DR HK BALI As we come to close of 2020, there is finally some good news to celebrate. Much awaited vaccine for SARS-CoV-2 virus which has been causing havoc all around the world is finally going to be available. At least in Europe and the US, two vaccines manufactured by Pfizer BioNtech and Moderna using novel mRNA technology is going to be available for mass use. Both have reported having shown more than 94 per cent efficacy in preventing infection in phase III clinical trials. Other vaccines produced by Astra Zeneca - Oxford, Russian Sputnik V, three Indian vaccines and a Chinese vaccine have also shown promising results. They are likely to be available for mass use in the next few months. Finding an effective and safe vaccine for a viral disease in less than one year is a remarkable achievement for the scientific community. Earlier it used to take 5-6 years to produce an effective vaccine. Vaccinating close to seven billion people of the world is going to be next big challenge. It may take as much as two years to achieve this target. As we celebrate the availability of the vaccine, we need to take stock of what we have learnt from this pandemic. Although this was the first pandemic of the twenty-first century, it certainly is not the last one. This pandemic has brought the world to its knees, killed millions, seriously sickened tens of millions, completely disturbed everyday life and brought economic activity to a standstill across the globe. It has also exposed our lack of preparedness to face natural or human-made disasters. Even the most developed countries of the world were not able to cope with the massive health crisis. Developing and underdeveloped countries had no clue how to safe lives while keeping their economies running. What are the lessons we need to learn from this pandemic, so humanity is better prepared to face the next one? A) International level: This pandemic started in Wuhan, and the first case was reported in late November 2019. The Chinese Government suppressed that information and continued to deny its severity for almost two months. China informed the WHO about possible human to human transmission in late January 2020. If the information had been available to the world as soon as the first cluster of cases were identified,it is possible pandemic could have been averted. So the foremost lesson is that world needs to strengthen WHO so it can do better surveillance and inform different countries if any suspicious cases are reported from anywhere in the world. There is a need to have WHO centres in all major cities of the world, and trained personnel should have uninhibited access to all healthcare facilities in that city. In the current digital age technology, it should not be challenging to transmit such information in real-time across the globe.WHO should also have the authority to recommend closure of all borders, including airports to limit the disease to only a localized area. There is also a need to strengthen the UN and other international bodies to impose punitive actions against countries not conforming to surveillance of healthcare facilities by WHO regulators. The international community should also declare possessing, experimenting with and use of biological warfare agents by any government as a crime against humanity. National level: In India, we need to strengthen our public health system by increasing spending on healthcare to at least 5 per cent of our national GDP. Subdistrict hospitals, district hospitals should have fully equipped ICUs, comprehensive testing laboratories and real-time availability of reports. We also need to create a workforce to run these ICUs efficiently. Only having medical equipment and beds is not sufficient, but trained human resources are even more essential to take care of sick patients. The workforce includes trained intensivists, anaesthetists, nurses, respiratory physicists and technicians to run these ICUs. The Government needs to encourage and incentivize medical personnel to opt for a career in running and manning ICUs. Medical students should be encouraged to choose basic medical sciences like microbiology, virology, parasitology as career options. All hospitals should start using Artificial Intelligence (AI) for rapid laboratory diagnosis, data storage, data availability and dissemination of information. The Government also needs to create infrastructure for mass production of medical equipment like ventilators, monitors, infusion pumps, and ICU beds should the need arise. There should be a statutory obligation for large corporates to commit to mass production of medical equipment, PPEs, masks in case of a national medical emergency. Similarly, hospital chains should commit to legally binding conditions to reserve a certain percentage of beds in case of emergency. Children in primary school should be taught about personnel protection like the use of masks, social distancing and hand hygiene as a compulsory subject. There should be regular and periodic health drills to see preparedness for a pandemic. Similarly, all service providers should have periodic training sessions for their employees about preparedness for a pandemic. All employees should have at least 25 per cent of their workforce at all times working virtually from homes. C) Individual level: Most important change should be at the individual level. Each one of us must be alive to the possibility of another pandemic at all times. Everyone should start giving utmost importance to personnel hygiene. New normal will be entirely different from what we have seen before the beginning of the current pandemic. We will have to learn to avoid very large gatherings, prolonged close contacts and crowded indoor meetings. Virtual should become the preferred mode of communication wherever and whenever possible. Everyone should be psychologically and logistically prepared for sudden and prolonged lockdown at very short notice. We should destigmatize infectious diseases. The Government needs to stop the centuries-old practice of pasting posters on doors of affected patients. People should be advised and encouraged to get tested at the first signs of disease and not to hide suspicious symptoms. We need to develop the capability to ramp up testing at very short notice. Laboratories should be equipped to have extensive facilities for testing and shorter return times. The most critical lesson to learn is that humans should stop tampering with nature and learn to live in harmony with other animals. Killing and eating exotic animals should be made a non-bailable offence. Too close contact with animals like bats, mongrels should be discouraged. This pandemic has brought life to a standstill. Still, at the end of the day ( if it is indeed the beginning of the end of a pandemic!) the current pandemic had low severity, high recovery, low hospitalization rates and low mortality. Next one may not be so forgiving and maybe as bad as the great Spanish flu pandemic of 1918- 19. The current pandemic may turn out to be a blessing and a great teacher for humanity. We should learn not to tinker with nature and to respect other animals, both small and big on this planet. We should also learn to share information irrespective of national boundaries, religious and cultural divides. It may also teach us how to share limited resources for the common good of humanity. We have learnt how to develop a vaccine in the shortest possible time. Next few months are going to be a huge challenge for governments across the world to make vaccines available to everyone irrespective of one's country of origin, religious or cultural beliefs. Different countries would need to collaborate both at the regional level and also at the international level to achieve this target in the shortest possible time. This pandemic may also make all of us value each other and value life more than we ever did. This year has been a fight for the survival for humanity. We can neither afford to lose this fight nor afford not to learn lessons for the future of humanity . (The writer is associated with Paras Hospital, Panchkula. Views are personal.)