[2]

The United States has weakened its public health infrastructure even as the likelihood of a new pandemic is high. Above, a health worker at an Ebola isolation ward in Kabala, Sierra Leone, in 2014. Photo [3]: United Nations Photo/Martine Perret via Flickr Creative Commons (CC BY-NC-ND 2.0 [4]).

Backgrounder: Are We Ready for the Next Pandemic?

By Joseph A. Davis

The world is worrying about fast-spreading viruses like Ebola — the latest outbreak in Africa has killed more than 2,000 as of this writing, an underestimate because it’s spreading so fast [5]. But is it prepared for coming pandemics? Spoiler alert: not even close!

Let’s take a step back. When Donald Trump took over the White House the first time, he quickly threw away the plan [6] set up by the Obama White House for dealing with the next pandemic. Then in the winter of 2019-2020, the COVID-19 pandemic started.

 

Trump kept downplaying

COVID-19, even as he

got to be on television

almost every day.

 

Trump started out by telling CNBC that January: “It’s one person coming in from China. We have it under control. It’s going to be just fine.” He kept downplaying it in later months, even as he got to be on television almost every day.

By the end, more than a million Americans died [7] and nearly 15 million [8] worldwide.

So much for pandemic preparedness.

Initial COVID-19 response

Scientists at a government lab developing methods to detect foodborne parasites, such as Cyclospora. Photo [9]: U.S. Food and Drug Administration/Michael J. Ermarth via Flickr Creative Commons (United States government work [10])

The U.S. Centers for Disease Control and Prevention was, back then, the home of the world’s foremost experts in pandemic prevention, preparedness and response. And CDC experts were a mainstay of the World Health Organization, the global backstop.

In February of 2020, Trump had put Vice President Mike Pence in charge of U.S. pandemic response (despite Pence’s lack of any medical background). 

By mid-March, Trump had begun almost-daily news conferences meant to convince a panicking public that he had the crisis under control — and that it wasn’t even a crisis. Trump himself took center stage at many of these pressers. Health science leaders like Dr. Anthony Fauci — not so much, or at least not so often.

Trump offered his own expertise to the medical doctors at an April 23 briefing [11], in which he speculated about whether UV light could be brought “inside the body” to knock out the virus “in a cleaning.”

The public health doctors looked really embarrassed. The late-night comedians (we imagine) grinned. Fact-checker Snopes [12] had to caution that Trump did not actually suggest injecting bleach.

Vaccine breakthrough

To be fair, Trump could plausibly claim credit for doing one thing right: his support for Operation Warp Speed [13], the federal-private crash program to develop a vaccine. It got the OK to start giving people shots in December 2020 under an emergency authorization.

Not only was that some kind of world speed record — it was a revolutionary validation of a breakthrough technology: mRNA vaccines [14]. It’s too complex to explain here — but basically the vaccine presents the body with partial genetic material (harmless) that fools viruses into thinking it recognizes a real virus and into making real protective antibodies.

 

The mRNA technology had been

experimental, but epidemiologists

saw that this was the right time

to take the plunge.

 

The technology had been experimental for a decade or more, but epidemiologists saw that this was the right time to take the plunge. That’s why it was developed so fast. The potential benefits clearly outweighed any possible harm. The vaccines saved hundreds of millions of lives.

But it seems Trump learned nothing. He appointed an anti-vaxxer, Robert F. Kennedy Jr., to be his second-term Health secretary, and Kennedy promptly cut most federal funds for mRNA [15] vaccines. 

And RFK Jr., who did not really believe in medical science (as opposed to, say, raw milk or swimming in polluted streams), finally had a chance to poleaxe most federal public health efforts — and got to run the CDC. 

Funding for other vaccine programs, especially research, was cut back, delayed or eliminated altogether. So nobody could show him evidence that vaccines (or modern medicine) worked. 

The full story of the destruction of the CDC — and medical research funding it — is much longer and more complex than we can go into here. Fortunately, science journalist Jon Cohen [16] (who writes for Science magazine as well as many others) has produced at least one book on the subject: “Planning Miracles: How to Prevent Future Pandemics. [17]” It was summarized in an article in Science [18], which is also too long to summarize, but tells you all you want to know.

