Intended for healthcare professionals

Letters Controlling the spread of covid-19

Cassandra’s curse and covid-19: why do governments listen to businesses over doctors?

BMJ 2020; 369 doi: (Published 13 May 2020) Cite this as: BMJ 2020;369:m1852
  1. Stephen T Green, honorary professor of international health and consultant physician1,
  2. Lorenzo Cladi, associate head of school (teaching and learning)2
  1. 1Sheffield Hallam University and Sheffield Teaching Hospitals, Royal Hallamshire Hospital, Sheffield S10 2JF, UK
  2. 2School of Law, Criminology and Government, University of Plymouth, Plymouth PL4 8AA, UK
  1. steve.green5{at}

Pollock and colleagues recently commented on governments that ignored the World Health Organization’s advice on covid-19.1 Unwillingness by some politicians to heed expert medical and scientific advice is not unsurprising. History shows that it should be expected.

Playing the odds and downgrading risks one would rather not hear about is a phenomenon that goes back a long way. Numerous experts have warned—based on sound science—that pandemic infectious diseases of either natural or man made origin were the number one risks facing mankind (not banking crashes, religious conflict, or climate activism).2

The need for better planning and preparedness has been repeatedly asserted.234567 A letter published in The BMJ 20 years ago said about pandemic influenza: “We have time to plan now but may not later.”5 As recently as September 2019, leading journalist Laurie Garrett stated: “The world knows an apocalyptic pandemic is coming, but nobody is interested in doing anything about it.”6

Unfortunately, many leaders have clearly found the well crafted messages coming from the lobbying activities of the business and finance worlds more appealing than any “message of doom” proffered by doctors and scientists. People who only listen to and believe what they want to hear, whatever the truth, sadly facilitate this process.

The enthusiasm of some governments to spend lavishly on the “military-industrial complex” warned of by President Eisenhower8 rather than on protecting their wider populations (and themselves) from pandemic infections is evident. In 2020 nearly 70% of the world’s countries were unprepared to respond to public health threats.7

Should everyone be welcoming leadership with such priorities? In Greek mythology, Cassandra’s gift of accurate prophecy was accompanied by a curse guaranteeing disbelieving dismissal. Humanity should learn to heed Cassandra and do better.



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