Health
Is the US Prepared for the Next Pandemic? Learning Lessons From COVID-19
More than 1.2 million Americans have died from COVID-19.
Despite having one of the most sophisticated health care systems in the world, the U.S. response to the coronavirus pandemic fell well short when compared to other developed nations.
So, five years after the World Health Organization declared a global pandemic, is the United States any better prepared to weather the next pandemic?
The good news is that we have “learned quite a bit,” according to Dr. Robert Murphy, executive director of the Institute for Global Health at Northwestern University’s Feinberg School of Medicine.
“We learned how fast this thing can spread if it’s a respiratory infection that transmits as easily as COVID does,” said Murphy, noting that “nobody predicted 1.2 million people dying in the United States.”
Murphy said that in one study that compared the U.S. response to the pandemic to that of other high-income countries, “the U.S. was 19th out of 20 in terms of death rates. The only country that had a higher death rate was Slovakia.”
A key reason for better health outcomes in other highly developed nations was that other countries had a more uniform approach to public health policy than in the United States — where mixed messages from federal, state and local authorities often confused the public, Murphy said.
But one area of success that the United States can be proud of is the speed with which effective vaccines were developed. Murphy said that at the onset of the pandemic, most experts predicted a vaccine would not be available until late 2021 at the earliest.
“It ended up being in December 2020,” Murphy said. “It was like one year ahead of the schedule that anybody predicted.”
That speed was in large part because of the development of mRNA technology over the previous 20 years that laid the foundation for creating vaccines rapidly.
“The mRNA technology was really something that caught everybody off guard by how easy it was to not only make the vaccine but then subsequently even alter the vaccine to adapt to the changing virus in the communities,” Murphy said.
Attempting to learn the lessons of the pandemic, the Illinois Department of Public Health in May 2024 issued an after-action report, which according to IDPH Director Dr. Sameer Vohra, was intended to create a kind of pandemic playbook for future administrations.
Vohra said there were three key takeaways.
First, was the recognition that Illinois needed to develop a structure to allow for private and public health systems in the state to come together in the event of an emergency “so that we’re not just depending on the federal government.”
Two, the need to develop technologies to provide health care officials with “immediate actionable data.”
And third, thinking about how better to engage communities and develop trust — especially in previously marginalized communities.
Communities of color were especially hard hit by the pandemic — and that was entirely to be expected and was predicted, according to Dr. Garth Walker, chief medical officer of Rush Health at Rush University Medical Center.
“Unfortunately, as soon as COVID-19 hit, it highlighted what was a weakness in our health care system to protect our most marginalized,” said Walker, who during the pandemic was deputy director at IDPH.
Walker noted that during the pandemic many people from Black and Latino communities were designated as “essential workers” and still had to go out in the community. In addition, many lived in homes with multiple generations present in crowded conditions.
“They could not distance, and they could not protect themselves to a certain degree,” Walker said. “Frankly, managing families who are in dense environments — that had cross-generational families that frankly just needed a better opportunity to be able to protect their most vulnerable, maybe a grandmother, maybe somebody that’s dealing with multiple chronic conditions, but that couldn’t based on their socioeconomic status.”
The pandemic also highlighted the challenge of trying to keep people healthy who have high rates of chronic conditions such as obesity or diabetes with little access to primary health care, Walker said.
“Add all of those factors together and it was a very difficult time to protect family members in our most marginalized communities,” said Walker.
According to Murphy, perhaps the biggest mistake made by health authorities during the pandemic were some of the draconian and at times contradictory restrictions placed upon people.
“We allowed people to go to stores with fewer people in the stores, so they weren’t so crowded, but we allowed them to go in there and to have the people at the checkout counters and the people stocking the shelves in there just with everybody else wearing a regular mask,” Murphy said. “And yet we wouldn’t let people go into a nursing home with a mask to be with their dying relative, and people remember that. It just was a terrible thing. So that was a mistake. They should have allowed people to visit their sick relatives. … That was a little bit too strict considering that we were letting people work at gas stations and people work in grocery stores and the like.”
As medical professionals ponder how to deal with the next pandemic, of immediate concern is President Donald Trump’s decision to withdraw the United States from the World Health Organization and the apparently indiscriminate cuts being made to the federal workforce, including at the Centers for Disease Control and Prevention and at the National Institutes of Health.
“The COVID-19 pandemic showed us we are an interconnected United States and world, and we have to do everything in our power to maintain those important global relationships to ensure that we are taking every precaution to protect our residents here in Illinois,” said Vohra.
The dissemination of vaccine misinformation — including from the likes of new U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. —- remains a major concern because if people ignore the science, then the best medical treatments and health guidance are worthless.
“If we have another infection come along as lethal as the COVID, we’re going to still do 19 or 20 out of the top 20 countries because basically half the country’s not going to take any precautions,” Murphy said. “And that’s what’s going to happen — and they’ll die.”
