Congress is spending peanuts when we need a moonshot
It's "metagenomic", not "meta-genetic." Genetics is the study of inheritance; genomics is the study of genomes (the complete DNA sequence of an organism.)
Great post! More sequencing would be great! One thing that has long puzzled me is how often we get sick and never find out what we had (“oh it’s a bad cold”). Pre-pandemic my kid would get sick all the time from daycare, and unless he tested positive via the rapid flu or rapid strep tests we basically never knew what he had, and the doctor would just prescribe antibiotics and either they would work or he would get better on his own. Clearly we can and should do much better, either on a patient level or at a macro level as Matt suggests.
I’m leery of increased pandemic preparedness because I don’t like coercive distancing. There has been exactly one pandemic in the last 100 years that (arguably) justified widespread coercive distancing. The more detection and surveillance we pay for, the more false alarms we will get. Places that take strong “protective measures” like Australia and New Zealand, deprioritized personal freedom and mandated a much higher degree of risk aversion than I like. I’m certainly willing to fund more vaccine research and streamline the approval process, but I doubt we have enough qualified molecular biologists to spend more than several billion usefully. $1 billion will pay for 5,000 scientist man years at $200/k a pop.
I think you cover all the bases. Rational policy would a) increase ongoing funding for pandemic prevention research; b) increase and maintain stockpiles of emergency materials; and c) repair regulatory mechanisms to permit a sane emergency response to the next pandemic. That we have already lost interest in supporting infrastructure necessary to ameliorate the threat of the next pandemic even while we suffer from this one does not speak well for the US political system.
Yeah categorizing pandemic preparedness as defense spending actually makes sense on the merits as much as it’s politically a good strategy. Like the defenses you need against a natural disease are the same ones you need against a bio-weapon pretty much
The line about base rates was interesting. What if we charged the Dept of Defense with the responsibility for biodefense? The budget required could be found in their couch cushions.
Go Braves!!! Can’t stop the chop!
More ventillation/filtration and indoor CO2 monitoring in schools and public places would be great too!
Stop pooh-poohing climate change. As nasty as the covid pandemic has been, the effects of climate change are way worse.
That out of the way, your point that governments should invest more in pandemic preparedness is essentially correct, and you identify many of the right targets. I'd add that what we could really do with is *instant* virus tests. With an instant (or, say, 30 second) test of sufficient accuracy and cheapness, we could have stopped covid in its tracks, including Delta, without a vaccine, and without mass lockdowns. Or, at least, sane developed countries could have stopped covid in its tracks. The United States is of course another matter.
Really good article! Wish these kinds of articles were more popular rather than clickbait culture war stuff
>>But as Noah Smith has written, oftentimes the U.S. gets useful things done (the original Interstate Highway System, the foundation for the Internet, etc.) by calling them national security. There’s no reason the next NDAA can’t find some way to smuggle in billions of dollars for pandemic prevention.<<
Yeah, I don't buy this. Regarding the IHS, while Eisenhower was impressed by Germany's autobahn system, national defense was at best a very minor factor for selling the IHS to the American people: economic growth was the big selling point (https://www.fhwa.dot.gov/interstate/interstatemyths.cfm#question3). And while the creation of the transformational Internet was a serendipitous outcome of the ARPANET, there was zero possibility of anticipating such a thing coming from this infinitesimal part of DoD R&D spending. Sometimes you get really lucky. (Sometimes you get Tang and Teflon, too.)
DoD is focused on traditional ideas of national defense. The idea that we could "smuggle in billions of dollars for pandemic prevention" in the DoD budget is laughable.
Is there a way we can start some policies local and then build up without needing federal involvement early? If companies start requiring daily rapid tests, as prices fall to the $1 range (the way they have been in Europe for months), then we could gradually add new virus tests to those rapid tests. This would then provide a local “weather report” for that region, which others might like to emulate.
I don't think there is any point to throwing more money at America's public health apparatus without root and branch reform. Despite being far better funded per capita and overall than any peer countries, they completely beclowned themselves throughout the COVID response.
Why should congress entrust these organizations with such a large sum of money?
Posts like this put one in mind of the "availability" bias trap. We're all focused on the dangers of pandemics because, well, duh. So many of us are focused on doing things because COVID has been such a disaster. That's great. But how will we feel in five or ten years if, as is highly likely, nothing as damaging as COVID has recurred? We'll feel like we have much bigger fish to fry and while preparing for the next pandemic would be great, right now we have to concentrate on crisis X or Y. We'll be like the Obama administration, which cut funds for PPE in the national stockpile because national debt and the deficit were such large concerns.
Hey, if we can do things like throw money at research that will lay the basis for general spectrum vaccines, great. Scientists are great at long-term research. But beyond that I cast a gimlet eye.
For example, in the Biden proposal Matt cites, the administration writes: "There should be a centralized ‘Mission Control’, acting as a single, unified program management unit,
that draws on expertise from multiple HHS agencies, including NIH, CDC, BARDA, FDA, and CMS, as well as other departments such as DoD, DoE, and VA." I have no doubt that within five years, and no pandemic emergency in the meantime, this "Mission Control" will be an empty shell of no importance, with at best pro forma meetings and each agency and department pursuing their own agenda and jealously guarding their autonomy.
Memories fade and people will lose any sense of urgency they may have now. That's just life.
The way to prevent pandemics and epidemics is to eliminate all animal use industries and stop damaging wildlife habitat.
The next pandemic is likely to come from an authoritarian country with tight control over the media. The US and other open societies need to figure out the signs that there’s an outbreak in an authoritarian country. The next pandemic may not come from China. It might come from Russia or one of the other former Soviet republics with a cartoonish authoritarian ruler, especially if he doesn’t want to look bad in front of other world leaders. I don’t know much about gathering intelligence but if the country suddenly starts buying up PPE or doctors are mysteriously falling out of windows, that may be a clue that there’s an outbreak and it might be a good idea to start collecting that kind of information. I don’t know how the US would start doing that but that’s what intelligence experts are for.
Classic SARS also came from China and it didn’t become a pandemic in part because of traits of the virus: it was less transmissible and is only transmitted when you’re symptomatic. However, Hong Kong was under leas control from Beijing and it had a much freer press than today. The Hong Kong press really did investigate what was going on. Foreign journalists had more access to mainland China where SARS had first emerged.
For all the many flaws of our media, an outbreak of a novel virus in the US would be something that the media were all over.