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One of the most heartbreaking aspects of the COVID-19 pandemic is how we ignored the warnings epidemiologists and infectious disease experts had been sounding for decades. The question had always been a matter of when and not if a global infectious crisis would occur. Yet, when COVID-19 began to spread around the world, country after county was caught flatfooted, woefully unprepared both materially and strategically. The cause of our collective failure stems less from skepticism toward what scientists and epidemiologists have been telling us; instead, a number of social and political institutions provide strong disincentives to proper preparation, as I will argue. Three examples stand out: representational democracy, a state’s obligation to its citizens, and unfettered dissemination and consumption of information. These institutions and practices are deeply entrenched and highly valued in the United States. If they are indeed barriers to effective responses to a pandemic, then we must consider if and to what extent we are willing to sacrifice them in combating the next global threat.
Consider the political leadership and foresight needed to prepare for a pandemic. The early days of COVID-19 painfully revealed our lack of critical resources such as personal protective equipment (PPE) ventilators, logistical networks to mobilize personnel, and clinical space. It took the Center for Disease Control over a year from the start of the outbreak to acknowledge that COVID-19 spreads largely through airborne particles; the usefulness of masks in mitigating the contagion might have been uncertain in the early months. But the possibility, if not likelihood, of an airborne pathogen was surely well-known to public health officials, especially given the warnings coming from Asia. The lack of PPE was not the result of SARS-CoV-2 catching us off guard with a novel vector of infection; rather, it was our political failure to prepare for a likely scenario. This failure can be partly attributed to political systems that reward short-term achievements over long-term catastrophic preparations. In the United States, federal election cycles range from 2 years (House of Representatives) to 4 years (President) to 6 years (Senate). Elected officials need to deliver tangible political results if they are to make a convincing case for their reelection. Spending tax dollars stockpiling PPE that might or might not prove visionary is...