What Covid Tried to Teach us — and Why it Will Matter in the Next Pandemic

Stat News | By Helen Branswell
 
Five years ago this week, STAT was interviewing nervous infectious disease scientists about a mysterious disease spreading in the central Chinese city of Wuhan, located roughly 500 miles west of Shanghai. On Jan. 4, 2020, we published the first of what would become a torrent of articles on the disease now known as Covid-19. 

The intervening years have both sped and crawled by, too busy at times to take stock of all that has changed, too plodding to believe we have arrived at this anniversary already. (The first case of Covid in the U.S., in a person who had traveled to Wuhan, was not confirmed by the Centers for Disease Control and Prevention until Jan. 20, 2020.)
What do we have to show for the time that has passed? Not enough.

There’s a saying attributed to all sorts of people that one shouldn’t waste a good crisis. In public health, especially, learning from disease outbreaks and environmental disasters is critical; figuring out what worked and what didn’t is fundamental to emergency response planning for the next time. Much as we all might hate the idea, the fact remains that there will be more pandemics. We cannot wish them away and we imperil ourselves if we do not prepare for them. Already, there are renewed concerns about the potential for an H5N1 flu pandemic, with the virus tearing through U.S. dairy cow herds over the past year and also infecting at least 66 people in this country, most of them workers exposed to infected cows or poultry. 

And yet there haven’t been the types of post-mortems or after-action inquiries that normally follow an event of the magnitude of the Covid pandemic. In 2021 a group of experts in public health, science, and other fields began to lay the groundwork for what they thought would be an independent commission looking into the handling of Covid. When the Biden administration decided not to appoint such a body, the group turned its work into a book that was published in the spring of 2023. “They didn’t have an agenda in mind. They could not articulate even to themselves internally as to how the system should change,” the lead author, Phillip Zelikow, said at the time of the administration’s decision to forgo an inquiry.

We appear to be trying to teach ourselves the lessons of Covid the hard way. 
So as we ruminate on the fact that a half-decade has passed since Covid entered our world, here are some thoughts about things we will likely have to deal with when the next pandemic hits — realities that can be traced back directly to the Covid experience.
Public trust in public health institutions has cratered

The CDC has long been the world’s preeminent public health agency. It’s not a coincidence the Chinese, European, and African equivalents are called China CDC, the ECDC, and the Africa CDC. But at the beginning of the Covid pandemic, when the United States was trying to identify newly infected individuals to limit transmission, a test devised by the CDC — the only one in use at the time — failed. Mistakes happen, but that was a bad mistake to make at a very bad time to make it. A successful test would not have stopped Covid. But the unsuccessful test made the CDC look inept just when the country turned to it to chart the path forward.

Later, messaging from officials at the CDC and elsewhere in the government discouraged the public from wearing masks, in part — though this was not generally acknowledged out loud — to preserve scarce supplies for health care workers who were forced to reuse disposable surgical masks for days on end because hospitals couldn’t replace them. Then the guidance shifted and people were urged to mask up even out of doors, with the CDC’s website offering instructions on how to make a mask using hair elastics and T-shirt fabric. A surreal read even back in 2020, those instructions can still be found in the agency’s online archives…