How to Be Prepared for the Next Pandemic

The coronavirus pandemic was unavoidable, but did it need to be as bad as it was? According to Dr. Scott Gottlieb, a physician and former FDA commissioner, the answer is no.

As Dr. Gottlieb writes in his new book, Uncontrolled Spread: Why COVID-19 Crushed Us and How We Can Defeat the Next Pandemic, there were structural features of government that made the U.S. vulnerable to the pandemic — more so than the experts thought we would be.

One major problem early on was a lack of reliable information. It turned out the systems we had in place for gathering public health information and informing policymakers and consumers were inadequate for this crisis.

The Centers for Disease Control and Prevention, for example, was primarily tasked with collecting information, analyzing it, and articulating conclusions that could inform policy and the American people about how to reduce their risk. But the CDC is used to being the definitive word on a clinical question after months of analysis, not the first word in a crisis.

There’s certainly a need for deep, analytical thinking and peer-reviewed work, but at the onset of an unexpected, rapidly spreading pandemic, we need to make decisions in real time. Further, we need real-time data to inform actions that must be taken immediately. Here even partial information is better than no information.

What’s more, when the CDC did publish findings, they were often incomplete. Dr. Gottlieb cites one CDC study that examined what people who contracted COVID-19 did in the two weeks preceding their infection. The study concluded that eating at a restaurant is a risk factor for contracting COVID-19, except the agency failed to ask people if they ate indoors or outdoors. Moreover, the CDC grouped going to a bar and going to a restaurant in the same category. It doesn’t take a frequent bar-goer to recognize a big difference between the two.

This lack of reliable information led some of our nation’s top health experts, such as Drs. Anthony Fauci and Nancy Messonnier, to say in February 2020 that risk was low to Americans, our country’s containment efforts had been successful, and community transmission had not yet begun. We now know such claims were premature.

But, as Dr. Gottlieb explains, the biggest problem with our public health establishment’s early response to COVID-19 wasn’t that we didn’t know –but that we didn’t express enough humility about what we didn’t know.

Of course, China lied to the world about the early spread of COVID-19 and refused to share vital information with the U.S. The Chinese are no doubt responsible for many of our gaps in information and should be held accountable for the devastation caused by the pandemic.

However, there were flaws within our own system that amplified the damage. Among the most notable examples is the CDC, which was reluctant, if not hostile, to others developing COVID-19 tests. In fact, the agency didn’t want to give viral samples to other labs. Worse, if a manufacturer wanted to develop a diagnostic test, the CDC would bury the company in legal agreements, which were essentially meant to compel it to hand over the intellectual property rights to the test. The CDC was jealously guarding its turf and held back the development of tests.

The lesson here is clear: We need to get all aspects of society, especially the commercial manufacturers, involved early for such a fast-moving virus —especially when no one is prepared.

For months, the virus was highly regionalized. Having better testing earlier would have shown not only where the virus was spreading but also where it wasn’t spreading. That way, places where COVID-19 wasn’t rampant initially—such as Texas and Florida —could have targeted the disease differently and, to paraphrase Dr. Gottlieb, preserved the political capital that was required to implement lockdown measures.

In other words, Texans and Floridians had their freedoms restricted when the pandemic wasn’t even in their state. But when the virus did arrive, the people weren’t going to shut down again when they didn’t need to the first time. By not having testing to specialize the response to local conditions, political capital was wasted early on.

Perhaps most striking was seeing the degree to which our public health structures at every level have failed to modernize. COVID-19 exposed how parochial and in some ways pre-information age the systems are.

There clearly needs to be a discussion about governmental reforms —almost a 9/11 Commission-type review of what didn’t work, how to improve, and where to make key investments. We probably won’t have such a discussion until we get through this last bad wave of the virus, but the best time to make policy is when these ideas are fresh in our minds.

I discuss all these ideas with Dr. Gottlieb on a recent episode of my podcast, “Newt’s World.” But beyond all the doom and gloom of the last 18 months, Dr. Gottlieb also explains why there’s reason for optimism. We are now entering a stage of new, improved therapies that will help us prevent people from getting severe cases of COVID-19 beyond vaccines.

Soon, the virus will become endemic but manageable. We of course must remain vigilant — as we are with the flu — but there is no need to return to the dark days of lockdowns. Life will go on, and Americans will be able to enjoy their freedoms.