The United States Must Lead in the Fight Against Coronavirus

By Dr. Beth Cameron and Dr. Jennifer B. Nuzzo

Beth
Cameron, PhD, is a vice president for global biological policy and programs at
the Nuclear Threat Initiative. She previously served as the Senior Director for
Global Health Security and Biodefense on the National Security Council staff at
the White House.

Jennifer
B. Nuzzo, DrPH, SM, is an epidemiologist with the Johns Hopkins Bloomberg
School of Public Health’s Center for Health Security. 

No
country is fully prepared for a pandemic, including the United States. This is
the overarching finding from the Global Health
Security (GHS) Index
that our organizations released last fall, and that finding has been borne out
as our country and others struggle to respond to the spread of the disease
caused by a novel coronavirus (COVID-19). With a daily escalation in cases
reported in the U.S. and in communities around the world, International
Monetary Fund (IMF) analysts now predict
that COVID-19 could cost the global economy $1 trillion in losses.

The World Bank and the United States Congress are beginning to step up, but a sustained and reliable infusion
of resources will be necessary to bolster readiness at home, stop the spread
internationally, and create countermeasures to ultimately end the outbreak. 

On
February 26, seeking to reassure the American people about the COVID-19
pandemic, President Trump heralded findings from the GHS Index, which ranks the
United States as the most prepared for a pandemic of the 195 countries it assesses.
Unfortunately, however, even the United States wasn’t afforded top marks. In
the face of a crisis, an overall score of 83.5 – a flat “B”—shouldn’t be
particularly reassuring.

In
fact, in measuring pandemic readiness, the GHS Index found that many countries,
including the United States, lack essential public health and health system capacities to prevent,
detect, and respond to health emergencies. How badly did countries do? Out of a possible 100 points, the average GHS Index score
across 195 countries was 40.2. The GHS Index also found that global health
systems, including doctors, nurses, and hospitals, are not ready to handle threats
like COVID-19. The United States did well in some areas, but scored quite low
in others – for example, access to healthcare and capacity within clinics,
hospitals and community care centers. The United States also scores poorly for some
risks that could exacerbate a pandemic, such as public confidence in
government.

We already are seeing troubling challenges. U.S.
surveillance for COVID-19 is weak, due to recent difficulties in developing and
deploying diagnostic tests. Until recently, the CDC had tested fewer than 500
people for COVID-19, whereas countries like South Korea and Japan had tested
tens of thousands. This means we don’t yet have a handle on the number of U.S.
cases, which is essential to stopping community transmission.

Like other countries, the U.S. will have to significantly scale up its
preparedness for COVID-19 – in short order and across all states, localities,
tribal, and territorial levels. A top priority should be ensuring the readiness
of our health systems and healthcare workers to safely and effectively treat
infected patients. This will mean surging workforce, training and equipping
healthcare workers. 

Effective public communication
also is crucial to ensure the sickest get treatment and those with milder
symptoms stay home to avoid infecting others. Health systems need to develop
rapid plans to encourage sick people to isolate themselves at home, and health-care
professionals need the capability to triage patients using telemedicine.

At the same time,
although the worrying gaps in U.S. preparedness must be addressed, our
government must understand and acknowledge that a solely inward focus won’t stop
this outbreak. Spread of COVID-19 in low-income countries means continued
global transmission. With disease now on most continents, it’s clear the U.S.
can’t keep COVID-19 from coming. To end this epidemic, we will have to fight it
on our shores, while also partnering with other countries to beat it on theirs.

What needs to happen
next?  Urgent investment, with large sums
up front, is required to reassure the American public and the world that U.S. leaders
are ready for the COVID-19 battle.

First, the United States
should urgently bolster U.S. programs to prepare at home, stop spread globally,
and develop vaccines and therapeutics to end the outbreak. The supplemental is
a good start, but it’s likely that more funding will be needed, and resource
reliability will be vital to effectively fight the disease, build and maintain
public trust, and ensure effective programs.

Second, the U.S. should
provide ample support to global partners and the World Health Organization
(WHO)  to stop the outbreak around the
world. The WHO has requested $675 million to combat COVID-19 and bolster health
systems. To date, few countries have pledged to help. American leadership is
irreplaceable; other governments and financial institutions will follow suit. 

Finally, the G7 group of
the world’s largest economically advanced countries, led by the United States
in 2020, should prioritize a package of support for COVID-19 and the next pandemic. This should include support for WHO and World Bank to stop the
outbreak; establishment of a new preparedness challenge fund for COVID-19 and
the next pandemic; and funding for other organizations, like the Coalition for Epidemic
Preparedness Innovations and GAVI, the Vaccine Alliance, to develop and deliver
new vaccines and therapeutics.

The U.S. is a country
with the resources and experience to stop COVID-19—but we must act fast. Now is
not the time for us to sit on the sidelines. Now is the time for the United
States to lead.