What the US can do to prepare for the next pandemic

According to experts, it isn’t a matter of if another pandemic will occur, but when.

The COVID-19 pandemic is not over yet. Even with vaccination rates accelerating, the United States is still months away from approaching herd immunity, even if enough people opt to get vaccinated. Some positive coronavirus-related news in recent weeks, though, has created the general impression that the end is in sight.

Researchers and epidemiologists have already been anticipating the next pandemic, as well as ones bound to come after that. That is because, according to these experts, it isn’t a matter of if another pandemic will occur, but when.

Deforestation and increasing globalization has all but ensured that viruses that originate in animals and then leap to humans – such as SARS-CoV-2 – are far more common. Multiple such viruses are already in circulation in the world.

Saydi Akgul, a public health professional who works in the nonprofit sector, explained to TMS why we should expect more diseases like coronavirus in the future.

“It is suspected by environmental health specialists that as we continue to invade ecosystems,” Akgul says, “the onset of zoonotic [jumping from animals to humans] and vector-borne (transmitted to humans or animals by blood-feeding arthropods including mosquitoes, ticks and fleas) disease will multiply.”

COVID-19 has already killed nearly 2.8 million people globally, including 550,000 in the US alone. While far from a benign virus, it could have been far worse. Experts have been warning for decades that a pandemic with a fatality rate closer to the Spanish Flu of 1918 (50 million deaths) is still possible.

This pandemic has been a learning opportunity for both medical experts and policymakers, allowing time to review the successes and failures of this pandemic and implement policies based on that analysis.

Individuals will certainly have a responsibility for how they react to future pandemics, but it will be governments and global health organizations that have the most say in the severity of the next pandemic.

Strengthening the pandemic playbook

In the early months of the COVID-19 pandemic, the administration of President Donald Trump was denounced for being unprepared despite the previous administration leaving behind a playbook for pandemic response.

The Obama administration’s “Playbook for Early Response to High-Consequence Emerging Infectious Disease Threats and Biological Incidents” was published in 2016. The 69-page document details a governmental response to future pandemics or epidemics emerging anywhere in the world. It organizes that response by identifying three factors:

(1) questions to ask

(2) agency counterparts to consult for answers to each

(3) key decisions which may require deliberation through the Presidential Policy Directive (PPD)-1 or its successor National Security Council process

Though the Trump administration acknowledged the existence of the playbook, then-White House press secretary Kayleigh McEnany claimed in May 2020 that the playbook was insufficient. McEnany criticized the Obama playbook as “a thin packet of paper” and said it had been replaced by “two detailed, robust pandemic response reports commissioned by the Trump administration.”

One of those reports was the 36-page National Biodefense Strategy, compiled in September 2018, that provided an outline for a coordinated response to both naturally occurring and deliberate or accidental biological threats. The other was the Crimson Contagion 2019 report published in early 2020, which provided the key findings of a joint exercise by federal and state agencies responding to a hypothetical outbreak.

While the pandemic response became highly politicized, all playbooks can and should play a part in planning for the future. The current Biden administration has both the research of these previous administrations and the knowledge gained from this pandemic to create a thorough playbook.

A pandemic response unit

In the current state of extreme political polarization, any future administration can simply choose to ignore the playbook of a past administration, as happened in 2020, making the existence of an impartial government body to coordinate a response, unburdened by political allegiance or the whims of any one administration, essential.

Akgul, who shared her thoughts with TMS about the US response to the COVID-19 pandemic and how best to prepare for the next outbreak, thinks a centralized pandemic response is vital.

“It is essential to public health and safety that the federal government have a pandemic response unit in place at all times to coordinate corrective action in the event of the next pandemic,” Akgul stated.

In 2016, the Obama administration added the Directorate of Global Health Security and Biodefense to the existing National Security Council (NSC). This department was responsible for assembling the Obama pandemic playbook and would have hypothetically coordinated a pandemic response.

