I'm angry in advance at the Biden administration for not preventing the next pandemic--a pandemic which experts warn could be anywhere from 1/10th to 10 times as deadly as Covid-19. I'm angry because I'm assuming that Biden's all-ivy-league roster of MD-PhDs are going to prepare for the post-Covid pandemic the same way their predecessors prepared for the post-H1N1 pandemic, which is to say not at all. It doesn't have to go that way. In this post I want to outline the handful of simple programs the Biden team needs to launch over the next three years to prove that my cynicism is petty and, more importantly, potentially save tens of millions of lives.
I doubt many Americans remember the H1N1 scare. I remember it because I was a new dad when it hit. Our newborn daughter was struggling to eat in her first weeks of life, losing weight and getting more frail with each passing day. During those weeks, the news and the Obama administration warned of a new virus that might or might not be the super lethal pandemic that experts had been predicting for decades. It turned out to be about as deadly as a mild flu season. We dodged a bullet. The Obama administration's response, therefore, was to do almost nothing to prepare for the next bullet.
They did do a couple things. They wrote a "playbook" for the next pandemic. And they created a new position that would coordinate responses to the next pandemic. Democrats have pointed to those two steps as proof that they would have handled the pandemic far better than Trump if they had been in power.
But have you read the Playbook? I have. It is a remarkable document for how few useful recommendations it contained -- even though the experience of H1N1 made a bunch of pandemic proofing actions perfectly obvious:
- Invest in industries to make masks, other PPE, and all the other medical supplies we ran out of and guarantee permanent demand with national stockpiles!
- Build a nationwide testing and tracing capacity!
- Prepare quarantine spaces so that potentially contagious people who don't need hospitalization can avoid spreading a new disease to family members and coworkers!
- Build a bigger, faster vaccine industrial complex so that we can start responding after weeks or months of identifying a new threat instead of a year. (A year was amazing progress! But if Covid-19 had been 10X as lethal, we'd have five million dead in the U.S. now. This is no time to rest on laurels.)
The closest the playbook got to a relevant recommendation was asking, but not answering, a few relevant questions such as:
Even if the Obama Playbook had been useful, we needed more than a playbook. We needed new things and systems to be built in the real, physical world, not in the world of policies, papers, and playbooks.
We needed, for example, new industries capable of building massive quantities of masks and other protective equipment, testing kits, vaccines, and all the chemicals, parts, and machines that feed into those production processes. Testing in the U.S. has been limited by shortages of gloves, plastic tips for pipettes, centrifuge tubes and other low-tech, easy-to-produce goods. This has cost us dearly. A handful of school districts stayed open through the Covid-19 pandemic by setting up weekly testing routines powered by local labs. I asked Edward Campbell, a virologist and school board member in a Chicago suburb who ran one of these programs why a system like his could not scale to the whole country. The culprit, he said, were the shortages of basic supplies needed for testing.
Those shortages could have been foreseen by the team responsible for the Playbook. They could have told the Obama administration what needed to be built. Obama could have gotten on TV after the H1N1 scared and told America what we needed to do to prevent the next, possibly much more deadly pandemic. Some Obama administration officials have blamed Republicans for blocking such preparations. But Obama never pushed it, and he never went to the voters and explained the urgency of the necessary preparations. How can we know Republicans would have blocked common sense preparations if Obama had used the bully pulpit to explain the threat to their voters?
Post-Covid, we no longer need to foresee what’s needed for pandemic proofing, because we have seen it. Now there is no question: We know we must build factories to produce all the medical and laboratory supplies that became scarce in the pandemic. We know we must stockpile those supplies, and keep stockpiling them all the way up until the next pandemic to keep the factories active. We currently do this for a long list of materials, parts, and machines that the military would need for the next world war--something far less likely than the next pandemic. Covid killed more Americans than World War II, we've had several outbreaks of deadly new viruses since World War II, and we know new ones will come more regularly in the future for several reasons, such as humans interacting more and more with populations of wild animals, like bats, that carry viruses that can infect humans.
