Lessons Learned from COVID-19: Policymaker Recommendations for Future Pandemics (Part I)

March 13, 2023 marked the third anniversary of when COVID-19 was declared a national emergency in the United States (U.S.), and soon after, states began to implement shutdowns. 2020 was a year filled with uncertainty; citizens and federal officials alike were unsure of when the shutdowns would end, not to mention the pandemic itself.

The U.S. response to the pandemic revealed many structural issues within our country’s pandemic preparedness and disaster response procedures. By reflecting on the consequences of various government responses, we can establish future recommendations for policymakers to improve our preparedness, change how we react to pandemic emergencies, and limit the impact of future outbreaks.

Although many Americans have returned to daily life in this new normal, COVID-19 is still causing infections, illnesses, and deaths, especially in underserved communities. As of March 2023, COVID-19 kills an average of 900 to 1,000 people a day worldwide, and the global total death count is about 6.8 million people.

Endemics and emerging diseases are nothing new, as the world has dealt with Ebola, SARS, swine flu, and avian flu in just the past twenty years. In the past few decades, more than forty new infectious diseases have emerged among humans.

It is important to note that there was a fair amount that went right in our nation’s disaster response to this new and shocking pandemic. The expedited investment into research of the virus and the development of vaccines demonstrated our scientific capabilities and offered protection to those who needed it most, such as our elderly population.

Furthermore, in the face of intense pressure, our front-line workers and public health system overcame tremendous challenges and did not collapse. We also witnessed a national outpouring of help and support from many Americans of all backgrounds, which served as a source of hope. Due to its tumultuous nature, not everything could be perfect in our response to the pandemic, but many people came together and put their own lives on hold to support their fellow Americans.

Inconsistent Communication and Dissemination of Information

The pandemic posed many challenges for information-sharing in the U.S. At the beginning, what important officials and scientists knew at first was limited and constantly changing. The evolving nature of COVID-19 information created mistrust of public health sources and further polarized beliefs about the pandemic along political lines. By being more transparent about the evolving nature of data and knowledge about the disease, news sources and scientific organizations could have prevented their credibility from being called into question.

At the outset of a disaster, there is often missing information, conflicting information, and other challenges. What is needed even before a disaster is declared is a coherent communications strategy that manages expectations, reduces panic, and educates the public about procedures and processes.

Furthermore, the COVID response revealed that organizing and consolidating public health information and resources is crucial to providing citizens with access to knowledge and remote and in-person resources. On March 31, 2022, the Biden Administration launched COVID.gov as a “one-stop shop” for resources like vaccines, tests, treatments, masks, and other centralized COVID-19 information.

This type of centralized resource center will not reach everyone on its own, however. Promoting a site like COVID.gov on social media and apps that people use on a daily basis can increase their online accessibility and the public’s knowledge of available resources. Additionally, there need to be resource options in localities without equal access to broadband and internet. It is not only important to have large governing bodies providing central resources. In disaster situations, it is also essential to have community-based resilience and more localized organizations serving the information and resource needs of their communities.

The sharing of nationwide information, along with localized information about confirmed cases through resource centers, can help dispel rumors and misinformation that reduce public trust. People learn and consume information in different ways, so resource communication also needs to be multilayered. This includes translation for English as a Second Language (ESL) citizens and non-internet-based resources for the 42 million Americans who do not have access to broadband.

Lack of Leadership Knowledge About Disasters

One of the largest failures in the U.S. response to COVID-19 was the lack of executive leadership knowledge about diseases and coherent disaster response. For example, former President Trump’s actions during the pandemic response included:

• did not follow the guidelines of previously established federal disaster response frameworks,

• conducted ambivalent messaging (including discouraging mask-wearing at later stages of the pandemic),

• did not roll out contact tracing even seven months into the pandemic when he caught COVID himself, and

• due to his Administration’s interpretations of federalism and subsidiarity, handed off responsibilities to underprepared states and local levels of governance.

The Trump Administration also elevated Dr. Anthony Fauci to have an outsized role in shaping policy, while simultaneously denigrating the scientific establishment consensus that Dr. Fauci represented.

New York Governor Andrew Cuomo also had some major missteps in his early response to COVID-19, such as his requirement that the state’s nursing homes take back residents who had been hospitalized with COVID-19 once they recovered. In reports of death tolls, the true number of deaths caused by this decision was obscured by Cuomo and his aides for at least five months. This nursing home disaster could have been avoided had there been greater knowledge of diseases among state leaders like Cuomo.

As a result of executive leadership failures, action against the pandemic was inadequate and uneven, the spread of misinformation and distrust proliferated, and millions of people suffered the consequences. In the future, there should be more:

• pre-planning,

• executive-level training and coaching, and

• a more process-oriented approach that helps people understand each level of the response process more clearly.

Local, state, and federal governments should prioritize hiring experts to train their employees in disaster preparedness to ease the process of disaster response and boost confidence and trust in leadership.

