Why the US government was unprepared for COVID-19, according to a biodefense expert
The U.S. government adopted a national biodefense strategy in 2018. Here's why it was still unprepared for rapid spread of the COVID-19 coronavirus
By all measures, the federal government of the United States has been unable to handle the spread of the COVID-19 coronavirus.
After weeks of insisting that the U.S. government was successfully fighting the spread of the deadly respiratory disease, President Trump on Mar. 16 finally admitted that the contagion is “not under control” both in the U.S. and abroad. The White House guidelines recommend that Americans practice social distancing by avoiding groups of more than 10 people; the Centers for Disease Control recommended that all gatherings of more than 50 people be cancelled for up to eight weeks as authorities work feverishly to halt the spread of the virus. In the meantime, there are currently more than 12,000 confirmed coronavirus cases across the country, according to the New York Times tracker, and federal authorities predict that the pandemic will last up to 18 months.
Coronavirus, it seems, has ground American life to a halt.
But the worst part of the coronavirus pandemic isn’t how much of a surprise it came to most Americans, but how utterly predictable it was — and how unprepared the U.S. government was on everything from funding to supplies to tackling the coming crisis.
“The U.S. was absolutely not prepared for a biological event like the spread of COVID-19,” Asha George, a former Army intelligence officer and executive director of the Bipartisan Commission on Biodefense, told Task & Purpose. “Any disaster, no matter what, reveals our vulnerabilities. This is exactly what we saw happen with Hurricane Katrina, where the federal response was flawed and the state and local authorities simply were prepared.”
In the world of national security, the world of “biodefense” doesn’t just refer to defense against biological weapons employed by state and non-state actors. It encompasses everything from surveillance and monitoring of global contaigions like the novel coronavirus to plotting responses to biological events like an outbreak. Indeed, biological events are becoming an increasingly common fixture of the geopolitical landscape; as George points out, the U.S. in particular has experienced incidents that include the threat of SARS from 2002 to 2004, the H1N1 pandemic of 2009, and the Ebola outbreak of 2014, not to mention the 2001 anthrax attacks that, having occurred so soon after 9/11, sent the country into a panic.
“It’s time to grow up and face the fact that we’re going to have more biological events, whether they’re caused by nature, accidentally released by laboratories, or generated by biological weapons,” George said. “How many more of these events have to occur before the U.S. government is convinced that this is something we have to deal with?”
Established in 2014, the Bipartisan Commission on Biodefense was tasked with developing America’s strategic approach to biosecurity, which it eventually produced in the form of a National Blueprint for Biodefense that the White House eventually adopted in 2018 as its National Biodefense Strategy. The goal of the NBS was simple: to enhance the “national biodefense enterprise” by laying out a coherent framework through which federal agencies would coordinate for the surveillance and monitoring of, the prevention of, and the response to, biological incidents.
In practical terms, the NBS established a Cabinet-level biodefense steering committee chaired by Department of Health and Human Services Secretary Alex Azar to actually execute the strategy. “It is really the first-ever holistic look across the government to see where are we acting, and where might there be any gaps in light of our awareness of threats, our preparedness needs, and our ability to respond,” Azar said at the time.
Despite this, the U.S. government ran into major obstacles that hobbled its COVID-19 response. While Azar was technically in charge of implementing the NBS at the federal level, a February 2020 Government Accountability Office audit found that HHS was unable to effectively marshall the resources of the federal government, and officials from various federal agencies “expressed reluctance” at reallocating resources towards a broad, somewhat vague government-wide mission since there “no clear processes, roles, or responsibilities for joint decision-making.”
Assessing biosecurity threats is one thing, according to George, but getting America’s sprawling bureaucracy and stakeholders like the Departments of Homeland Security, Defense, and Veterans Affairs to actually prepare for them is another.
“All departments and independent agencies have these responsibilities for biodefense, but you need to have someone above the level to govern that and get them to do what they’re supposed to do,” George said. “One department can’t really tell another what to do, so putting HHS in charge of the National Biodefense Strategy was a mistake. It has never worked historically in this country and it didn’t work this time — the bureaucracy got in the way of actually implementing and executing the NBS, and now we have COVID-19.”
That the U.S. was fundamentally unprepared for the threat of COVID-19 should have come as no surprise to HHS. According to the New York Times, the agency ran a series of exercises named ‘Crimson Contagion’ that, from January to August of 2019, simulated the spread of a respiratory virus from China to the continental United States, killing nearly 586,000 Americans and sickening a projected 110 million more. The results of the exercise were defined by ‘confusion’ and ‘bureaucratic chaos,’ the New York Times reports, with friction emerging between state governments and the federal government over issues ranging from equipment shortages to guidelines for social distancing and, on the federal level, between agencies like HHS and the Federal Emergency Management Agency. A clusterfuck was inevitable.
Among the most tangible results of the ‘Crimson Contagion’ scenario was an “inability to quickly replenish certain medical supplies, given that much of the product comes from overseas” — a phenomenon that the U.S. is currently experiencing with the COVID-19 pandemic thanks to, George says, poor maintenance of the Strategic National Stockpile, which currently maintains a cache only 12 million N95 respirators, among other critical pieces of medical gear.
As The War Zone points out, the federal government released 85 million N95 masks to handle the H1N1 outbreak of 2009 and failed to actually replenish the stock, resulting in a major shortage among hospitals and other health care providers (The Pentagon has announced it is contributing five million more N95s from its own reserves).
“We didn’t have enough in our strategic national stockpiles,” George said. “We didn’t consider the possibility that China would be so affected that it would be unable to manufacture the health care supplies we use.”
Then there’s the matter of funding. In early February, HHS notified Congress that the agency needed to tap $136 million from elsewhere in the government to help combat the coronavirus epidemic, an early sign of a funding shortage for the agency’s rapid response capabilities. While the Congress authorized a total of $8 billion in both new funding and reallocated funds as part of an emergency measure to help halt the spread of the disease, NPR notes that only $3.1 billion will go to HHS to help lead the response, while the rest will be dispersed through state and local governments.
“Our funding mechanisms that are intended to get emergency funds to states and localities simply aren’t that great,” George says. “They aren’t set up particularly well, and it’s money that should come from HHS but the department doesn’t necessarily know how to distribute that funding. There’s a lot of confusion as to how and where that funding gets out.”
The underlying problem, George says, isn’t a shortage of masks and funding, but a shortage of substantial attention and concern in the run-up to the pandemic that left the country’s bio defenses vulnerable to the spread of COVID-19.
Although the country has faced biological events before, crises quickly fade from memory, supplanted by other bureaucratic and political priorities that end up taking precedence. The U.S. may be among the healthiest countries in the world, but its slow response compared to other advanced countries like South Korea speaks to an irrational level of poor planning and preparedness for what was, in the eyes of experts like George, an inevitability. Simply put, the broad U.S. population believed that a pandemic could happen — but it couldn’t happen here.
“We enjoy a high level of health in this country, and a lot of elected leaders assume that high levels of health mean we’re prepared for biological events,” she said. “But it’s not true: We’re vulnerable in what assumptions were made about the actual threat and what we have in place. The rest of it was entirely predictable.”