What to do Differently when the Next Pandemic Hits
Lessons learned from two years of Covid-19.
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I usually talk about money, and this column is no different. But today I’m also talking about public health policy with the help of an expert, because even though we may not be able to prevent another pandemic, we can certainly improve our response.
I have a dust-covered desk inside the CNBC Los Angeles bureau on the Universal lot that I haven’t seen since March 13, 2020. I haven’t seen my grandson in Japan since November 2019, and I’ve never met my granddaughter, who was born there last June. Thankfully, everyone is healthy.
Looking back two years ago, here’s the first Covid-related story I covered. It was February 6, 2020, as San Francisco was moving forward with plans to celebrate the Chinese New Year in Chinatown.
That feels like ten years ago, not two. I’m not going to bore you with the details of how bad Covid has been, the six million people around the world who’ve died, or the $12.5 trillion impact on the global economy. You already know that.
Instead, I’m looking forward. The next time we have a pandemic — and there will be a next time — what might we do differently to achieve better outcomes? What investments should we make now? Where should we deploy resources? How can politicians and health officials do better? How can we do better?
Another 100 Years?
“I don’t think it’s going to be 100 years for whatever comes around next time,” says Dr. James Hamblin, a physician and journalist who specializes in public health and preventive medicine. He also writes “The Body” for Bulletin.
Jim (I’m calling him Jim because even though he’s a brilliant physician, I’m old enough to be his mother) says he first realized Covid-19 was going to be an immense problem as he watched it spread in China. “They were building these huge field hospitals and massive structures,” he tells me. “Just looking at their caseload, something was clearly spreading really very aggressively, and we were not getting all the information about it.”
Then Covid showed up in other countries. In late February, 2020, Jim wrote an article for The Atlantic titled, “You’re Likely to Get the Coronavirus.”
“With its potent mix of characteristics, this virus is unlike most that capture popular attention: It is deadly, but not too deadly. It makes people sick, but not in predictable, uniquely identifiable ways. Last week, 14 Americans tested positive on a cruise ship in Japan despite feeling fine — the new virus may be most dangerous because, it seems, it may sometimes cause no symptoms at all.”
We still had a lot to learn.
Good news! We‘ve since learned a lot! And here’s what Jim says we should do next time.
— Separation of Science and State
Much like we separate church and state (or we’re supposed to), Jim suggests we separate the medical information coming out of the scientific community from the policy decisions being made about things like masks and closing schools.
The problem with both U.S. presidents who’ve governed amid this pandemic is that they lumped science and policy together. They’re still lumping. “It gets all mixed up,” Jim says.
He explains that under the Trump administration, there was “a lot of contradiction“ in Covid messaging. “[Anthony] Fauci said one thing, and [former CDC chief Robert] Redfield would say something else, and Trump would say something else, and people didn’t quite know what to make of things.”
Under the Biden administration, everyone’s on the same page. “Insofar as they’ve succeeded in that, they have also been slow to respond, because it takes time for people to reach a consensus,” Jim tells me, “and I think that’s been frustrating to people, too.”
Jim suggests that next pandemic, officials hold frequent press conferences, much like the Trump administration did at the beginning of Covid, but in these new pressers, scientists present the latest information — “Here’s the facts: There’s a variant, it’s going to spread at this rate, and at our current vaccination levels, we expect this.” Then the scientists would step aside and policy-making leaders would lay out next steps. “What do we do about this? Maybe we close schools, or not.”
You’d separate the science from the policies.
Jim compares this separation to weather reports. “You get a warning from the National Weather Service, ‘There’s a hurricane coming.’” Weather forecasters report this as a scientific fact. But it’s up to local officials to decide whether to issue an evacuation order — not the meteorologist, who’s just telling you the science. You could disagree with authorities and ignore the evacuation order, but you don’t deny there’s a hurricane.
The same approach to a pandemic might help more people trust the science and the scientists. Jim says the current blurring of lines has too many people blurring their opinions between policy and the disease. “If you don’t like masks, you don’t like closing schools,” he says, “then you reverse-engineer this story [to] ‘The variant must not be that dangerous.’”
— No End Dates
Telling everyone in March 2020 that we needed to shut the country down for a couple of weeks to “bend the curve” turned out to be a dumb idea. “It was just wrong, from the start,” says Jim. “And I think that is what has led to so much frustration.”
