Letters to the Editor • Opinion
We already know how to prevent pandemics
On Oct. 2, 2021, a visitor looks at a temporary art installation on the National Mall in Washington commemorating Americans who have died of covid-19. (Jose Luis Magana/AP)
5 min

Amy Maxmen is a science journalist and a press fellow at the Council on Foreign Relations.

Among the many actions included in the $1.7 trillion budget deal Congress is looking to pass this week is a vital effort to make sure the United States never again responds to a pandemic as poorly as it did with covid-19. This legislation needs to make it across the finish line.

Americans remain shaken by the covid experience, including the government’s feeble and at times counterproductive responses. The coronavirus cost more than 1 million Americans their lives and left millions more disabled by extreme fatigue, neurological issues and other symptoms of long covid. At the same time, people are angry that government efforts to keep covid from causing even more harm cost many their jobs, set children back in academic development, and led to an uptick in depression and poverty.

Better public health policies could have prevented this devastation.

Many analyses have detailed the failures. The most recent are reports published this month by the Senate Homeland Security Committee and the House Select Subcommittee on the Coronavirus Crisis. Both of these reviews — as well as others from nongovernmental groups — describe how the United States was derailed at the start of the pandemic when the virus spread undetected in the country for months. That meant missing a brief opportunity to slow transmission, prevent hospital overflows and avoid long-term school and business closures.

At the root of this problem was an outdated testing strategy. Rather than deploy diagnostic tests vetted by the World Health Organization in January 2020, the Centers for Disease Control and Prevention insisted on developing and conducting its own limited tests, many of which turned out to be flawed. At the same time, the Food and Drug Administration was dragging its heels on authorizing alternative tests that could be run by academic institutions and the private sector.

In contrast, South Korea immediately rolled out commercial laboratory tests and deployed hundreds of thousands of contact-tracers to ensure that infected people didn’t spread the virus. Aggressive testing followed by contact-tracing also enabled New Zealand and Taiwan to limit covid's spread without long-term closures.

Contact tracing and outreach were sorely lacking in the United States, whose state and local public health departments had been operating on shoestring budgets for years. Over the past decade, CDC funding for public health preparedness and response programs have shrunk by half, and local health departments have cut more than 56,000 employees. Likewise, contingency funds to ensure that hospitals have surge capacity in emergencies have been cut in half since 2003.

Other problems cited in covid reports have to do with the CDC’s inability to answer questions about coronavirus variants because the agency lacked data, and the FDA’s slow process for vetting new covid drugs and vaccines.

Then, too, there were dire shortages — of N95 masks, cotton swabs for tests and other vital items that had to be imported from Asia.

To address these problems and more, last March, Sens. Patty Murray (D-Wash.) and Richard Burr (R-N.C.) introduced the Prevent Pandemics Act (Prepare for and Respond to Existing Viruses, Emerging New Threats and Pandemics). The bill languished for months, but now the senators have managed to squeeze it into the $1.7 trillion omnibus federal budget bill that Congress is working to pass by Friday.

It is essential that Congress act this year, before Burr leaves the Senate and a divided Congress makes agreement more difficult. Moreover, history shows that complacency sets in soon after health emergencies.

The legislation would require the CDC to update its strategy every few years, including its plan to contain disease outbreaks. It would also give the Department of Health and Human Services the authority to contract with public and private entities to ramp up testing rapidly in an emergency. It asks the department to collaborate with these groups to establish a network to track genomic data on pathogens. And it aims to bolster the public health workforce through loan repayment schemes, as well as by hiring community health workers who are adept at reaching marginalized groups.

As for the FDA, the law would give the agency the power to expedite drug and vaccine approval in a crisis, and direct it to issue a plan for collecting real-world evidence to assess treatments after they have been authorized for emergency use. Other provisions would expand domestic manufacturing and stockpiling of medical equipment needed in outbreaks.

The bill is missing certain reforms that public health experts have called for, such as granting the CDC authority to collect disease data from states. It also lacks a budget request. More funding for public health and for health emergencies remains sorely needed. President Biden’s proposed budget for pandemic preparedness and biosecurity — $88 billion over five years — would help. Separate legislation asks for $4.5 billion in mandatory annual funding to ensure that public health departments have the tools, workforce and systems they need.

Congress would have to appropriate both of these budget requests next year. And they might not. Many Republicans declined to authorize the Biden administration’s request earlier this year for funds for the covid and monkeypox responses. If they block policies and funds for pandemic preparedness, it would be a sad departure from the past, when Republicans and Democrats cooperatively confronted Ebola, Zika virus, avian influenza and other outbreaks.

Note that more than half of the omnibus package — $858 billion — is earmarked for the military. Defenses against pathogens aren’t given the same priority in Congress as defenses against weapons. But the toll from covid, exceeding that of multiple wars, shows that this preference makes no sense. If the next epidemic causes as much unnecessary devastation as this one, today’s uninterested leaders will be among those to blame.