The Epidemic Failure Cycle hypothesis: Towards understanding the global community’s recent failures in responding to an epidemic

Background: Within a few years, the global community has failed twice in responding to large viral infec-
tion outbreaks: the Ebola epidemic in 2014 and the SARS-Cov-2 pandemic in 2020. There is, however, no
systematic approach or research available that analyses the repeated failures with regard to an adequate
response to an epidemic.
Methods: For a better understanding of failing societal responses, we have analysed the available research
literature on societal responses to epidemics and we propose a framework called the ‘Epidemic Failure
Cycle’ (EFC).
Results: The EFC consists of four phases: Negligence, Arrogance/Denial, Panic and Analysis/Self-criticism.
These phases fit largely with the current World Health Organization pandemic influenza phases: Inter-
pandemic, Alert, Pandemic, Transition. By utilizing the Ebola epidemic and the SARS-Cov-2 pandemic as
case studies, we show striking similarities in the response to these outbreaks during both crises. Finally,
we suggest three major areas to be of utmost importance for triggering and maintaining the EFC. In terms
of ecology, zoonoses, supposed to be the main biological origin for virus epidemics, have been largely
neglected by politicians, the media and the scientific community. Socioeconomic and cultural conditions
such as harsh living and working conditions as well as conspiracy theories hinder effective preventive
and counter measures against epidemics. Lastly, in terms of epistemology, the reliance on knowledge
about previous outbreaks has led to slow and inadequate decisions.
Conclusions: We conclude that any current society has to be aware of the risks of repeating responses to
epidemics that will fail. Being aware of the societal mechanisms that trigger inadequate responses may
help to get to more appropriate decisions in the face of an epidemic.