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The imperative for pandemic preparedness

This piece reflects the opinions of the author.

As of December 6, 2021, COVID-19 has taken nearly 800,000 in the U.S. Globally, over 5.25 million deaths have been reported to the WHO, with the true total likely surpassing that number by millions. The damage is striking. Economically, the pandemic destroyed 9.5 years of job growth and raised the unemployment rate to 14.8%, a high not seen in the U.S. since 1948. From 2019 to 2020 the United States’s GDP shrunk by nearly 3.5%, the largest decrease since 1946. The rate of reported anxiety/depressive disorders rose from 1 in 10 adults to 4 in 10 adults experiencing symptoms.

Additionally, in the field of U.S. research and development, from February to May 2020, 43% of projects that were scheduled to begin did not. The pandemic also made cancer survivors 20% less likely to enroll in a clinical trial, which will cause ripple effects for years to come. This pandemic wreaked havoc on American lives, our nation, and the world, and it is vital we prevent this from happening again.

The last year has been a process of adjusting to a new normal, trying to regain equilibrium. This time last year a vaccine was not yet available, travel was restricted, and many spent the holiday season away from loved ones in order to protect their communities. As we approach two years of living with COVID-19, it is important to reflect on lessons learned to ensure we are prepared for future health crises. 

Never again should the United States be caught so flat-footed in the face of a global pandemic. Adequate preparation is not only possible, it is a necessity as we move forward, but it’s clear we have a long way to go. We cannot let this policy window close and allow other priorities to emerge and overshadow the importance of funding proper pandemic preparedness.

Past funding and planning for pandemic preparedness in the United States has largely been limited to influenza preparedness. While this is a very important component of comprehensive pandemic preparedness planning, influenza is only one of many viral threats that can spur a pandemic. Former FDA Commissioner Scott Gottlieb captures this view in his book Uncontrolled Spread:

“Even if a disease like COVID could have been foreseen, we still wouldn’t have been ready for it. We needed an approach that prepared us for unforeseen risks and focused on establishing core capabilities…We shouldn’t accept that we’ll be able to anticipate the next threat or that even a predictable risk (like a pandemic strain of the flu) won’t adapt in some sinister way that allows it to slip past out countermeasures.”

A critical starting point to bolstering public health preparedness is increased resources. In 2019, the National Health Expenditure, a statistic that captures both private sector and government health spending, grew to $3.8 trillion dollars; an American Journal of Public Health study showed only 1.5% of health care spending was used toward public health, highlighting how the U.S. greatly undervalues public health..

In the House version of the “Build Back Better” reconciliation package, $1.3 billion is allocated under the line item for “Public Health and Preparedness Research, Development, and Countermeasure Capacity.” These funds would be set aside:

“To prepare for, and respond to, public health emergencies, including supporting surge capacity; supporting expanded global and domestic vaccine production capacity; supporting activities to mitigate supply chain risks and enhance supply chain elasticity and resilience; supporting activities conducted by the Biomedical Advanced Research and Development Authority; and supporting increased biosafety and biosecurity in research on infectious diseases.” 

While ensuring financial resources to support the response of recovery from COVID-19 is a step in the right direction, the proposed amount is only 4.3% of the original ask of $30 billion. This package isn’t sufficient for the development of sustainable public health preparation efforts and infrastructure. If we don’t allocate adequate funding now to prevent the next pandemic while COVID-19 is still ongoing, it is unlikely funding will increase in a few years when the pandemic is further from our minds.

Another pandemic is a question of when, not if. This sentiment is supported by numerous leaders in public health around the globe. We need to use our time wisely, and procure adequate funding, enact proactive policy, and build flexible infrastructure that will enable us to weather future public health emergencies better than the current one. It was unacceptable to lose nearly 800,000 American lives to COVID-19, it would be an atrocity to let anything similar happen again.

Caterina DiBiase is a Science Communications Intern at Research!America.