However, in 2018, the Directorate was disbanded by Trump’s then-National Security Adviser John Bolton, who reorganized the NSC to address “bloat” in the department. While many members of the department remained active within the NSC, there was no longer a dedicated unit for biodefense.

Instead, as the pandemic worsened, the Trump administration quickly assembled a coronavirus Task Force, headed by then-Vice President Mike Pence. Over the subsequent months of the pandemic, Drs. Anthony Fauci and Deborah Brix became the most recognizable faces of the task force, which occasionally butted heads with Trump. Fauci, in particular, has discussed how his job was at times harder because of clashes with the president.

Going forward, Congress can create a new department solely devoted to pandemic response, preferably as its own individual organization. In fact, much as the Department of Homeland Security was created in the wake of the September 11 terrorist attacks in 2001, this department could involve a new Cabinet-level position specifically to oversee future pandemic responses.

Communicating with the American people

One of the biggest issues that plagued both the US and the global response to the pandemic was a lack of coordination.

In December 2020, billionaire philanthropist Bill Gates, who has been warning about an impending pandemic for years, said the world needs a global group dedicated to pandemic response, one with which the US could synchronize its efforts.

Gates also said that one of the most important things the US government could do is provide a more coherent message to the American people, preferably through one central source.

Trump was often accused of contradicting his task force on topics like mask wearing and the use of experimental drugs such as hydroxychloroquine for treating COVID-19. Fauci said having to at times refute Trump was one challenge of leading an effective response.

Under the new administration, the White House COVID-19 Response team, still led by Fauci, has continued to hold regular press briefings on the nation’s progress. In contrast to Trump, Biden has stayed out of the way of those briefings, letting the medical experts be the sole messengers.

Still, Biden has faced criticism for not holding a formal press conference since taking office, with critics saying the president should be more visible in a time of crisis. The Biden administration, however, has framed the lack of press conferences as an intentional effort to maintain controlled messaging as it tackles the pandemic and ailing economy.

Biden is gambling that the American people care less about what he says and more about what he does, though some members of the media disagree. His first official press conference as president is currently slated for March 25.

Helping the American people

Though many were critical of how the US government responded to the COVID-19 pandemic, bright spots did emerge. Akgul told TMS that one of the main things the government did correctly in the first months of the pandemic was getting help to Americans.

“The Families First Coronavirus Response Act provided many Americans financial relief in the event that they or a family member became infected with COVID-19 and were unable to report to work,” Akgul said. In fact, the first coronavirus relief package was passed with bipartisan support within weeks of the first lockdowns and travel bans.

Though the stimulus rollout had its share of hiccups, it was still largely a success, one that the government has now repeated with two more relief packages, the most recent passing earlier this month. In addition to a third round of stimulus checks, the latest relief package extends unemployment payments through September and provides aid to states.

Beyond helping people stay afloat, these benefits help slow the spread of the disease by allowing people to stay home and be socially distanced. The ability to work from home is also important for the purposes of social distancing and technology is making that easier to do. Industries that can adapt more readily to remote workforces will be less economically damaged by a future pandemic.

In recent years, some cities and states have been creating incentives for remote workers to relocate to those locations. The federal government could do likewise, using financial incentives, including tax breaks, to encourage people to work from home, especially during a pandemic. It could also reward companies that make it easier for their employees to work from home.

The US could look to their northern neighbor Canada, which has invested heavily in expanding high-speed internet access. While the US has spent millions building up their internet infrastructure, Canada recently invested CA$1.75 billion to expanding their infrastructure.

While the effort isn’t a direct response to the pandemic, it would help millions of workers and students have faster internet at home. Rural communities often lack access to high-speed internet and studies have found that poor children with insufficient technology at home fell behind their wealthier counterparts when schools were shut down due to COVID-19.

A greater investment in high-speed internet allows people across the country to have equal access to online opportunities and ensures the population as a whole has access to vital health-related information.

“Technology has allowed not only our activities of daily life to go remote,” Akgul told TMS, “but has also educated our general public in compliance for strategic containment of a pandemic, arguably more than any past generation could report.”

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