In 2018, Bill Gates called for the world to funnel resources into pandemic preparedness. With his statement that “the world needs to prepare for pandemics in the same serious way it prepares for war,” Gates expressed an immediate urgency to prevent mass devastation. Just three months before the COVID-19 Pandemic emerged, the Global Preparedness Monitoring Board warned that a pandemic was brewing and immediate actions needed to be taken to avoid the disaster. Despite international warnings and extensive research, the COVID-19 Pandemic threw the world into shambles, halting life as we knew it: tearing apart families, leaving billions without jobs, and demolishing the education system, but still, at least we can say that we are lucky to face the consequences when millions were left with a much more devastating fate. As we pick up the pieces and recover from the pandemic, it is crucial to consider how nations, governments, and people can prepare for another pandemic. How can we be better prepared? What steps should we take? Are there ways the pandemic left the world more vulnerable to another wide-scale pandemic? 

Prior to the COVID-19 Pandemic, most preparedness efforts were funneled into influenza preparations. From international surveillance systems to analytic warning systems, global leaders thought they were well prepared for the pandemic. The United States was ranked the best-prepared country for a pandemic by The Global Health Security Index in 2019. According to the index, in 2019 there were more than 70 countries deemed incapable of detecting epidemics and 130 health systems unable to successfully combat an outbreak. Perhaps the world was unprepared, but it seems that the United States, along with other developed countries, should have been more successful with response efforts. Unfortunately, preparedness and responsiveness are two different things. Although it was within the capacity of the United States to form a coherent response to the COVID-19 Pandemic, its failure to do so indicates a corrosion of public trust in science and the intrusion of politics into pandemic response.

I recently attended a discussion with Dr. Bryan Lewis, a researcher at the Biocomplexity Institute at the University of Virginia whose work was crucial to shaping state policy decisions during the pandemic. He revealed that while the United States was technologically prepared, citizen reception of these methods was astoundingly low primarily due to the political distrust on both sides of our divided government. One of the biggest flaws in the U.S. response to the pandemic was the lack of urgency in research implementation and testing strategies. For example, the massive network of premier research centers could have been used for diagnosis and infection analysis. A sluggish testing rate and slow processing times allowed for a silent spread of the disease. This reaction was in part due to the extreme political influence on response strategies with, “Republicans express[ing] support for COVID‐19 measures that invest the federal government with strong national control, [and] Democrats support[ing] welfare‐oriented policies.” Furthermore, the viewpoints espoused by the Republican government led to a rise in COVID-fueled disparities which impacted the scope of measures taken. The lack of an effective response took an enormous toll on American citizens, with an overall two-year drop in life expectancy and deaths exceeding one million at the height of the pandemic.

It is important to learn from both the shortcomings and the successes of the United States government during the COVID-19 Pandemic and ensure that more thought, money, and resources are put into public health and pandemic readiness. This is especially crucial as it is likely that the world will see another pandemic. According to a study published in the scientific journal Nature, “Evidence suggests the probability of another pandemic occurring within one’s lifetime is roughly 17% and may even grow to 44% within the next couple decades.” A leading cause is climate change, as high temperatures are melting layers of permafrost and breaking ice sheets that have preserved dormant viruses and other pathogens with the potential to infect the world.

Fortunately, many global entities have implemented new processes to enhance preparedness and restock many resources used during the pandemic. The World Health Organization’s Pandemic Treaty and International Pathogen Surveillance Network hopes to create a global surveillance system to ensure that potential cases of concern are discovered early and that nations are more transparent with one another. In response to the vaccine shortage which crippled many low- and middle-income countries, organizations such as COVAX mediated vaccine distribution, but ambiguous policies sidetracked progress. To facilitate better distribution, it is crucial to engage in global discussion regarding intellectual property waivers and promote a shared knowledge system for vaccine manufacturing.  

There is still a long path ahead, and in some ways, the world is even less prepared now than it was before the COVID-19 Pandemic. As a result of the stringent conditions, global mental health has declined by 25%. Additionally, psychological pandemic fatigue and a lack of motivation to comply with future safety measures present a challenge for adequate disease mitigation. 

