We Are Not Prepared For A Future Pandemic

We should have learned a valuable lesson from this pandemic -- how to prepare for the next one. But we didn't. It was nothing more than an opportunity for our politicians to play politics with American lives. We must do better, but that won't happen until Republicans are diminished enough to stop blocking preparedness.

Here is what the editorial board of The Washington Post says we need to do:

There are many reforms Congress and the White House should embrace.

The federal government must overcome the fragmentation of the nation’s public health system. The 10th Amendment to the Constitution and many Supreme Court rulings have given state governments primary authority to control the spread of dangerous diseases within their jurisdictions. But the dedicated workers in this patchwork of localities are overburdened and underfunded. The Commonwealth Fund reportcalls for creating a national public health system that would provide more leadership, resources and direction, perhaps led by a new undersecretary or assistant secretary of Health and Human Services. While it wouldn’t replace the work in states and localities, a national public health system would help ensure state and local health departments gain basic capabilities and resources to protect their communities, however different. The report says that government funding for core public health functions remains “grossly insufficient.”

Every virus or bacteria has a genetic blueprint. With advances in bioinformatics, scientists can use genetic sequencing to identify the variant, spot mutations and chart possible spread among people. This ought to be harnessed into a nationwide — or even global — trip wire for disease among humans, animals and plants. We already rely on early-warning systems to watch for hurricanes and tornadoes; radars and satellites keep watch for ballistic missile threats; prompt warning is critical to intelligence gathering and financial markets. But so far, early-warning systems exist only in fragments for disease. Also, there’s a crying need to build better data-sharing systems to improve the link between genomics (genetic blueprints), health care (what doctors, hospitals and emergency rooms are seeing among people) and epidemiology (the patterns of disease in the population).

The nation’s capabilities to create and manufacture vaccines must be strengthened. Operation Warp Speed showed what can be done. With years of previous research, and a mountain of government money, the mRNA coronavirus vaccines were developed and manufactured in record time and saved millions of lives. But the mRNA vaccines are not a long-term answer; their effectiveness wanes. We need a second massive research and development effort, an Operation Warp Speed 2.0, to overcome many hurdles to a coronavirus vaccine that would work against all variants and for a long duration. It won’t be easy. A universal flu vaccine has been an elusive goal for years. In parallel, we need an organized effort to create platforms for future vaccines with enough science and resources behind them to kick-start development as soon as a pandemic flares — to be ready to deploy shots rapidly.

The recent announcement of an overhaul at the CDC made a point to shift the agency’s culture to be more action-oriented in the face of emergencies. The idea is a good one for more than just the CDC. The emergency side of public health should be organized like the military, with money, staffing, a clear command structure, exercises and a mission of urgency.

Finally, the nation’s public health authorities must rebuild trust. In an emergency, public trust is fragile — when broken, it is extremely difficult to regain. Transparency, promptness and clarity were too often missing during this pandemic, and online disinformation further corroded public confidence. A concerted effort must be made to rebuild public trust in the digital age.

The prospects for wide-scale reform do not look good. Partisan conflict on Capitol Hill has stymied further funding to respond to the current pandemic, not to mention prepare for the next one. Where is the willpower that arose after 9/11? Where is the bipartisan consensus that existed during the Cold War? Clearly, the political scene has been clouded by pandemic fatigue and looming elections. But the need for preparedness is not going away.

A transformation in public health requires a sea change in thinking. We must value this endeavor for our own protection, rather than continue to neglect it. We have been warned.