The coronavirus is a relentless stalker. And not only of the humans it infects. As it has spread around the world and now across the country, it has exposed weaknesses and deficiencies in public health infrastructure, emergency response systems and global cohesion.
The nation risks paying a heavy price for that now; not learning from that experience to help us better prepare for the next one would be unforgivable.
That’s the first, most elemental lesson: There will be another outbreak. Doctors and scientists have warned us about that repeatedly in the last 10 years. Just last year, the Trump administration itself conducted an exercise simulating an outbreak in China that spread via air travel and caused the deaths of 586,000 Americans. The simulation revealed an underfunded and ill-prepared federal government that struggled with everything from coordination to medical supplies to school closings. Five months after producing its report, the administration is mired in a mirror real-world fight.
History has borne out those predictions. Viruses, of varying virulence, seem to arrive once a decade now. The consequences of failing to prepare are deadly. COVID-19 has taught us a lot already, with more lessons sure to come as it wreaks increasing havoc.
- We need government. Strong federal and state mobilization in a crisis is necessary. An emergency like this is a powerful reminder that only a prepared and effective government can mobilize resources on a large scale and change behavior across society. But only if it has the resources. We cannot starve of funding the institutions that research infectious diseases or the agencies that spearhead the fight against them when they emerge. And we must be a solid partner in a global coalition to detect, warn about, and fight the next pandemic.
- Government needs to be stable. In the week before President Donald Trump’s inauguration, officials from the outgoing Obama administration conducted an eye-opening tabletop exercise for senior Trump staff much like the one Trump’s staff did last year. But about two-thirds of the Trump officials present for the briefing have already left the administration. The job of being prepared and on watch must be done primarily by career civil servants; the continuity of knowledgeable and experienced people is critical.
- State and local governments need rainy-day funds for these emergencies, and plans drawn in advance to deal with them. The need for planning is true also for entities like school districts, hospitals, workplaces and social welfare organizations, which must be forward-thinking, not merely reactive. And government at all levels must plan ahead to alleviate the anxiety that arises when businesses close or curtail operations and people lose jobs and income, as a pandemic problem quickly becomes an economic problem.
- Governments need to be nimble, and not parochial. When Centers for Disease Control and Prevention testing kits did not work, the agency should have quickly looked elsewhere — to other nations, state health organizations or private business — to accelerate test development. Sometimes, the fastest solutions come when government directs and business delivers. This failure was critical given the importance of early, frequent and pervasive testing in defining the scale of the outbreak, the places that most need resources, and the level of stringency of containment measures.
- Governments and news organizations should always tell the truth, but especially in times of crisis. Elected leaders set the tone for the nation, tell us what to expect, and explain our role as citizens. When their words are contradicted by experts their credibility is damaged, their message is undermined, and an effective societal response is hindered. When government makes promises, then fails to deliver, which occurred with the testing, people lose faith. When the president gives false hope by misstating the development or availability of vaccines or drugs to treat the virus, people lose faith. Recent polling shows less than half of Americans think the federal government is doing enough to fight COVID-19, and barely one-third believe what the president is telling them. The media should report the events of the day without a partisan lens, with an emphasis on uncovering facts regardless of whom they help or hurt. And the president should refrain from attacking the press when it does just that.
- We need science. We need experts. We need to fund their research, then accept their findings, follow the facts, and heed their advice. We need more doctors and nurses; our chronic shortage has been laid bare especially in places where medical professionals are quarantined due to a positive test or possible exposure. But the CDC and state health organizations need a coordinated messaging system.
- We need a health care system that covers everyone and does not require that they pay for tests that determine whether they have a communicable infectious disease. And we need a robust safety net for low-wage workers who are most at risk of losing jobs in times of crisis. Paid sick or emergency leave is essential.
- We need to diversify our supply chains. The scarcity of masks and drugs, for example, underscored the danger inherent in relying on China and other overseas producers when air travel and shipping are grounded. Nearly 90 percent of the factories that make active pharmaceutical ingredients in drugs used in the United States are located outside the United States. Making our nation less reliant on overseas producers of critical supplies is one thing. We also must make sure we have adequate stockpiles of these goods and an efficient way to disseminate them.
Tabletop exercises and modeling are useful, if we apply the lessons offered. Actual crises reveal shortcomings; we must address them.
—The editorial board