Every week or so, scientists issue another warning that the H5N1 bird flu is inching closer to exploding into a pandemic. Despite having contended with a pandemic that broke out less than five years ago, the U.S. has no solid plan to handle a new one — nor have our leaders done anything to incorporate the lessons learned from the government’s less-than-ideal handling of COVID-19.
Too many Americans died from COVID because the public health community took too long to issue warnings, was slow to create tests to assess the situation, and was sluggish in shifting its response to fit the data on airborne transmission. The much-criticized lockdowns could have saved more lives had they been periodically adjusted as data changed on who was most at risk and which activities were riskiest.
Already, some of the same mistakes can be seen in the response to H5N1, which started in poultry before a new variant began infecting the nation’s dairy cows. The U.S. Department of Agriculture announced this month that it would start sampling the nation’s milk supply to test for the virus. But there’s a lot more that could be done to reduce the odds of this situation leading to a pandemic.
Moreover, President-elect Donald Trump’s picks to lead the nation’s top public health agencies — the officials who would be in charge of any pandemic response — have prompted concerns among scientists and health experts. They include Robert F. Kennedy Jr., a vaccine skeptic and raw milk enthusiast, for the top job of secretary of the Department of Health and Human Services.
Trump’s pick to run the Centers for Disease Control and Prevention, former Rep. Dave Weldon, pushed false theories about childhood vaccines as a member of Congress and was a critic of the CDC’s vaccine program. And to lead the National Institutes of Health, Trump has named Jay Bhattacharya, author of the “Great Barrington Declaration,” which criticized the government’s COVID response and promoted the theory — based on bad science — that the pandemic would end quickly through herd immunity.
There will be another pandemic at some point, said Michael Osterholm, an epidemiologist who has advised every president since Ronald Reagan and is now director of the University of Minnesota’s Center for Infectious Disease Research and Policy. “The pandemic clock is ticking. We just don’t know what time it is,” he said.
That means we should plan for the possibility. And we need something more detailed than the National Security Council playbook drawn up during the Obama administration and famously ignored by Trump.
It outlined organizing an initial pandemic response, such as connecting political leaders with scientific experts. But it didn’t include details for things like shutdowns, mask mandates or other measures taken during COVID. Osterholm said drafting a new plan should begin with a bipartisan investigation into how COVID-19 was handled — like the 9/11 commission. “Not to point fingers,” he told me, but to prepare for next time.
A new playbook should also consider long-term sustainability. Osterholm said data available in 2020 showed COVID was so easily transmissible that the pandemic could drag on for years. And yet, nobody wanted to hear it. A preparedness plan should also include more protection for essential workers and their families. During 2020, many people with known risk factors or elderly relatives at home were thrown into dangerous work situations.
The U.S. endured waves of deaths in the winter of 2020-21 when many Americans could no longer tolerate staying in their homes. Sustainability would matter even more if the next pandemic had a higher fatality rate.
While it’s often repeated that more than 1 million Americans died, we lack an analysis of how they got infected and how they were in harm’s way. It wasn’t about bad behavior but inadequate policy. Good policy is designed to work for human beings the way we are. With COVID, it was all created on the fly. It doesn’t have to be that way next time.
F.D. Flam is a Bloomberg Opinion columnist covering science.