Pandemic Preparedness: Lessons Learned?
“The limits of science have always been the source of bitter disappointment when people expected something from science that it was not able to provide.”
- Karl Jaspers, German-Swiss psychiatrist and philosopher
“The world needs a well-funded system that is ready to spring into action at a moment’s notice when danger arises. We need a fire department for pandemics.”
- Bill Gates
May 11, 2023 marked the official end of the COVID-19 Public Health Emergency in the U.S. While the emergency is over, this pandemic is not. Even if it were, one thing is certain, there will be others. Now we should focus on the most important lessons of this pandemic so we are not caught flat-footed when we face the next one. (See Janeen Interlandi’s New York Times editorial, “America Is Forgetting the Lessons of the Covid Health Emergency” published on the same day the Public Health Emergency officially expired in the U.S.) In this week’s Germ Gems post I summarize these lessons and also discuss the importance of leadership when dealing with a public health emergency.
Lessons from the COVID-19 pandemic. Two recent articles provide lists of lessons we learned from the COVID-19 pandemic. On May 11, 2023, in a guest editorial in the New York Times titled, “13 Lessons from the Covid Pandemic”members of the “2020 Biden-Harris Transition Covid-19 Advisory Board” provided their assessment of the government’s pandemic response. While all 13 lessons are important, I believe the following deserve highlighting: (1) “Trust is crucial;” (2) “Prepare now;” (3) “School should not be interrupted or placed online except in rare circumstances;” (4) “Social isolation is harmful and can increase mortality;” and (5) “Covid will not be the last pandemic to strike the United States and the next one could be worse.”
In the April 10, 2023, issue of the Journal of Infectious Diseases, former director of the National Institute of Allergy and Infectious Diseases (NIAID) Dr. Anthony Fauci co-authored the article “Pandemic Preparedness and Response: Lessons from COVID-19.” In it, the authors offer “Ten Lessons From COVID-19 for Pandemic Preparedness,” two of which stand out in my mind: “Global information sharing and collaboration are essential for a successful response to a pandemic,” and “Misinformation and disinformation are the enemy of public health and pandemic control.”
Both articles are important in providing insight into how the world might better respond to the next pandemic. The critical question is which organizations will lead the response and who will lead these organizations.
Leadership matters. In the U.S., the NIAID and the Centers for Disease Control and Prevention (CDC) are, arguably, the government’s leading institutions for providing clinical and public health guidance on pandemics for health professionals as well as for the general public. At present, both institutes are undergoing changes in leadership. In December 2022 Dr. Fauci stepped down as director of the NIAID. Director of the CDC, Dr. Rochelle Walensky, has resigned and will be leaving her position at the end of June. The appointment of comparable people to lead both the NIAID and the CDC has to be a top priority for pandemic preparedness not only for our country but also for the whole world.
Mistakes and missteps were made in the way the U.S. responded to this public health emergency. Fauci, in particular, and the CDC, in general, received withering criticism from those with opposing views who often had little or no knowledge of either public health or clinical medicine. The pandemic became politicized.
Nonetheless, Fauci’s and Walensky’s leadership of their respective institutions during these very trying times mattered. As someone who also practiced as infectious diseases physician scientist, I believe they both deserve enormous thanks for their intelligent leadership.
Other key partners. Successful pandemic preparedness is a team activity involving both international and national organizations. The World Health Organization plays a pivotal role in planning for the next pandemic because, by definition, pandemics are infectious diseases that have crossed national borders.
Founded in 2020, the UK organization “Pandemic Action Network” is a more recent force for pandemic preparedness. According to its Executive Director Eloise Todd, the principal goal of the network is “to make sure that what happened during COVID-19 just simply isn’t allowed to happen again so that every country is better prepared for a future pandemic.”
The U.S. “team” should involve not only experts from federal and state governments but also from the many excellent academic institutions we have in this country. While that entire list is too long to cite here, the University of Washington’s Institute for Health Metrics and Evaluation and Johns Hopkins Coronavirus Resource Center come to mind as prime examples.
Next steps. As we’ve witnessed with COVID-19, an effective response to pandemics requires a tightly coordinated “all hands on deck” approach. In addition to building stronger local and global collaborations, we must also develop more effective communication systems to combat misinformation and disinformation.
We are fortunate that there are many talented people throughout the world who can lead the way in preparing us for the next pandemic. And I firmly believe that “where there’s a will there’s a way.” But, only time will tell if we learned any lessons from COVID-19.