Pandemic predictions don’t get much more on the nose than a U.S. intelligence report made more than a decade ago — projecting a global coronavirus outbreak that would start in East Asia and kill “tens of millions” of people by 2025.
But it didn’t help stop it from happening. That’s because the 2008 National Intelligence Council failed to anticipate how politics and partisanship in the U.S. could hinder the global response — like too many similar warnings from both the intelligence and public health communities in the years before covid-19, notes a new Political Science Quarterly study.
With a monkeypox outbreak growing worldwide, also the subject of unnoticed earlier warnings, both the study authors and public health experts are calling for fixing disaster forecasts by figuring in not just how viruses misbehave but how people do, ahead of the next inevitable pandemic.
“The real punchline is that covid-19 was not the ‘big one,’ the pandemic that we really have to worry about. The lethality just isn’t there in terms of the worst concern,” said study author James Wirtz of the Naval Postgraduate School, the author of “Understanding Intelligence Failure: Warning, Response and Deterrence.”
“There’s still a lot of really dangerous airborne viruses out there,” he added. “And we have to be ready for the next one.”
Covid-19 still kills around 300 people every day in the U.S. now, more than two years after its appearance. The pandemic has killed more than 6 million people worldwide, according to the World Health Organization. More than a million of them are Americans.
Public health and intelligence leaders began warning about the risk of a coronavirus pandemic in the wake of the 2003 outbreak of the SARS coronavirus, which killed around 8,000 people, and the 2012 emergence of the MERS coronavirus. In 2017, the Johns Hopkins Bloomberg School of Public Health even ran a SPARS pandemic training exercise for health agencies that included the risk of misinformation and a virus that spread without symptoms in its scenarios.
Nevertheless, the SARS-CoV-2 coronavirus that emerged in late 2019 still shocked the world by spreading without symptoms, defying plans to contain it with travel bans and hospital isolation implemented during the 2003 SARS outbreak. In the U.S., the federal government relied on a pandemic flu playbook that counseled against masking and ignored ventilation. The understaffed Centers for Disease Control and Prevention labs tasked with designing, running and distributing coronavirus tests for public health labs produced contaminated test kits. Instead of a federal dashboard, case numbers were tracked by one set up by the Johns Hopkins Coronavirus Resource Center, and testing was watched by another project maintained by the Atlantic.
The mess led to a pandemic takeover by the Trump administration, which politicized the response ahead of the 2020 presidential election. That ultimately has split vaccinations — the one success story of the pandemic — along party lines.
“It’s a really hard thing to write about, that the American system really cannot withstand the shock,” said Wirtz.
The 2008 intelligence council warning of the potential for a coronavirus pandemic was based on input from the National Institutes of Health about the largest viral threats, said Mathew Burrows of the Atlantic Council, a leader of the Global Trends 2025 report. The warning really got a lot right, he said, but it could not address the elephant in the room — U.S. politics — and its potential to wreck things both domestically and internationally. That’s by design.
“We cannot address U.S. partisanship and its effects. That is a step too far for the intelligence community,” said Burrows, who called the requirement a “structural defect” in intelligence warnings overall, driven by the bedrock need to not entangle spy agencies in domestic politics in a democracy and, more practically, to not antagonize the political leaders who are funding them. “We always talked about the need for leadership, but that is as far as we could go.”
Even though it was prescient, the 2008 warning assumed wrongly that vaccines would take years to develop — which was then the standard for the pharmaceutical industry — and that the government response would be unified and effective, foreseeing such problems overseas but not in the U.S. This kind of straight-line extrapolation from existing trends into the future is another standard shortcoming of disaster warnings, said Wirtz. It doesn’t help, he added, that preparing for a pandemic with measures such as bulwarking public health agencies don’t make for a simple fix unlike something easier to sell like a pill.
Medical experts could tread where spies fear to by warning how malignant politics derails a pandemic response, but in the past they have likewise shied from chiding the politicians who fund their agencies, say critics. And politicians themselves weren’t asking questions that would have revealed this fatal flaw in pandemic threat assessments.
“Predictions about future pandemics were unfortunately too easy to dismiss,” said Adam Kamradt-Scott, a global public health expert with the European University Institute. Primarily political leaders just saw one as a remote possibility, “not something that they would necessarily see in their lifetimes,” despite the evidence, Kamradt-Scott said.
But politicians don’t deserve all the blame, he said. “In my view, and I realize some will vehemently disagree with this, but some of the fault unfortunately lies with the public health community that has often tried to distance themselves from politics because they see it as dirty or something. They don’t want to have to deal with,” said Kamradt-Scott.
“We need to get better at understanding how politics works and how knowledge and evidence are used to shape outcomes.”
The weight of the warnings and past outbreaks did over time shape a view among scientists that a pandemic was inevitable, said David Morens, a public health researcher and senior adviser at the National Institute of Allergy and Infectious Diseases. In particular, this emerging consensus spurred researchers led by his then-NIAID colleague Barney Graham to push ahead with research on mRNA vaccines that lead to the first covid-19 shots, surprisingly effective ones unimaginable in 2008. (“Barney articulated his vision better than I did, for all the warnings I wrote,” said Morens.)
But that widespread conventional wisdom among scientists didn’t make it out into the wider world. That mattered, because states, counties and cities have the primary public health responsibilities in the U.S., not federal agencies, added Morens. And federal agencies such the NIH, the CDC and the Food and Drug Administration have different parts of the puzzle assigned to them. Even if outbreak warnings were somehow perfect, all of this isn’t a perfect setup to respond to them.
In the last year, the Biden administration has called for a central pandemic response office based in Washington, D.C., to handle future outbreaks and released plans calling for more vaccines, surveillance of emerging diseases and health workers overseas. Congress balked at the $65.3 billion, seven-to-10-year price tag of the central office.
The real problem with such plans and pandemic warnings is they are predicated on responding with drugs, vaccines and tests to the emergence of every unguessable new virus, said Aaron Bernstein of the Center for Climate, Health, and the Global Environment at Harvard T.H. Chan School of Public Health. That’s a costly Whac-A-Mole approach to pandemic prevention, compared with just paying people not to cut down the forests where emerging diseases are hiding, he said, and to not engage in wildlife trade there.
Rather than trying to predict exactly the next pandemic virus, to develop drugs, vaccines and tests for it ahead of time, Bernstein and his colleagues suggested in a 2020 Science Advances report that it would be cheaper to stop making it more likely for new pandemic viruses to emerge in the first place. For about $20 billion a year, a program to survey for emerging diseases, limit livestock disease transmissions and reduce deforestation would limit the spread of all kinds of potential new pandemic bugs. The International Monetary Fund forecasts that the covid-19 pandemic alone will cost the global economy about $12.5 trillion by 2024, for perspective.
“Nostradamus could have told us there was going to be a disaster, but what good is that?” Bernstein asked. “All of these warnings and plans are trying to get the horse back in the barn after it’s loose.”
Thanks to Alicia Benjamin for copy editing this article.