The huge effort made to tackle the COVID-19 pandemic should be maintained and leveraged for all respiratory diseases, to address the short- and long-term impacts on the lungs.

The novel SARS-CoV-2 coronavirus and associated respiratory disease COVID-19 has highlighted the importance of respiratory health. This affords a once in a lifetime opportunity to concentrate minds on resources and to build unmet needs into the new EU health programme.

A long-term response balanced against all respiratory needs

Sustainable health systems improve preparedness for health emergencies: COVID-19 has highlighted the need to be better prepared for respiratory viruses or viruses that enter via the respiratory system. The appetite to invest in better preparedness should be exploited through funding programmes and be reflected in policy changes. Better international coordination on respiratory viruses and infections should emerge, including a European biomedical research agency. The leap in the use and development of remote monitoring services and digitally enabled trials which work better for people with respiratory disease should be maintained and extended. Preparedness measures should take account of wider lung health issues with a holistic approach to respiratory health at their heart. This would include planning for the needs of existing respiratory patients.

COVID-19 survivor needs are met: COVID-19 survivors represent a new respiratory health challenge. As the COVID-19 advances, we are seeing that many survivors are left with a range of respiratory and other health issues. Specific needs for people left with lung damage will increase in the burden on patients and demands on respiratory health services. A blend of in person and digital care should help address patient need. As this situation evolves, we expect a measured and evidence-based policy response. Damaged lungs affect all aspects of life and many people will require long-term support. Issues of diversity and impact on population groups should be focused on in managing survivor needs.

The Non-Infectious Diseases epidemic is tackled: One risk with the focus on COVID-19 is that policy may pivot towards infectious diseases, such as tuberculosis, at the expense of non- infectious, chronic lung diseases such as asthma, pulmonary hypertension, and COPD. Given the impact on and vulnerability of people with respiratory disease to COVID-19 we envisage a balanced response to COVID-19 that enhances attention to chronic non-infectious diseases and existing infectious diseases. This should take care not to overshadow the widespread and serious nature of these existing lung diseases. In addition, the impact of COVID-19 on the range of respiratory patients should be addressed, including the provision of targeted and specific information, and measuring the impact COVID-19 has on the outcomes of lung diseases.

Prior to COVID-19 in WHO European Region, non-infectious diseases accounted for 86% of deaths and 77% of the disease burden.