The rolling deadlines certainly frustrated him. Promises that the country would be open by Easter — “the churches will be packed” — damaged trust in public officials.
Jim says next time, political leaders should set honest expectations, decline to make concrete predictions, and not issue end dates. “Everyone wants timelines, but this virus defies them.”
— More Communication More Often
Jim thinks next time there should be more communication, and more two-way communication.
“I would have town halls,” he says, with “a big, diverse group of people who can speak to all sorts of different concerns, and [who] don’t seem like they’re pushing an agenda.” He thinks this would help those who disagree with the policies “feel heard and seen,” because people who don’t like the government’s actions “have been dismissed, have been mocked.”
— The Mask Thing
What a disaster, right? The messaging on masks was all over the place, and masks became political weapons. First we didn’t need a mask, then we did, then it had to be a certain kind of mask, then maybe the mask didn’t protect against Omicron, then maybe masks were useless.
I pity the poor food servers and flight attendants who’ve been turned into the Mask Police.
“It is actually impossible to implement a mandate if people are not on board with it,” Jim says. He says it’s not like the federal government deciding to build a highway, “where it’s just there,” and you have to deal with it.
Telling Americans they have to do something usually backfires. Perhaps it would be better to encourage best practices (and consistently model those practices, which Governor Gavin Newsom did not do). In contrast to masks, nobody was forced to use hand sanitizer — there was no ”hand sanitizer mandate” — but I bet Americans’ hands have never been cleaner.
— Incentivize Cures: “Vaccines are not generally high profit-margin products.”
Operation Warp Speed was an amazing bet by the government, as it funded potential vaccines from a half dozen companies. The results are nothing short of astounding.
But…
“It’s really unfortunate that it didn’t start a decade ago,” Jim tells me, bursting my bubble of appreciation for America’s can-do spirit.
Why didn’t we start earlier? Jim points out something I never thought about. “Vaccines are not generally high profit-margin products, so a lot has to be done to incentivize companies to take on the research and development to make them.” That’s because they’re a CURE. They’re usually a one-and-done.
“Every drug company wants a product that people are taking every day for the rest of their life, right?” he continues. That’s why there’s so much investment in cholesterol drugs, or blood pressure medications, or antidepressants, or Viagra.
Fortunately, because of Covid, vaccines have gone from worst to first. In fact, the Financial Times reports that Moderna believes all of us may need an annual coronavirus booster, just like the flu, allowing the vaccine to become both the cure and a continuing treatment.
Jim’s not so sure. He says there’s a lot of momentum to create a universal coronavirus vaccine, “but if this pandemic fades and our vaccines hold up, they’ll stop producing them.”
Unless we incentivize someone to keep at it. And that probably means support from the government (i.e., taxpayers).
— Be Global
The U.S. was fantastic at ramping up and making vaccines for Americans, but Jim says we haven’t been a very good neighbor when it came to helping others, and it hurt us. “That’s the reason we have so many variants.”
We also punished South Africa with a travel ban after that country did the right thing and warned everyone about Omicron. Jim says the ban continued “until well after the U.S. was the center of the Omicron outbreak.”
He says that during the next pandemic, “Any country that finds something concerning needs to be able to raise a flag and be thanked, be supported.” That’s not to say you don’t also slap on a travel ban, “but it [also] means you’re giving that country resources, you’re sending supplies and doctors and doing everything you can, and lifting the travel ban as soon as there’s no basis for it.”
— Be Compassionate
I’ve been quick to judge people whose outlook differs from mine on the virus, masks, and vaccines. Sometimes I judge them harshly. Families are divided; friendships have been destroyed.
We didn’t used to be so polarized. Back in the days of the polio vaccine, there was no question over whether it worked. But now there’s a lack of trust in government, in science, in policy, and in each other. I believe in a healthy dose of skepticism, and public officials can seldom be taken at their word, but I agree with Jim when he says that the current divide is exacerbated by “a lot of people who are willing to sow discord and profit from the attention that they get.”
This goes beyond the pandemic to the heart of our culture. I hope there comes a time when we are willing to be more open-minded, when officials are more transparent with us, and when we feel more confident that we have both facts and choices.
Maybe by the next pandemic…
I’m sure you have opinions about this, so please join the discussion below. You can always reach me on social media (where I’m a lot funnier, by the way) — follow me on Twitter, Facebook, Instagram, and LinkedIn.
Cover photo by SDI Productions/Getty Images