The United States could have been better prepared for the coronavirus — and it could be better prepared for the next deadly pandemic. The government has many other tools available to handle outbreaks in the future. The last year shows it's time to use them.
For many years, we've largely treated pandemic planning solely as a matter of concern for public health agencies. We've relied on them to spot emerging outbreaks in other parts of the world, gather information that could inform America's preparations and then game out our response.
But time and again, nations have concealed dangerous outbreaks. Even when these events have become apparent, the United States has struggled to gather the data needed to mount an effective response. In the case of the coronavirus, China didn't share critical information from its initial experience with the virus. Leaders there knew much earlier than they revealed that a SARS-like virus was circulating in Hubei province, that it spread through asymptomatic patients and that there was widespread transmission among people.
That information could have made a difference, but we didn't have access to it, and many of the mistakes we made early last year derived from that obliviousness. The United States made plenty of missteps, including marked failures of leadership, even after these facts became known. But early data-sharing and other critical insights could have alerted our public health experts sooner to the threat the coronavirus posed and helped us mount a better response. At the outset, weeks matter. Critical time was lost because of poor situational awareness.
To promptly collect this kind of information, we can't rely only on public health agencies and their tools of international collaboration in known hot spots. Our government has the capacity to gather epidemiological facts even when other nations don't want to share them. Deploying intelligence agencies and assets to monitor outbreaks would advance our public health goals and help guard against adversaries who would try to exploit the chaos brought on by a health crisis.
The U.S. government has made past attempts to bridge the gap between our intelligence services and public health agencies. When the Obama administration's national security team developed a Global Health Security Agenda in 2014, it deliberately put the words "health" and "security" together as part of an effort to bring national security and public health authorities closer. This move sparked controversy among both camps, with each worried that mission creep would degrade their core functions.
This discord foreshadowed the challenges the country faced last year in integrating national security agencies like the Defense Department into the coronavirus response. In the earliest days of the pandemic, the department resisted calls to reprogram its biodefense resources to focus on combating the virus; I'm told that some in the Pentagon argued that its role was to counter deliberate biological threats, not a naturally occurring pathogen. The result is that no government body fully owned the mission of protecting the homeland from the coronavirus.
National security officials generally believed that the Centers for Disease Control and Prevention had the ball, but the CDC lacked the culture, clear authority from Congress and resources to respond to a crisis of this magnitude. It also couldn't properly assess the risk if its counterparts in China weren't forthcoming. This left it unable to mobilize the kind of sweeping logistical effort needed to organize a domestic response, such as widespread diagnostic testing. The CDC has a retrospective mindset, looking backward to do careful analysis of known contagions. It isn't in the businesses of gathering and sharing real-time, partial data to inform active decision-making.
The intelligence community, by contrast, has robust capabilities for making assessments with sparse, uncertain information, which makes it much better at anticipating events and trends. Its analytical culture learns from what's occurred and what's unfolding, but always with an eye toward what can happen next. What we needed last year was something akin to a Joint Special Operations Command for generating actionable information, analysis and coordination. Instead, what we had, in the CDC, was an agency that operated like an academic department of public health.
The pandemic has raised the stakes. Our adversaries now know that one way to harm America is with a respiratory virus. The spread of the coronavirus was not a deliberate act, but the arrival of the next respiratory pathogen could be. Adversarial groups may now see that respiratory pathogens can be dressed-down nuclear weapons. Viruses are far more accessible than enriched uranium and easier to engineer — but still capable of unleashing mass destruction.
U.S. intelligence experts once thought a terrorist group or nation-state would be unlikely to weaponize a respiratory pathogen like influenza because it could just as easily blow back on them. The pandemic may have changed some of that calculus: The coronavirus hurt the United States and its allies much more than it hurt many other parts of the world. Western democracies, especially the United States, proved uniquely challenged in implementing precautions, marshaling collective action like mask-wearing and promoting vaccination. The United States was one of the worst-hit nations throughout successive waves of the original virus and its variants. Some adversaries may now be watching the heavy effects on the United States and supposing that they could weather a deliberately engineered respiratory pathogen better than we could.
It's not just a question of intentionally released illnesses. We also need to involve our intelligence assets in guarding against similar dangers from nature. The list is long, but those that demand our greatest focus are respiratory RNA viruses — not just influenza or coronaviruses, but the entire category of respiratory pathogens that derive their genetic instructions from RNA. These viruses can undergo rapid mutation when they face selective pressure and can adapt to threaten humans in unforeseen ways, including by evading our drugs and vaccines. Something that spreads through inhalation is also difficult to isolate and contain.
Leveraging intelligence assets to alert us to novel outbreaks and the conditions that create them would also complement our diplomatic tools. The intelligence community has access to alternative sources of data — signals, satellites and human assets — that could be mined and shared with diplomats to alert us to an emerging disease. If intelligence estimates identified certain weaknesses in a foreign country's scientific institutions, our diplomats would be in a better position to know where to prioritize their own efforts; for example, a lab with poor internal controls or certain regions where disease surveillance is especially weak.
These sorts of collaborations, in which diplomatic initiatives are supported by intelligence agencies, are a hallmark of arms-control efforts, nuclear nonproliferation activities and nuclear inspections. A similar approach can help improve our biosecurity and disease surveillance as well. Intelligence activities are no substitute for multilateral conventions and capacity building within nations, but the two missions — public health engagement guided by diplomacy, and security efforts led by intelligence agencies — need to find more seamless ways to coexist.
A new doctrine for looking at public health preparedness through the lens of national security would allow us to more quickly mount a response when new threats emerge. There are many respiratory viruses that might spark the next pandemic. We know that one of them will. The coronavirus won't be the last such pathogen that tries to overwhelm us. By leveraging our national security tools, we can help ensure that the next one doesn't succeed.
Scott Gottlieb is a fellow at the American Enterprise Institute and the author of "Uncontrolled Spread: Why Covid-19 Crushed Us and How We Can Defeat the Next Pandemic," from which this essay was adapted. He served as the 23rd commissioner of the Food and Drug Administration and has advised members of the national security community on issues related to public health.