When the Next Pandemic Comes… Will We Be Ready?

“It’s going to be bad,” my wife said.
Like many people, I had paid little attention to the “novel coronavirus,” but my wife has always followed the news more closely than I have.
She was right. Despite knowing something of history and having worked in healthcare for over 40 years, I never expected to live through a pandemic, especially not one that lasted so long as COVID-19 has. I never thought I would see so many people die so quickly unless the nuclear attack that we practiced for in school happened. But here we are.
Fortunately, we got a lot of things right. Previous research on vaccines for HIV and other infections, along with dramatic progress in the ability to see protein structures and measure immune responses, enabled scientists to create effective vaccines in record time. Operation Warp Speed leveraged public-private partnerships and financing for vaccine development. Health care workers risked – and some sacrificed – their lives to care for COVID patients. Front-line workers in food production and delivery services were the often-unsung heroes who made it possible for most of us to isolate in relative safety.
The president pushed General Motors to produce intensive care ventilators by invoking the Defense Production Act. States with unused stockpiles shared ventilators with states that needed them. Medical journals made most of the COVID research they published freely available to everyone online. Science journalists produced hundreds of news stories to bring accurate explanations of rapidly changing recommendations and the ever-evolving technical details to the lay public.

Organizations such as Johns Hopkins, The New York Times, and the Centers for Disease Control and Prevention (CDC) created COVID trackers to keep people informed about infection levels and risks. Many of us took the necessary steps to protect ourselves and others by avoiding crowds, social distancing, wearing masks, and getting vaccinated when the shots became available.
All these made the pandemic less damaging than it might have been.
But we could have done much better.
As many as one fourth of the 1,130,000 Americans killed by COVID-19 might be alive today if our pandemic response had been better organized. Because we were not ready.
New York Times reporter German Lopez said it was like trying to fly the plane while building it. Hospitals have code teams that respond when a patient crashes. Necessary equipment is ready to go; the team members know what to do. When COVID-19 swept the world, our code teams were ill-equipped and poorly prepared.
Our under-funded public health system lacked the resources to respond effectively. The government had not built adequate stockpiles of masks and other PPE (personal protective equipment.) Because SARS-CoV-2 was new (although related to other known coronaviruses) it took time to analyze the virus and develop tests, vaccines, and treatments. But even after these were developed, rolling them out to the people who needed them was slow and inconsistent.
The U.S. public health system is decentralized and disjointed. Authority resides in government levels ranging from federal to local; response roles and responsibilities are dispersed among many public and private organizations.
Leadership was also lacking. The president, who should have been the voice of unity, seriously underestimated the threat, promised an unrealistically quick end to the crisis, scorned science, ignored or contradicted experts, recommended unproven and potentially dangerous treatments, micro-managed the CDC, and set a terrible example, conducting daily briefings in a crowded room where few people, if any, wore masks.
COVID messaging was inconsistent, confusing, and contradictory. Guidance from the CDC was complicated and seemed to change constantly as the pandemic evolved.
All this undermined public trust, already weakened by deep political divides and our almost pathological obsession with unbounded freedom to choose. Too many people made pandemic decisions based on bias and political allegiance. Misinformation and disinformation mushroomed in the media and on social networks.
Another pandemic will happen. Another nasty virus may emerge. The next COVID variant could make it happen sooner. Experts see a 20-40 percent chance in the next decade.
We must learn the lessons of COVID-19. And use what we learn.
That’s the message of a book just published: Lessons from the COVID War by the COVID Crisis Group, a panel of 34 experts charged with planning an assessment like that of the 9/11 commission. Neither the Biden administration nor Congress established the commission, a clear sign that we are not ready for the next pandemic. The publisher says, “The Covid war showed Americans that their wondrous scientific knowledge had run far ahead of their organized ability to apply it in practice. Improvising to fight this war, many Americans displayed ingenuity and dedication. But they struggled with systems that made success difficult and failure easy.”
We deserve better. We must do better.

Michael Heyd, a retired medical librarian from Fairfield Township who spent more than forty years searching the literature for professional hospital staff, is a member of Let’s end COVID!
Published: 4/29/23

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