Accusations and Targeted Embargos

Before COVID-19 was declared an emergency in the U.S., one of the immediate responses to the worsening global crisis was a travel ban on China, barring entry into the U.S. for individuals recently in that country. Coupled with the anti-China rhetoric used by the president and others, this policy sparked racism against Asians and Asian-Americans throughout the nation and did not prevent the virus from entering and rapidly spreading throughout the U.S.

Alternatively, a total air embargo would have been a better public health response, as opposed to the targeted ban enacted by President Trump. We see this exemplified in Canada where, on March 21, 2020, the nation enacted a total border closure, as opposed to only banning “high-risk regions.” Reports claim that in the first two years of the pandemic, Canada performed notably better than the majority of other G10 countries. Aside from Japan, Canada was the only other G10 country to experience less than 1,000 COVID-related deaths per 1 million people.

Understanding Cascade Effects

There was a lack of understanding and preparedness for the cascade effects of a pandemic like COVID-19. Not only did the pandemic directly affect the U.S. economy, but it was particularly dangerous for small businesses, intensely amplified mental health issues and concerns, and radically altered education systems and student learning with unknown future impacts.

In February 2021, about one year into the pandemic, 39.3% of adults reported symptoms of anxiety and/or depressive disorder due to various pandemic impacts like job loss and isolation. Students across the country also faced devastating effects on their academic performance and capabilities. The average performance of 9-year-olds in math and reading dropped to levels equivalent to students from twenty years ago. Additionally, gaps in performance between high- and low-performing students and between Black and White students widened significantly.

Nationwide, the pandemic resulted in steep job losses and pushed the unemployment rate to 13% in the second quarter of 2020, while also causing many people to leave the labor force. Also in the second quarter of 2020, the U.S. GDP fell by 8.9%, which was the largest single-quarter GDP contraction that the U.S. has experienced in more than seventy years.

This is why experts from all disciplines, including education, mental health, disaster recovery, healthcare, business, and more should have been brought together to work as a system. This would have allowed them to create a more nuanced and holistic response. At all levels, various organizations with different expertise must collaborate to find the best ways to approach multifaceted crises such as the pandemic.

Research should be conducted on the long-term ramifications of COVID-19. Such research can inform future disaster response and create a procedure to be followed in the case of other disease disasters. For example, in May 2021, FEMA published their “Local Government Solutions Guide for COVID-19 and Beyond,” which suggests methods that local governments can use to provide services and meet resident needs in a pandemic, even if they are facing budget constraints.

Furthermore, the United Nations Office for Disaster Risk Reduction authored a research paper consisting of case studies that examine the effects of the pandemic on our systemically interconnected world. This is a starting point for our comprehension of the societal risks associated with a pandemic and our exploration of how to best combat these cascading effects.

Disaster Recovery Process and Stabilization

Disaster recovery is a long process usually consisting of the following phases in order:

1. Immediate response

2. Stabilization

3. Long-term recovery

4. Return to normal.

In the U.S., the COVID-19 recovery process was almost entirely handed over to the Centers for Disease Control and Prevention (CDC) and individual states. This hurt the recovery process, as both the CDC and states were overextended in their duties and unable to focus on where their particular strong suits might lie. Additionally, sometimes the CDC and states did not communicate well with each other, leading to divisiveness.

Furthermore, for many months, stabilization after the pandemic never really occurred uniformly. In disaster recovery, stabilization is an important step before long-term recovery, so that information and resources can be organized and prepared. Due to the decentralized response approach of the U.S., stabilization was unable to happen as different localities, which were underprepared to deal with a pandemic themselves, oscillated between open and closed based not only on COVID cases, but also local public reactions to the pandemic.

It makes sense that some states and constituents would want to diverge from the federal model of COVID-19 response due to the amount of distrust that circulated during the pandemic. This level of animosity and skepticism can be avoided in the future if health and disaster experts are kept in their designated role, and not touted as the end-all-be-all solution to the pandemic as a whole. Therefore, states and localities can:

• look towards their expert recommendations,

• understand their role in enforcing public health best practices, and

• adapt their capabilities in ways that best support their communities.

At a national level, each phase of disaster recovery should be designated to and conducted by the experts and organizations most equipped to understand what the public’s needs are and how to best fulfill them. Furthermore, their recommendations and plans of action should empower states and localities to follow similar steps to the best of their ability and dependant upon the individual needs of their community.

At the beginning of the pandemic, one of the most successful responders, Taiwan, took strong action and created the Central Epidemic Command Center (CECC) to lead all COVID-19 related matters. This centralized Taiwan’s COVID-19 response and established strong connections between the public and government during the pandemic.

Additionally, while public-private relationships and COVID-19 regulations were managed by the CECC, the National Health Insurance Administration (NHIA) helped prepare their healthcare systems for a large influx of patients, demonstrating an effective division of duties in the different phases of disaster recovery.

As we hope to put the COVID-19 pandemic in the rearview, future policymakers should take time to seriously evaluate our nation’s pandemic response in order to learn from our mistakes. Improvements in pandemic preparedness and disaster mitigation need to be made at the federal, state, and local levels. Lives depend on it.

Find COVID-19 resources here.

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