Pandemic Preparedness Recommendations

Max Bronstein and I submitted the following recommendations to the US Senate Committee on Health, Education, Labor & Pensions.

COVID-19 presents a challenge unlike the modern world has ever seen. It has posed, and continues to pose, a major threat the American way of life and has wrought sickness and death at an unprecedented global scale. Public health experts expect that COVID-19 will not be the last pandemic the world sees, and we must be better prepared for the next wave of communicable disease(s). 

What follows is a set of recommendations outlining roles for government, the private sector, and non- governmental organizations. 

Preparing for the Next Pandemic

1. R&D Investment – our national investment in R&D relative to GDP is severely lagging and no longer globally competitive. While short term increases for NIH and CDC are helpful, we need a decadal strategic plan to boost investment in R&D broadly, with targeted increases for agencies vital in the fight against future pandemics. Robust investments in life science research, with proper incentives, for both the public and private sector, will be critical for improving our national and global biosecurity.
2. Stockpiles – continuing national efforts around stockpiling are essential, but the government should incentivize innovation in instances where life-saving supplies are lagging or in short supply. Consider prizes or challenge grants to reconceptualize ventilators, develop masks with longer and more effective lifespans, find alternatives to alcohol-based sanitizers that are as or more effective than current tools, and develop multiple testing modalities to increase our nation’s diagnostic capacity.
3. Global Collaborations & Diplomacy – effectively countering a global pandemic requires robust collaboration and information-sharing among affected countries. Diplomats with knowledge of public health should be deployed to communicate and coordinate with top health officials in affected countries so as to develop up-to-the-minute health intelligence for review and potential implementation in the US. 

Information Management and Coordination During a Pandemic 

1. Public Private Partnerships – the ACTIV-partnership, launched and coordinated by the NIH, should be a standing committee that remains on-call to respond new and emerging potential pandemics. The need for collaboration and coordination between the large and growing number of stakeholders is essential to speed drug and vaccine development, while avoiding duplication of effort.
2. Coordinate and Synchronize Messaging Across Health Authorities – Throughout the COVID-19 pandemic, the American Public has received varied, and at times, contradictory information from government officials (local, state, and federal). This mixed-messaging has resulted in general confusion on topics relating to social distancing, the drug development process, and outlook for the future. As a result of non-definitive information sources, this has also created an information vacuum, which has been filled with those advancing non-evidence-based conspiracy theories or profiteering activities. A single committee, spanning the various levels of government, should be convened and empowered to provide unified messaging to better inform the public and prevent the spread of misinformation that can cost lives. 

Investing in Healthcare Infrastructure 

1. Reinvigorate the US Medical Reserve Corps – the COVID-19 pandemic has shone a light on the limits of our healthcare workforce. In the same way that our outstanding military has a robust and ready reserve infrastructure, we must build-out our reserves of health professionals as well. These health reservists should be on-call to help respond to emergent health crises, especially in rural areas which may lack access to health personnel during an outbreak. The CDC should be tasked with reinvigorating and fully funding the national medical reserve corps. 
2. Build a Robust TeleHealth Network – adoption of modern telehealth technology has been variable across healthcare systems and providers in the US. Ensuring that patients have access to medical professionals even during a pandemic, is critical in preventing needless morbidity and mortality from conditions which are known and often treatable. CMS should develop a TeleHealth Checklist and incentivize providers to meet basic guidelines for delivering remote care to patients. 
3. Strive to Eliminate Health Disparities for People of Color – for too long, communities of color have lacked robust access to healthcare. This lack of access is one of the key drivers of health disparities that have been well-documented during the course of the COVID-19 pandemic. Renewing our national commitment to community health centers, federally qualified health centers, and vital safety net hospitals will go a long way in preventing and treating diseases that would otherwise put people of color at high-risk during times of a pandemic. 

While we must recognize COVID-19 for what it is, a global tragedy, we can and must use this crisis to build a healthier, safer, and more just society in America. In doing so we will ensure our national leadership in developing innovative medicines and diagnostics that will ultimately save lives at home and abroad. We thank the Members and Staff of the Committee for your consideration of these recommendations, and, for your unwavering service to the Nation during this challenging time.