How To Beat The Next Pandemic

 


Photo by Branimir Balogović | Unsplash

Photo by Branimir Balogović | Unsplash

With light visible at the end of this pandemic’s achingly long tunnel, now’s the time for a candid assessment of what we’ve learned.

Pandemic preparedness must be our first national security imperative.

More people die from viruses than all types of war and violence combined. So we need to get organized as if on war footing for the long term.

It’s a disgrace that we weren’t ready with ample quantities of vaccines immediately upon their approval and that our distribution system was unorganized.

For future pandemics, there needs to be a clear supply chain for the manufacturing of a vaccine that can be activated as soon as a threat is identified, and ramped up while the vaccine is in the clinical trial stage so that adequate doses are ready as soon as there is FDA approval.

There also needs to be a clear distribution plan so that once the vaccine is tested and approved by FDA, millions of doses can be administered without delay.

The FDA needs to be more flexible.

Thousands of lives could have been saved if the FDA had applied common sense to the vaccine rollout.

While the Moderna and Pfizer vaccines had clinical trials predicated on two doses, it was evident early on that compared to a placebo, one dose was around 80% effective, as against about 95% for two doses.

The smart strategy, employed by the United Kingdom and a few other nations, is to space the doses at roughly four-month intervals, allowing many more people to be protected much sooner.

A little math shows the folly of the FDA’s decision not to allow greater dose-spacing, at least with the vast majority of the adult population.

If we have 200 doses available and give two shots to 100 people we’ll have 100 people covered to 95% effectiveness. If we give 200 people one shot we’ll have 200 people covered to 80% effectiveness. They can get the second shot later, which also permits them to be covered for longer. That’s a big part of how the British got the virus under control. Their confirmed COVID-19 rate is about 20% of ours and they seem on the verge of herd immunity. Our current strategy minimizes the effectiveness of our vaccine supply, sacrificing health and lives. It ought to be changed right now to save lives right now.

Political decisions should be made by elected officials.

Throughout the pandemic, CDC epidemiologists have grabbed the mantle of political leadership, ordering national behavior.

But they were elected by no one, were focused mostly on the statistics around spread, and not on the ripple effect in our communities of depression, violence, and suicide, as well as staggering losses in education, the economy, and health care. Progress has been retarded in every facet of life. Emptying our streets and sidewalks of human activity has been an incalculable tragedy, rippling in unforeseen dimensions.

It contributed to urban unrest and has hollowed out our cities and towns like a neutron bomb, leaving behind buildings but not people. The scars — both visible and psychic — will never fully heal. We can’t let that happen again. Policy needs to be set by people responsible to the electorate.

Governors must share power with their legislatures.

Long ago, states passed emergency powers statutes reposing enormous power in the hands of governors in times of sudden crisis.

That makes sense in the immediate response to a monumental natural disaster or unthinkable act of war, when there’s no time for reflective representative democracy.

But soon after the pandemic started, governors should have shared power with legislatures, which more closely represent the will of the people.

Instead, governors have ruled by nearly unreviewable fiat not seen on our soil since before we declared our independence from a faraway king.

While well-intentioned, governors have vastly exceeded their intended authority by (1) dispensing special privileges and immunities, (2) favoring some commercial actors over others, and (3) favoring some types of gatherings over others.

When legislatures have sought to intervene, governors have vetoed, thereby maintaining their plenary power.  The courts have mostly stayed out of it, though the US Supreme Court has begun to fashion limits.  

Structural reform is necessary. The mid- and long-term response to an emergency should be based on the existing American political framework of three-branched government, with its vaunted checks and balances.

The emergency powers statutes need to be overhauled by legislative action, state constitutional revision or judicial review so executive branch excesses may be curtailed.

Politics should stop at the pandemic’s edge

In the mid-20th century, Senate Foreign Relations Chair Arthur Vandenberg said that “politics stops at the water’s edge.” He cooperated with his president of the opposite party for the good of the nation.
That sentiment has mostly guided American foreign policy for the last three generations, to great effect.

When the pandemic arose, Democrats saw it as an opportunity to sharpen the argument for the defeat of President Trump. The president assisted, by repeatedly minimizing the danger, which helped lead to his defeat.

It’s no accident that pandemic politics flowed down ballot. Gubernatorial policies fit into tribalism — Democrats more restrictive, Republicans more open. The virus doesn’t distinguish red from blue, but you wouldn’t know that while traveling from state to state, which even now are open or closed in disturbing correlation to political affiliation.

That needs to end. Our recovery from the pandemic is too fragile to be sacrificed on the altar of political gain.

The electorate should revolt against the politicization of pandemic measures.

Speak effectively.

The public health message has been muddled, whether it was the early advice against masks, overstating the import of flattening the curve or understating the effectiveness of the vaccine.

Now, there’s distressingly poor confidence in vaccination coupled with an anemic public information campaign. This is shocking, especially in light of the sophisticated marketing skills of America’s pharmaceutical industry.

The vaccine works and we know how to say so but we aren’t getting that job done, either.

Act now.

After the Second World War, Winston Churchill joked that the War Office was preparing to fight the last war.

We are going to have another pandemic, maybe sooner than we think. This one’s been bad and it’s not over. Daily worldwide confirmed case counts are nearing an all-time high, so much good work needs to be done.

The next pandemic could be as bad, or even worse. We need to act now to protect the human species.

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