Some on the Biden team might ask how it is possible for the U.S. government to build new industries, such as a mask industry. It’s very easy: Just give loans to existing companies to expand, and guarantee permanent demand by promising to purchase huge quantities of product for stockpiling. Who will give the loans? The U.S. government already has many loan programs up and running that could handle this, just pick one. At New Consensus, we’ve written about this in the context of general industrial policy, and we’ll be releasing papers in the future that talk specifically about how pandemic proofing investments could be funded.
Something that further clarifies the basic principles of 21st century pandemic prevention is the example set by dozens of countries, many with far fewer resources than the U.S., that stopped Covid dead in its tracks. If Vietnam could get through this pandemic with 35 deaths, we have no excuse for not matching their performance in the next pandemic. You can't credit un-American factors such as authoritarianism for their success. Taiwan, South Korea, Japan, and Australia are if anything less bureaucratically authoritarian than the United States. These nations learned lessons from SARS and had the foresight to create new, innovative capacities for fighting infectious diseases. Now that they've shown the way, we don't even need to innovate, we just need to build.
For all these reasons, the Biden team doesn't need a cutting edge, contrarian think tank like New Consensus to tell them what needs to be done. Mainstream voices--both expert and amateur--are all saying the same things. The topic of pandemic preparedness gives me a wonderful feeling of comfort and calm because all we have to say is, "Just do what Bill Gates says." No centrist needs to leave their comfort zone. Even though Bill Gates, the leader of the world's largest public health-oriented foundation, is wrong about pharmaceutical intellectual property, he's been advocating for all the obvious and sensible measures governments must take to prevent the next pandemic that I've covered in this post -- which, as he says, could be ten times more deadly than Covid-19.
Finally, all these pandemic prevention measures can be done for pennies compared to the trillions Biden recently transferred into the bank accounts of every middle and working class American.
If making America pandemic proof is a) obvious, b) simple, and c) cheap, then what possible reasons could there be for the Biden team not to implement them? There are no good reasons. The Biden team knows what they need to do, they know they can do it, but I believe that they probably will not do it -- based simply on observing many of them and their predecessors after similar crises in the past.
Over the past few months, the meritocracy has shown that it is capable of leaping into action and doing a good job when faced with an immediate crisis--as long as their friends and colleagues are aware of the crisis and are actively holding them accountable to solve it. If the Biden team had not sped up vaccinations from Trump's snail pace, they would have gotten a whole lot of flack at a whole lot of dinner parties. They would have gotten concerned and then angry emails from friends, family, and former professors. They would have been regarded as failures, in real time, by the people who they respect and care about the most.
Unfortunately, as things stand, that same force will not be present when it comes to proactive preparation for the next pandemic. Most people will forget about pandemic prevention as soon as they get vaccinated, just like they forgot all about it when H1N1 turned out not to be all that deadly.
That needs to change this time around. Educated professionals with ties to the Biden team are the only ones with the power to change it. If you’re one of them, write a concerned email today, just to put your friends on the inside on notice that you’re watching and waiting to see a pandemic proofing plan for America. If peers of the Biden team are aware that there is an easy way to prepare for the next pandemic, a way laid out by leaders as safe and moderate as Bill Gates, a way that has been implemented by nations with far fewer resources than ours, and let them know that there is no excuse for failure, then these things will get done.
Here’s a wacky idea: If Bill Gates really wants to prevent the next pandemic, he should fund a public awareness campaign directed at elites that will give the Biden team a simple choice between doing what needs to be done or lose the respect of their peers. I know it’s an unconventional idea but I’m dead serious about it. These people can’t tolerate being perceived as failures or slackers by their peers. I don't see any other way that we'll get the basic pandemic prevention measures enacted. Maybe in past times we could have relied on the media to hold them accountable. Not anymore.