Unfortunately, there has been an overall decline in trust in the American healthcare system and a weakened global health system. Especially in the United States, a lack of trust was fueled by a high level of political polarity, which persists. A Gallup poll in 2022 demonstrated the impact of partisanship in the United States on vaccine acceptance with 40% of Republicans stating that they do not plan to get the Covid-19 vaccine compared to only 3% of surveyed Democrats. This politically-fueled divide in trust is primarily due to the Trump Administration using the COVID-19 pandemic to brew displeasure regarding the Democratic Party. Trump contradicted globally-accepted scientific information throughout the pandemic, ranging from falsely claiming that “99% of COVID-19 cases are totally harmless,” to blocking leading National Institute of Health disease expert Dr. Anthony Fauci from testifying about the U.S. Pandemic Response.  A Pew Research poll from November 2023 found that only 11% of Republican or Republican-leaning adults had “a great deal” of trust in the scientific community, compared to nearly 40% of Democrats. Interestingly, the trust in scientists increased among Democrats during the first year of the pandemic, while it dropped significantly among Republicans. While all American adults have reported lower faith in science over the past few years, the more pronounced Republican decline is a result of their most central beliefs. What started originally as a desire for limited government and a belief in the free market has morphed into a distrust and fear of any and all government interventions, recently spilling into a distrust of scientists as well. Many forms of scientific skepticism, from the anti-vax movement to climate change denialism, have been grounded in fears of “Big Government” and a descent into socialism. These fears have only been propagated during the past few years and especially under Trump’s presence in politics, especially due to his rhetoric regarding the government and the so-called “deep state”.

While countries are taking strides to mend gaps in the system and restock depleted resources, focusing on the short-term bandage to the effects of the pandemic may lead to neglect of long-term preparedness. During the pandemic, government efforts were made to expand access to healthcare in the most rural parts of the nation. The Centers for Medicare & Medicaid Services (CMS) issued waivers to expand telehealth services which gave access to millions of Americans who just do not live close enough to a quality medical center. Unfortunately, these efforts, which have the potential to make a huge impact on healthcare equity and future pandemic preparedness, were rolled back once the pandemic ended. Another effort that has the potential to improve the nation's health are the telehealth vans deployed across the country during the pandemic to give people easy access to vaccinations and COVID-19 testing. Initiatives passed as a response to COVID-19 attributed to the Mobile Healthcare Association seeing a 30% funding increase in 2023, and it is crucial to maintain this and provide ongoing resources to support mobile healthcare. 

The Biden Administration funneled resources into constructing a path of pandemic resilience with grand claims such as this statement made by President Biden: “We’re not going to solve this crisis with half-measures or middle-of-the-road ambitions. We need to go big. And we need to do our part: governments, the private sector, civil society leaders, philanthropists.” As the United States transitions back to a term governed by the GOP and led by President Trump, pandemic response progress looks bleak. 

Pandemic preparedness means walking a fine line between meeting current needs and ensuring enough resources to respond to potential future needs. At the foremost, nations must prioritize health equity and global access and avoid an over-reliance on technological solutions while finding a balance between individual freedoms and public health security. 

Pandemic preparedness requires constant monitoring and actions at a public and bureaucratic level. One of the most simple, yet often the most effective efforts is simply increasing infectious disease control and hygienic practice education in schools, workplaces, and medical clinics/hospitals. Furthermore, these locations can serve as vaccine distribution sites that are more accessible to rural and underprivileged areas in the United States. The efficiency of these education campaigns, as well as vaccine distribution efforts, should be enhanced through the use of data simulation models. Furthermore, modeling is a low-resource way to validate different policy implementations and ensure optimal impact. The current political climate implements federally unified healthcare initiatives as difficult as the newly elected GOP pushes for state-led policy initiatives. As seen in the COVID-19 pandemic, a lack of policy unification throughout the country led to major neglect of lower-income areas and served as a barrier to achieving herd immunity crucial for the recovery of the country.                   

The glaring inadequacy of America’s approach to pandemic response was not a lack of vaccine resources, nor a hole in distribution infrastructure, but rather a minimal level of adoption of pandemic safety guidelines. The United States  ranked 175 of 195 in healthcare access and received a 0 in public confidence in the government. Future preparation for the pandemic should work towards raising awareness about general hygiene, pandemic response protocols, and vaccination procedures to help better educate the general population about pandemic response strategies. Furthermore, the United States must develop a large-scale and elaborate testing and contact tracing system that can be immediately implemented if the need arises again.