³Ô¹ÏÍøÕ¾

Anniversaries are usually festive occasions, marked by celebration and joy. But there’ll be no popping of corks for this one.

March 11 2024 marks four years since the World Health Organization (WHO) a pandemic.

Although officially a public of international concern, the pandemic is , and the causing serious harm.

Here are three priorities – three Cs – for a healthier future.

Clear guidance

Over the past four years, one of the biggest challenges people faced when trying to follow COVID rules was understanding them.

From a behavioural science perspective, one of the major themes of the last four years has been whether guidance was clear enough or whether people were receiving too many different and messages – something colleagues and I called .

With colleagues, I conducted an of communication during COVID and found that the lack of clarity, as well as a lack of trust in those setting rules, were key barriers to adherence to measures like social distancing.

In future, whether it’s another COVID wave, or another virus or public health emergency, clear communication by trustworthy messengers is going to be key.

Combat complacency

As Maria van Kerkove, COVID technical lead for WHO, puts it there is no from COVID. is setting in as we have moved out of the emergency phase of the pandemic. But is still much work to be done.

First, we still need to understand this virus better. Four years is not a long time to understand the longer-term effects of COVID. For example, evidence on how the virus affects the and is in its infancy.

The extent, severity and possible treatment of is another priority that must not be forgotten – not least because it is still causing a lot of long-term .

Culture change

During the pandemic’s first few years, there was a question over how many of our new habits, from elbow bumping (remember that?) to remote working, were .

Turns out old habits die hard – and in most cases that’s not a bad thing – after all can be good for our health.

But there is some pandemic behaviour we could have kept, under certain conditions. I’m pretty sure most people don’t wear masks when they have respiratory symptoms, even though some health authorities, such as the , recommend it.

Masks could still be thought of like : we keep one handy for when we need it, for example, when visiting vulnerable people, especially during times when there’s a spike in COVID.

If masks hadn’t been so politicised as a symbol of so early in the pandemic, then we might arguably have seen people in more countries adopting the behaviour in parts of east Asia, where people when they are sick to avoid spreading it to others.

Although the pandemic led to the growth of remote or hybrid working, – going to work when sick – is still a .

to send children to school when they are unwell is unlikely to help public health, or attendance for that matter. For instance, although one child might recover quickly from a given virus, other children who might catch it from them might be ill for days.

Similarly, a culture of presenteeism that pressures workers to come in when ill is likely to backfire later on, helping spread in workplaces.

At the most fundamental level, we need to do more to create a culture of equality. Some groups, especially the most , fared much worse than others during the pandemic. Health inequalities as a result. With ongoing pandemic impacts, for example, long COVID rates, also , health inequalities are likely to persist without significant action to address them.

Vaccine inequity is still a problem . At a national level, in some wealthier countries like the UK, those from more deprived backgrounds are going to be less able to afford .

We may be out of the emergency phase of COVID, but the pandemic is not yet over. As we reflect on the past four years, working to provide clearer public health communication, avoiding COVID complacency and reducing health inequalities are all things that can help prepare for any future waves or, indeed, pandemics.

Simon Nicholas Williams has received funding from Senedd Cymru, Public Health Wales and the Wales Covid Evidence Centre for research on COVID-19, and has consulted for the World Health Organization. However, this article reflects the views of the author only, in his academic capacity at Swansea University, and no funding or organizational bodies were involved in the writing or content of this article.