Public health infrastructure weakened

Pandemic prevention in the U.S. had, for decades, been centered in the staff of the CDC: Its large and top-rung staff (researchers and contact-tracers alike) were the best in the world, called on by other countries and the World Health Organization in outbreaks like the rare Bundibugyo virus ravaging Africa with Ebola right now. 

Yes, CDC staff are in the Democratic Republic of the Congo and Congo right now. But not many, you see — because of Trump-Kennedy layoffs.

Potentially, U.S. pandemic preparedness involves a bunch of other agencies. Or could. The U.S. Agency for International Development used to be one of them — at least before Trump and Elon Musk abolished it. 

Leaving out USAID, others have included the National Security Council, the (nongovernmental) National Health Council, the Defense Department, the State Department, the Agriculture Department, the National Institutes of Health, and the Health and Human Services Department generally. And more.

In the wake of Trump’s response to COVID-19, Joe Biden’s administration came up with its own pandemic preparedness plan [19] before he left the White House. But Trump, upon entering office for the second time, threw that out too [20] — and withdrew the U.S. from the WHO, which he blamed for the COVID-19 pandemic. 

 

Trump, Kennedy and the

GOP-controlled Congress

have weakened much of the

public health infrastructure as well.

 

Since then, Trump, Kennedy and the GOP-controlled Congress have weakened and reduced not just CDC but much of the U.S. public health infrastructure as well. Advisory committees were disbanded and replaced [21] with Kennedy think-alikes. That kind of thing. 

Trump’s third nominee to head the CDC, Dr. Erica Schwartz, had a hard time convincing senators at her July 15 confirmation hearing [22] that she would not “betray the science.” The Senate confirmed her [23] in August.

Coming threats

Here’s the thing. Forget Ebola for just a minute. There’s also bird flu, a virus that is still bouncing around among all kinds of species from penguins to sea lions [24]. And, yes: causing the occasional human death [25]. Occasional at least so far. We hope. 

It’s a kissing cousin of other viruses like influenza A virus subtype H7N9 [26] that have, in recent years, started to become epidemic. Did we mention that viruses mutate far more readily than other microbes? Which is why they can turn from bat-hosting to human-killing in a sneeze.

Forgetting Ebola again, we could urge journalists to occasionally browse the journal, Emerging Infectious Diseases [27], in their copious spare time. It’s full of horrors.

It was public health nerds like those at CDC and WHO who eradicated the scourge of smallpox. We in the U.S. were about to [28] declare measles (easily controlled by vaccine and sometimes deadly) gone from the United States — until our Kennedy anti-vax era witnessed a resurgence. Last we looked, the current number [29] of U.S. measles cases had climbed to more than 2,500.

 

You don’t have to read a book

like ‘The Coming Plague’ to

understand the threat of

the next pandemic.

 

You don’t have to read a book like Laurie Garrett’s “The Coming Plague [30]” to understand the threat of the next pandemic. But if you think we are ready for it already, think about the pain and human devastation from diseases caused by viruses like Zika, chikungunya, Marburg, hantavirus, dengue, mpox, Nipah and others. 

This summer, we are getting the Cyclospora parasite and Legionella bacteria (not viruses, but still outbreaks). And shuddering at mosquitoes and ticks. Best estimate: The evolution of the next pandemic is coming before we will be ready for it.

Joseph A. Davis [31] is a freelance writer/editor in Washington, D.C. who has been writing about the environment since 1976. He writes SEJournal Online's TipSheet [32], Reporter's Toolbox [33] and Issue Backgrounder [2], and curates SEJ's weekday news headlines service EJToday [34] and @EJTodayNews [35]. Davis also directs SEJ's Freedom of Information Project and writes the WatchDog [36] opinion column.

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* From the weekly news magazine SEJournal Online, Vol. 11, No. 29. Content from each new issue of SEJournal Online is available to the public via the SEJournal Online main page [37]. Subscribe to the e-newsletter here [38]. And see past issues of the SEJournal archived here [37].