13 May 2020, COVID-19 Narratives

By Dr David Nabarro, Strategic Director of 4SD, Special Envoy of World Health Organization Director-General on COVID-19 and Co-Director of the Imperial College Institute of Global Health Innovation at the Imperial College London

TEN COVID-19 LEARNING POINTS

By Dr David Nabarro and John Atkinson


Lockdown Is an opportunity to pause and collectively make sense of the world we’re in.

  • Move fast, move early. Exponential growth is not outpaced by linear action. Countries and places that rapidly adopt actions that break transmission control outbreaks. When you don’t, severe measures become necessary.
  • Everywhere is different. Demography, access to health services, travel patterns for work, vary by country. Responses to COVID-19 work best when designed appropriately to the place where they are to be applied.

Solidarity is critical, we have never been so well connected.

  • Solidarity matters. We are only safe if everyone is safe. With liberty comes responsibility. Selfishness increases the risk to all.
  • We need great public health capacities. Case identification, contact tracing and isolation slows COVID down and gives our health and public health systems a chance to build the capacities they need to manage COVID. Building public health capacities at community level to track the virus and isolate does and will save lives.

Humanity is ingenious and the signs are everywhere.

  • Humanity is ingenious. Our ability to rapidly advance our science or design responses in places with little or no resource is phenomenal. Creativity, ingenuity and the ability to rapidly learn from each other are the characteristics that are shaping the ’next normal’.
  • Harnessing innovation is the true exit plan. Biomedical and scientific advances in vaccines, diagnostics and therapeutics are going to be the game changers in this pandemic. In the meantime, people in every circumstance – north, south, salaried, daily wage – are adapting the guidance for slowing COVID transmission to suit their circumstances.

Equity, fairness, justice and sustainability need to flow through all our decisions.

  • Those who serve suffer. Health and care professionals, bus drivers and grocery store cashiers who interact with hundreds of people every day are much more likely to get the disease. They are also more likely to be low paid and female.
  • The disease exacerbates inequality. Inequalities in wealth between nations is accentuated as low resource in poorer nations means they cannot respond as effectively to a disease largely brought to them from richer nations. Inequalities in wealth between individuals mean that it is those who live in crowded conditions and have to keep attending work to live get infected and suffer more, particularly as their general health is also poorer.

Leadership is about helping others be better; we are all leaders.

  • Command doesn’t mean control. Populations will accept instruction when the threat feels immediate. This is challenged as the threat diminishes so being able to anticipate, articulate and adapt whilst remaining accountable is the COVID leadership paradigm.
  • Culture matters. Different places respond differently to the same advice. Some dutifully follow government/scientific advice, others look for ways to work around it. Know your context.

Download Narrative as PDF English (168kb)



There are many great sources of advice for governments and healthcare systems and the people who work in them, particularly the World Health Organization website. This is the trusted source for clinical information. Please bookmark it and keep checking it as it is updated.


On 21 February 2020, Dr David Nabarro, Co-Director of the Imperial College Institute of Global Health Innovation at the Imperial College London and Strategic Director of 4SD, was appointed as one of six Special Envoys of World Health Organization (WHO) Director-General on COVID-19.

In this role, David provides strategic advice and high-level political advocacy and engagement in different parts of the world to help WHO coordinate the global response to the epidemic.

The COVID-19 Narratives are being written by David and peers to share with those who want more information about the situation and to help raise awareness and readiness of all actors.


Snapshot from WHO COVID-19 Situation Report – 113, as of 10:00 CET 12 May 2020

→ 4,088,848 confirmed cases (+82,591 new in the last 24 hours)
→ 283,153 deaths (+4,261 in the last 24 hours)
→ WHO issues statement on Tobacco use and COVID-19 urging researchers, scientists and the media to be cautious about amplifying unproven claims


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