In October, 2019, the first Global Health Security Index appeared, a sober report of a world largely unprepared to deal with a pandemic. “Unfortunately, political will for accelerating health security is caught in a perpetual cycle of panic and neglect,” the authors observed. “No country is fully prepared.” Yet one country stood above all others in terms of readiness: the United States.
During the transition to the Trump Administration, the Obama White House handed off a sixty-nine-page document called the Playbook for Early Response to High-Consequence Emerging Infectious Disease Threats and Biological Incidents.
The Trump Administration jettisoned the Obama playbook. In 2019, H.H.S. conducted Crimson Contagion, a simulation examining the government’s ability to contain a pandemic… The Crimson Contagion exercise inspired little confidence that the government was prepared to handle such a crisis. Federal agencies couldn’t tell who was in charge; states grew frustrated in their attempts to secure enough resources…
Government policies, the report concluded, were inadequate and “often in conflict.” The Public Health Emergency Fund and the Strategic National Stockpile were dangerously depleted; N95 masks and other medical essentials were in short supply, and domestic manufacturing capacity was insufficient. Congress was briefed on the findings but they were never made public. By the time COVID arrived, no meaningful changes had been made to address these shortcomings.