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Pandemics: past, present, and future: multitasking challenges in need of cross-disciplinary, transdisciplinary, and multidisciplinary collaborative solutions

Osong Public Health and Research Perspectives 2024;15(4):267-285.
Published online: July 23, 2024

1Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden

2Gothenburg Emergency Medicine Research Group (GEMREG), Sahlgrenska University Hospital, Gothenburg, Sweden

3Center for Disaster Medicine, Gothenburg University, Gothenburg, Sweden

4Woodrow Wilson International Center for Scholars, Washington, DC, USA

5Department of Security, Polish Air Force University, Dęblin, Poland

Corresponding author: Amir Khorram-Manesh Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 405 30 Gothenburg, Sweden E-mail: Amir.khorram-manesh@surgery.gu.se
• Received: December 11, 2023   • Revised: May 29, 2024   • Accepted: June 3, 2024

© 2024 Korea Disease Control and Prevention Agency.

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Pandemics: past, present, and future: multitasking challenges in need of cross-disciplinary, transdisciplinary, and multidisciplinary collaborative solutions
Osong Public Health Res Perspect. 2024;15(4):267-285.   Published online July 23, 2024
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Pandemics: past, present, and future: multitasking challenges in need of cross-disciplinary, transdisciplinary, and multidisciplinary collaborative solutions
Osong Public Health Res Perspect. 2024;15(4):267-285.   Published online July 23, 2024
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Pandemics: past, present, and future: multitasking challenges in need of cross-disciplinary, transdisciplinary, and multidisciplinary collaborative solutions
Image Image Image Image
Figure 1. Common measures in the management of pandemics.
Figure 2. Pillars in the prevention of pandemics.
Figure 3. The impact of plague in Vietnam, combined with a chart from the World Health Organization. Reproduced from Plague cases reported in Asia to the World Health Organizations for the period 1954–1986. Other peaks in India, Tanzania, and Madagascar are also visible. Available from: https://timelines.issarice.com/wiki/Timeline_of_plague.
Graphical abstract
Pandemics: past, present, and future: multitasking challenges in need of cross-disciplinary, transdisciplinary, and multidisciplinary collaborative solutions
Name Time Comment
Antonine Plague [25] 165–180 AD Believed to be caused by either smallpox or measles, this pandemic affected the Roman Empire during the reign of Marcus Aurelius.
Justinian Plague [26] 541–542 AD This pandemic, possibly caused by the Yersinia pestis bacterium (which also causes the bubonic plague), affected the Byzantine Empire and contributed to the decline of the Eastern Roman Empire.
The Black Death [27] 1347–1351 One of the most devastating pandemics in human history, the Black Death was caused by the Yersinia pestis bacterium. It swept through Europe, Asia, and North Africa, leading to the death of millions of people.
Third cholera pandemic [28] 1852–1860 Cholera, caused by the Vibrio cholerae bacterium, spread from India to Asia, Europe, North America, and Africa, causing significant mortality and social disruption.
Spanish flu [29] 1918–1919 The H1N1 influenza A virus caused the Spanish flu, which infected about one-third of the world’s population and resulted in an estimated 50 million deaths worldwide. It was unique for its high mortality among young, healthy adults.
Asian flu [30] 1957–1958 The H2N2 influenza A virus caused the Asian flu, which originated in East Asia and spreading globally. It resulted in an estimated 1–2 million deaths worldwide.
HIV/AIDS pandemic [31] 1981–present The HIV causes AIDS. This pandemic has had a profound impact globally, with millions of people infected and millions of deaths since it was first identified in the early 1980s.
H1N1 influenza pandemic [32] 2009–2010 The H1N1 influenza A virus, also known as swine flu, spread globally and resulted in an estimated 151,700–575,400 deaths.
COVID-19 pandemic [33] 2019–present The coronavirus SARS-CoV-2, which causes COVID-19, was first identified in Wuhan, China, in late 2019. The virus quickly spread worldwide, leading to widespread illness, social and economic disruptions, and significant loss of life.
Positive aspect Negative aspect
Increased travel and connectivity Globalization has facilitated increased travel and connectivity, enabling the exchange of goods, ideas, and cultures. This has contributed to economic growth, cultural exchange, and scientific collaboration. The increased movement of people also means that infectious agents can spread more rapidly across borders. An individual infected with a pathogen in one part of the world can travel to another, potentially introducing and spreading the disease in new regions.
Global trade and supply chain Global trade and supply chains have led to economic development, increased access to diverse goods and services, and promoted the transfer of technology. Disruptions in supply chains can impact the availability of essential medical supplies, medications, and equipment during a pandemic, posing challenges for healthcare systems.
Urbanization and population density Globalization has been associated with urbanization and the concentration of populations in urban centers, leading to economic opportunities and improved living standards. High population density in urban areas can promote the rapid spread of infectious diseases, especially in the absence of effective public health measures.
Environmental changes Globalization has contributed to advancements in technology, science, and environmental conservation. Activities associated with globalization, such as deforestation, habitat destruction, and climate change, can alter ecosystems and increase the risk of disease spillover from animals to humans, leading to the emergence of novel pathogens.
Information exchange and awareness Globalization has enabled rapid information exchange, scientific collaboration, and the dissemination of health-related information. Misinformation can also spread quickly, influencing public perceptions and responses during a pandemic.
