Researchers warn that the World Health Organization’s post-pandemic guidelines risks repeating COVID-era missteps, as evidence for many new public health measures remains limited and inconsistently applied.
Study: WHO’s pandemic response recommendations after COVID-19: lessons learned or learnings lost? Image credit: oatawa/Shutterstock.com
Researchers at the University of Leeds, UK, have recently analyzed the World Health Organization (WHO) 's pre- and post-pandemic reports to explore the scientific basis and rationale for implementing recently updated public health and social measure guidelines and recommendations in the post-coronavirus disease 2019 (COVID-19) pandemic era. The findings are published in Frontiers in Public Health.
Why WHO is rewriting its pandemic response guidelines
WHO’s recent reports showcase significant changes in recommendations and guidelines on public health and social measures in response to the COVID-19 pandemic. According to the organization, public health and social measures are defined as non-pharmacological interventions implemented by individuals, communities, and governments to reduce the spread of infectious diseases during pandemic or epidemic situations.
These measures, including quarantine, travel restrictions, and face masking, are required to reduce pathogen transmission and are intended to reduce the burden on healthcare systems so that essential health services can continue, along with pandemic-specific health services.
In response to the COVID-19 pandemic, the WHO issued non-binding recommendations and guidelines to Member States. WHO appeared to follow a rigorous internal quality assurance process to develop these guidelines. However, many guidelines did not consistently adhere to the quality assurance process. At the initial phase of the pandemic, the WHO advised against “any travel or trade restrictions,” which was eventually dropped after most countries ignored it.
Following a resolution at the 2021 World Health Assembly, WHO started an initiative to measure the effectiveness and impact of non-pharmacological measures on public health. The 2025 World Health Assembly recently reinforced the process. As part of this effort, WHO is re-examining its recommendations on non-pharmacological measures to reflect the lessons learned from the pandemic.
In the current study, researchers analyzed three pre-pandemic reports and six recent WHO reports on non-pharmacological measures to explore the changes the WHO has already made and whether these are based on systematic, evidence-based evaluation of public health outcomes.
Shifts in WHO’s post-COVID guidance
The study analysis highlighted significant changes in the WHO’s recommendations on non-pharmacological measures. However, these recommendations often lacked a consistent, systematic, evidence-based evaluation.
Despite being previously discouraged, several population-wide interventions, including quarantine, travel measures, and universal masking, have become normalized in post-COVID reports.
According to the analysis, scientific evidence supporting the WHO’s updated recommendations is dominated by low-quality studies with sometimes contradictory findings. This evidence failed to provide long-term efficacy and impact of non-pharmacological measures and adverse outcomes associated with their large-scale implementation. Such information is vital for evaluating policies with complex health, economic, and other societal consequences.
Several reports that were analyzed in this study highlighted WHO’s awareness about the adverse effects of non-pharmacological measures, including food insecurity, financial deprivation, loss of education, inaccessibility to healthcare services, social isolation, domestic violence, and emotional distress. However, the primary focus within these reports remained on mitigating disease transmission risk rather than preventing adverse outcomes caused by these measures.
WHO’s review of learnings from COVID-19 identified the need for a strong social safety net program. However, such programs are unlikely to fully offset non-material and socioeconomic harms, particularly in low-income settings. These observations indicate that WHO’s mitigation recommendations are not always well aligned with on-the-ground socioeconomic realities.
WHO’s learnings from COVID-19 report stated that “Pandemic plans should also explicitly account for the threats posed by misinformation and disinformation about (…) government decisions regarding pandemic mitigation and response.”
The term “misinformation” was frequently used during the COVID-19 pandemic to dismiss or censor valid scientific viewpoints. During the pandemic, when policies were often based on epidemiological models resting on unproven assumptions, it was demonstrated that excluding contrary opinions carries a high risk. A 2024 report by the WHO highlighted the need for strengthening the role of integrated epidemiological and economic modeling for pandemic response, which may perpetuate some of these risks if alternative perspectives are insufficiently considered.
Data-driven pandemic preparedness
The study findings highlight that despite poor-quality risk-benefit evidence, the WHO has incorporated and normalized several pandemic-related non-pharmacological measures in its post-pandemic recommendations and guidelines.
Many of these measures can potentially negatively impact social, economic, psychological, and health outcomes. Therefore, an accurate and in-depth evaluation of evidence is essential to support the post-pandemic implementation of non-pharmacological measures and to guide future policies.
A systematic evaluation of the long-term efficacy and impact of these measures and associated adversities is highly needed before recommendations for future pandemics are changed.
As the researchers stated, the one-size-fits-all approach suggested by these policy changes and evidenced in the COVID-19 response is a significant break from more orthodox and targeted approaches that consider the local context when weighing risks together with benefits.
They also surmise that WHO’s recommendations can potentially trigger inequalities, further highlighting the need for more rigorous research and real-world monitoring.
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