Thus, President Trump failed his first test in dealing with the virus, by brashly asserting that the U.S. government has the coronavirus “completely under control.” While there is no reason to panic, we simply do not know, with China’s seventh-largest city under a lockdown, how serious it will become.
The good news is that there have been substantial improvements to global and U.S. public-health systems since the related SARS virus struck in 2003. U.S. infectious disease response systems were particularly improved after the West African Ebola epidemic of 2014. The new coronavirus’s gene was sequenced rapidly, and a test to diagnose the disease has already been developed. The World Health Organization — properly criticized for a flaccid response to the 2014 Ebola outbreak — is moving quickly: organizing a response and meeting urgently to determine if a Public Health Emergency of International Concern should be declared.
But if these are reasons to avoid the kind of fear that spread in our country during the “Ebola Autumn” of 2014, there are reasons for great concern as well. Some gaps in our disease response system were patched at that time, but serious holes remain and new ones have emerged. Policymakers need to move immediately to address four particular issues in light of the new infectious virus.
First, there needs to be leadership in the White House. President Barack Obama followed his designation of an “Ebola response coordinator” in October 2014 with a permanent office on pandemic preparedness and response in 2015. While Trump maintained this structure into 2018, John Bolton abolished it when he took over as national security adviser. With threats such as the new coronavirus requiring an “all of government” response — domestic and foreign; health and security agencies; federal, state and local authorities — someone needs to be in charge at the highest level of our government. Additionally, critical organizing structures throughout the executive branch that have been weakened in recent years — including the Public Health Emergency Medical Countermeasures Enterprise — need to be reinvigorated and empowered.
Second, Congress must change the way it funds epidemic responses. Congress did move on a bipartisan basis during the 2014 Ebola outbreak to fund the Obama administration’s response plan, but even that relatively prompt action created delays in vaccine development and on-the-ground response. When it comes to making a new vaccine to stop an epidemic, developing treatments or deploying other countermeasures, funding delays mean countless people are infected or die as a result.
Last year, Congress did beef up a fund that could be tapped by the president to respond to public-health emergencies without waiting for a specific funding bill. But these funds are limited, and Congress rejected proposals for a dedicated emerging infectious disease fund that could be used to further public-private partnerships to develop diagnostics, vaccines and treatments. These shortcomings should be addressed.
Third, Congress needs to fund the full network of hospitals and treatment facilities nationwide it established after the 2014 Ebola epidemic, which enables prompt testing and isolation of patients with deadly infectious diseases. This funding is set to expire in four months, and while Congress is moving on a plan to renew the 10 most advanced such facilities, that could leave scores of American cities without the kind of testing and treatment centers that could be critical in dealing with the new coronavirus or other future threats.
Finally, policymakers in all branches and at all levels of government must let science and the best medical expertise — incomplete as it is — govern the decisions that lie ahead. The first victim of an infectious disease outbreak is often rational decision-making; fear can spread even faster than disease in an era where social media can transmit misinformation in a manner not ironically called “going viral.” Xenophobia is a particular risk; it’s unjustified when Americans returning home from a foreign trip are just as likely to carry a disease with them as immigrants or foreign tourists. Our government is filled with the best scientists, medical professionals and researchers in the world. Their expertise — not fear or politics — should guide critical decisions.
The weeks ahead will be tense and challenging. But with the right leadership, adequate funding, key investments and scientifically led decision-making, lives can be saved and the risks and damage can be reduced.