International cooperation in healthcare Globalization has facilitated international cooperation in healthcare, research, and the development of medical technologies. Challenges in international coordination and cooperation may arise during a pandemic, affecting the equitable distribution of resources and access to medical interventions.
Country Measures Summary
New Zealand [61] Swift and strict measures: New Zealand implemented strict lockdown measures early in the pandemic, closing its borders and implementing a nationwide lockdown. The government’s approach focused on eliminating the virus rather than merely containing it. Command and control, safety, communication
Effective communication: Clear and consistent communication from Prime Minister Jacinda Ardern and health officials helped build public trust and compliance with health measures.
Isolation and quarantine: The country implemented effective isolation and quarantine measures for incoming travelers.
Taiwan [62] Early action and surveillance: Taiwan took early and aggressive measures to control the spread of the virus, including comprehensive testing, contact tracing, and quarantine measures. Command and control, safety, communication
Experience from SARS: Taiwan’s experience with the SARS epidemic in 2003 contributed to a well-prepared and responsive healthcare system.
Technology and data integration: The use of technology for contact tracing and integrating data from various sources facilitated a targeted and efficient response.
Australia [63] Stringent border controls: Australia implemented strict border controls and quarantine measures for international arrivals. Command and control, safety, communication, collaboration
Effective testing and contact tracing: Australia had a robust testing and contact tracing system, contributing to the early detection and containment of outbreaks.
Regional collaboration: Collaboration between different states and territories in Australia allowed for coordinated responses.
Vietnam [64] Proactive measures: Vietnam implemented proactive measures, including widespread testing, contact tracing, and quarantine for affected individuals. Command and control, safety, communication, collaboration
Effective communication: Clear communication from the government and public health authorities contributed to public understanding and compliance.
Community engagement: Vietnam emphasized community engagement and mobilization in its response efforts.
Republic of Korea [65] Mass testing and contact tracing: Republic of Korea implemented widespread testing, extensive contact tracing, and technology-driven solutions to identify and isolate cases. Command and control, safety, communication
Transparent communication: Transparent communication, including the use of mobile apps for real-time information, helped keep the public informed.
Experience from previous outbreaks: Previous experiences with outbreaks like MERS influenced the country’s preparedness and response strategies.
Status High-income countries Low- and middle-income countries
Economic Generally, have high-income economies with well-established industries, advanced technology, and diverse service sectors. Examples include the United States, Germany, Japan, and Australia. Tend to have lower-income economies, with a focus on agriculture, manufacturing, and resource extraction. They may have emerging industries and face challenges related to economic development. Examples include India, Nigeria, and Bangladesh.
Infrastructure Typically, have advanced and well-maintained infrastructure, including modern transportation systems, reliable energy networks, and widespread access to technology. Often face challenges in infrastructure development, with issues such as inadequate transportation, limited access to electricity, and less widespread technology adoption.
Education and healthcare Generally, have well-established and accessible education and healthcare systems. There is often a higher literacy rate, and life expectancy tends to be longer. May face challenges in providing universal access to quality education and healthcare. Issues such as limited resources, inadequate infrastructure, and health disparities can be more pronounced.
Political stability Tend to have stable political systems with established democratic institutions, the rule of law, and low levels of political violence. Political stability can vary widely, and some nations may experience political instability, governance challenges, and conflicts.
Technology and innovation Are often at the forefront of technological innovation, with advanced research and development capabilities and a high level of technology adoption. May face challenges in adopting and developing advanced technologies, although there can be pockets of innovation and efforts to bridge the technological gap.
Income inequality Often have social safety nets and policies aimed at addressing disparities, despite the existence of income inequality. Income inequality can be more pronounced, with limited resources and challenges in implementing effective social welfare programs.
Access to basic services Generally, provide widespread access to basic services such as clean water, sanitation, and electricity. May face challenges in ensuring universal access to these basic services, contributing to issues related to public health and quality of life.
High-income countries Low- and middle-income countries
Healthcare infrastructure Typically, have more robust and well-established healthcare systems with advanced medical facilities, a higher number of healthcare professionals, and better access to medical equipment and supplies. May face challenges with limited healthcare infrastructure, fewer healthcare professionals, and inadequate medical resources. This can impact the capacity to diagnose, treat, and manage the spread of infectious diseases.
Access to testing and diagnostics Often have better access to diagnostic tools, testing facilities, and a more extensive network for mass testing. This facilitates early detection and containment efforts. May experience delays in testing due to limited resources, leading to challenges in identifying and isolating cases promptly.
