This money was to be spent on “biopreparedness and biosecurity.” Think: rebuilding the national stockpile of personal protective equipment (PPE) and other medical supplies. Expanding lab and testing capacity. Supporting faster vaccine production. Hiring supervisors who can quickly train and scale up the workforces needed in a crisis, such as contact-tracers. Research and development for new therapeutics.
And more basic uses, such as upgrading health officials’ IT.
“I literally would wake up at 2 and 3 in the morning [last year] in a cold sweat because we couldn’t get data out of our data systems,” said John Wiesman, who was secretary of health for Washington state last year when it was an early covid-19 hotspot. “The volume of lab test results coming in was way larger than the systems were ever designed for.”
With computer systems down for hours or sometimes days, Wiesman told me in an interview, he and his colleagues were frequently in the dark about the extent of the outbreak and which populations were at greatest risk. Many others were too.
“A common theme that I heard from a lot of our members is that they were keeping the fax industry alive during the pandemic,” said Carolyn Mullen, who runs government affairs and public relations at the Association of State and Territorial Health Officials. “There’s one story where one fax machine couldn’t talk to another fax machine, so someone had to go to [the store] and purchase an updated fax machine.”
Despite these and other troubling incidents, Biden’s preparedness-funding request got cut completely from the bipartisan infrastructure deal. Public health experts then hoped it would be shifted into the reconciliation bill that Democrats plan to pass with a party-line vote. Senate aides have told me, however, that while there is a line item in the reconciliation package for pandemic preparedness funding, it has been shaved down — from Biden’s original $30 billion to about $5 billion.
The White House has so far not publicly weighed in on the shrinkage.
Lawmakers do not appear to have substantive objections to spending more on pandemic preparedness; rather, they are slimming down lots of programs to fit everything into this one bill. So what’s the big deal if some public health money gets left out? After all, Congress already appropriated $10 billion for similar measures in an earlier covid-19 relief bill. But despite this useful down payment, public health experts worry about the “cliff” looming in a couple of years when this money runs out.
“People don't move or take a job if you say, ‘Oh, well, I can basically assure you funding for nine months or a year,’” Wiesman said.
Pandemic preparedness would be a disastrously short-sighted priority to short-change, for at least three reasons.
First is (obviously) the potential to prevent needless suffering and death. Completely eliminating casualties from infectious disease or other public health threats would be impossible. But lives could have been saved last year if government officials had had the foresight and funds to invest in better public health infrastructure in advance.
Second is the economic argument: Not spending adequately on pandemic preparedness is more expensive than adequately spending on it. Covid-19 cost the U.S. economy around $16 trillion, according to an estimate last fall from economists David M. Cutler and Lawrence H. Summers (a Post contributing columnist). That’s more than 3,000 times the cost of what Dems presently plan to add to their spending on pandemic preparedness.
An ounce of prevention in this case is truly worth pounds — if not tons — of cure.
Finally, consider the national security implications.
The United States can’t use the tools available to China and other authoritarian states to control outbreaks — which include, say, limiting population movement under threat of force. Presumably we don’t want these tools, either. That means we need to invest in public health interventions that conform with democratic values, such as the wraparound services (food and PPE delivery, sick leave, etc.) that allow people to self-isolate safely and voluntarily.
If we don’t undertake these measures, bad actors might notice, and ultimately exploit, our relative vulnerabilities.
A year and a half into covid-19, with more than 613,000 Americans dead and cases rising again, lawmakers still aren’t ready to commit the funds necessary to prevent another tragedy of this scale. If these conditions aren’t sufficiently motivating, what would be?