Covid-19 Is Bad. But It May Not Be the ‘Big One’

In 2005, US government health agencies were obsessed with a disease threat that was rolling across the globe: H5N1 avian flu, which had leaped from wild birds into chickens, and from there into humans, and was killing more than half of the people unlucky enough to become infected with it. It was the second international disease emergency of the decade, following SARS in 2003, which had swept out of southern China, sickened people in two dozen countries, and cost the economies of the Pacific Rim approximately $40 billion.
sanitation workers cleaning stairs

Everything You Need to Know About the Coronavirus

Here's all the WIRED coverage in one place, from how to keep your children entertained to how this outbreak is affecting the economy. Kicked into action by SARS and alarmed by the potential for bird flu to wreak havoc, the government was on the verge of publishing an ambitious plan, a National Strategy for Pandemic Influenza, to anticipate any fast-moving epidemic. But at the Department of Health and Human Services, epidemiologist Michael T. Osterholm—the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, who was wrapping up a four-year stint as a special adviser to HHS secretary Tommy G. Thompson—was not convinced that the US, or the world, was doing enough.
In an article for the journal Foreign Affairs, Osterholm laid out the problems inadequate preparation would create, if a planet-spanning pandemic got going: It would shut national borders, create shortages of essential goods, collapse major industries, and close theaters, restaurants, and schools. And then he wrote this: “Someday, after the next pandemic has come and gone, a commission much like the 9/11 Commission will be charged with determining how well government, business, and public health leaders prepared the world for the catastrophe when they had clear warning. What will be the verdict?”Fifteen years on, Osterholm’s forecast has proven unnervingly correct. His prediction that the US will need a second 9/11 Commission to examine its failed pandemic response is getting a second look as well—because health experts are coming to the realization that, as devastating as Covid-19 has been, it could have been far worse. This pandemic has not approached the apocalyptic impact of the 1918 influenza, which killed an estimated 100 million people between 1918 and 1919, or of HIV, which has killed 32 million people since it arrived in 1981.
Spillovers of animal pathogens into the human world—the source of flu and HIV and the virus behind Covid-19—happen on no predictable timeline. That means another pandemic could be on its way at any moment. Robert Redfield, director of the US Centers for Disease Control and Prevention, seemed to acknowledge as much when he told the House of Representatives at a hearing on June 4: “You think we weren’t prepared for this, wait until we have a real global threat for our health security.”

That expectation is leading modelers and planners to a difficult realization. Not only will the US need a high-level effort to figure out what went wrong in its response to the novel coronavirus, it needs to start soon, and not wait for whenever the end of this pandemic might be.

Looking back at his 15-year-old prediction, Osterholm said last week that it’s critical to begin the accounting now. “We have to take the information that we get from this pandemic—all aspects of it—and ask ourselves, much like the National Transportation Safety Board takes the black box from a crashed airplane: What can we do to make sure it doesn't happen again?” he says. “And part of this needs to occur throughout the duration of this, because we’ll need to pivot quickly based on whatever is going on.”
The 9/11 Commission (formally, the National Commission on Terrorist Attacks Upon the United States) was an independent bipartisan group chartered by President George W. Bush a year after the 2001 World Trade Center attacks. It conducted two years of hearings and research, and at the end issued a massive but absorbing report—people said at the time that it read like a novel—documenting how the government failed to act on credible warnings of terrorist threats.