Public health response Generally, have more sophisticated public health systems, which can facilitate coordinated responses, contact tracing, and the implementation of public health measures. May face challenges in coordinating an effective public health response, including issues related to communication, resource allocation, and the implementation of widespread testing and contact tracing.
Economic impact and social support Often have the financial means to implement economic stimulus packages and social support programs, helping individuals and businesses cope with the economic fallout of a pandemic. May struggle to provide adequate economic support, leading to increased vulnerability among populations that rely on daily wages and have limited access to social safety nets.
Vaccine access and distribution Typically, have greater resources to invest in developing vaccines, obtaining vaccine supplies, and implementing vaccination campaigns swiftly. May face challenges in accessing vaccines, obtaining sufficient doses, and distributing them efficiently to the population due to financial constraints and logistical challenges.
Information technology and communication Often have more advanced information technology infrastructure, facilitating communication, data collection, and the dissemination of accurate information during a pandemic. May encounter difficulties in widespread communication, data collection, and information dissemination, leading to challenges in managing public perceptions and behaviors.
Logistical challenges Generally, have better logistical capabilities to manage the distribution of medical supplies, establish testing centers, and implement quarantine measures. May face challenges in logistics, including transportation, storage, and distribution of medical resources, which can impact the effectiveness of response efforts.
Population density and living conditions Often have lower population density and better living conditions, enabling more effective implementation of social distancing measures. May have higher population density, crowded living conditions, and challenges in implementing social distancing, leading to a higher risk of disease spread.
Major theme Category Subcategory Measure
A. Interdisciplinary strategies for pandemic preparedness 1. Strengthening surveillance and early warning systems Advanced technology Utilize AI and big data analytics to improve disease detection and prediction.
Promote international data sharing and collaboration for robust early warning mechanisms.
2. Promoting interdisciplinary collaboration Collaborative efforts Encourage collaboration among virologists, public health experts, technologists, economists, and social scientists.
Establish interdisciplinary task forces to oversee pandemic preparedness and response efforts, ensuring a coordinated approach.
B. Improving global health infrastructure 1. Equitable access and healthcare logistics Infrastructure improvements Improve global health infrastructure, particularly in low- and middle-income countries.
Invest in healthcare logistics for efficient distribution of medical supplies and vaccines.
2. “One Health” approach Integrated health strategies Implement a “One Health” approach that integrates human, animal, and environmental health to address zoonotic spillovers.
C. Rapid vaccine development and distribution 1. Funding and global agreements Vaccine development Fund rapid vaccine development platforms.
Create global agreements to ensure fair vaccine distribution, especially to vulnerable populations.
D. Building community resilience 1. Education and resources Local empowerment Build community resilience through education and resources to empower local responses.
Foster global cooperation and governance to streamline international pandemic response efforts.
E. Technological advancements in pandemic response 1. Role of AI and big data analytics Data processing and decision-making Use AI to analyze vast amounts of data from social media, health records, and environmental sensors to identify early warning signals of potential outbreaks.
Utilize big data analytics to predict disease spread and allocate resources by creating predictive models from multiple data sources.
2. Improving diagnostic capabilities AI-driven tools Deploy machine learning algorithms to analyze medical images and test results with high accuracy, providing faster diagnoses compared to traditional methods. Rapid diagnostic capabilities are crucial for the timely identification of cases to prevent further spread.
3. Telemedicine and digital health tools Healthcare delivery Provide remote consultations through telemedicine platforms, reducing the risk of virus transmission.
Use AI-powered digital contact tracing applications to identify and notify individuals exposed to infectious diseases, enabling timely quarantine and isolation measures.
F. Ensuring data privacy and security 1. Protecting health information Privacy frameworks Establish robust frameworks to protect sensitive health information and ensure compliance with privacy regulations.
Invest in training and resources to integrate AI and big data analytics into existing public health infrastructures, building the necessary technical expertise.
Table 1. A brief overview of some major pandemics throughout history

HIV, human immunodeficiency virus; AIDS, acquired immunodeficiency syndrome; COVID-19, coronavirus disease 2019; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2.

Table 2. Positive and negative aspects of globalization in pandemics
Table 3. The countries that have been most frequently cited for their effective management of the COVID-19 pandemic

COVID-19, coronavirus disease 2019; SARS, severe acute respiratory syndrome; MERS, Middle East respiratory syndrome.

Table 4. Differences in status in selected areas between high-income and low- and middle-income countries
Table 5. Differences in management between high-income and low- and middle-income countries
Table 6. Recommendations for the management of future pandemics

AI, artificial intelligence.