turned out that this statement was wrong. Poor people, people in precarious living situations or people in resource-poor countries had a significantly higher risk of becoming infected, to get seriously sick, to suffer long-term and to die early. The consequences were many times more dramatic for them, as they were much less resilient. The outlook into the future is also grim. The people in the Global South will continue to be without vaccination protection for a long time.

In conclusion the end of the pandemic has not been reached yet and its impact will be felt in the decade to come.

Looking into the future the question is, how to prevent that we either never face again a pandemic or minimize its impact by creating resilience. The question is, how to strengthen the global structures that are in charge of pandemic control. As a consequence of the COVID-19 pandemic, the world community has apparently understood the necessity to build an efficient pandemic control. As a first step, the UN has commissioned a high-ranking committee of politicians and scientists to work out a realistic plan. The so-called ‘Pandemic Treaty’ is taking shape and is to be agreed soon. The initiative is also approved by the Vatican, according to Msgr. Robert Vitillo. The essential building block is the so-called Global Health Security. To explain it, I have to go into detail, because it is based on the One Health approach.

Form a perspective of faith, the Encyclical ‘Laudato Si’ could provide guidance how to first develop more resilience as a faith institution and secondly how to develop the healing ministry for the years to come. Thus Laudato Si’ provides the perspectives to respond the post-pandemic health work.

In my talk I have applied an interpretation of Pope Francis’ teaching that is also used by public health experts in other contexts, for example Lindström and Erikson from the Norwegian School of Public Health. They see salutogenesis as an approach to problem solving based on existing opportunities and resources. A solution succeeds with coherent interdisciplinary cooperation. The concept of salutogenesis was introduced into the social sciences and medicine by the American-Israeli medical sociologist Aaron Antonovsky (1923-1994). Antonovsky investigated the question of why do people remain healthy – despite many potentially health-threatening influences? How do they manage to recover from illness? What is special about people who do not become ill despite the most extreme stresses? Accordingly, the salutogenetic perspective primarily asks about the conditions of health and factors that protect health and contribute to invulnerability. People are not dichotomously healthy or ill, but work their way to a state of greater health. They achieve this through what he calls a sense of coherence. Pope Francis focuses on the question of the active factors for maintaining health. He expresses through his statements the danger that the mandate to humanity to preserve creation in the closed system of our world and our planet will come to a standstill in a state of entropy, at least for humanity.

The challenges for the post-pandemic work for health and well-being of humans is formulated by science, some politicians and also Pope Francis. All teach us the sense of absolute urgency in this matter. The following bullet points can guide us in or strategy development:

• Human health has improved worldwide in recent years, but not all people have benefited. We rapidly need to overcome the disparities.
• Our actual way of life including actual wars are making us all sick and destroy the planet.
• Healthy people only exist on a healthy planet.
• We must initiate a civilizational turnaround for planetary health.
• The One Health policy approach can be but only a first step for a Global Health Compact.

What is the role of our Christian Church and for health workers rooted in Christian faith?

• Our Church and we as Christians must ‘re-engage’ in dialogue with science on an equal footing to define an ethical framework for technological progress and scientific knowledge.
• Our Church and we as Christians must be an advocate for the marginalized and disadvantaged and call for access, acceptance, social protection or good governance.
• Our Church is already leading by example in caring for a healthy planet, sustainability and intergenerational justice. But it must become a constant habit questioning and testing itself.

Instead of feeling powerful, privileged or the crown of creation, it is very reasonable to feel vulnerable, dependent or part of creation and to abandon any anthropocentric position of power. The Jewish philosopher Hans Jonas postulated in 1979 an ecological imperative: “Act in such a way that the effects of your actions are compatible with the permanence of genuine human life on earth” or, negatively, “Act in such a way that the effects of your actions are not destructive of the future possibility of such life”. He classifies this approach as ‘Future Ethics’.

A logical consequence of this consideration is to extend the theological maxim of the ‘Option for the Poor’ to the new dimension of ‘Option for the Planet’, which of course includes the original option. Abandoning anthropocentric positions implies that we grant essential basic rights to nature at least to items of common good and value like air, water, ground or bioreserves. These items must get an elementary right to be protected and to become a common good, like human rights. This is further explained by Global Bioethics. This is an obligation for and expression of Christianity. Isn’t it the lesson to be learned by Laudato Si’?