A War Plan for the Next Coronavirus Starts Now
Bloomberg · by · March 14, 2020
Photographer: Angus Mordant/Bloomberg
Photographer: Angus Mordant/Bloomberg
History tells us that every century or two, there is a particularly virulent pathogen that poses a significant global threat to humans. We don’t know if the coronavirus will have the transmission rate of the Spanish Influenza of a century ago — which infected more than a third of the world’s population — and it hasn’t had anything like the 60% lethality of the Avian Flu of 1997. But what if someday we face a biological opponent that combines both?
Obviously, we are in an all-hands-on-deck moment. Our best scientists and physicians are working desperately to develop both a vaccine to prevent infection and drugs to mitigate the effects of Covid-19, the actual disease caused by the coronavirus. But even as we struggle to contain, treat and ultimately defeat the coronavirus, we need to be thinking about next pandemic. How can experience from past crises be useful in combating this one? How can we ensure that lessons learned from the coronavirus fight are used to prepare us for the next time?
I’ll start with my area of expertise. People usually think of our militaries as optimized to destroy things and apply lethal force. But in my career, I learned that the best use of the military is to bring order out of chaos. For example, when I was commander of the U.S. Southern Command in 2010, we dealt with a cholera outbreak that infected half a million Haitians. Working with militaries of friendly nations — Chile, Brazil, Argentina — we built hospitals and shelters; oversaw improvements in water supplies and hygiene (the keys to battling cholera); provided electricity to schools, hospitals and clinics; and gave a sense of stability with crowd-control and law-enforcement assistance.
Similarly, the U.S. response to Ebola in West Africa in the mid-2010s included quickly building new clinics and hospitals. In such cases, the U.S. coordinated extensively with key organizations such as Project Hope, the Red Cross and Doctors Without Borders. (Unfortunately, the military has been very uneven in maintaining those connections with nongovernmental groups when the crisis de jour passes.) Another key lesson I learned was the immense power of our massive Navy hospital ships, the Comfort and Mercy, with a dozen operating rooms and 1,000 hospital beds each. We could use more seaborne capability like that.
Speaking of big ships, the U.S. military has already learned a great deal about reacting to the coronavirus in aiding the more than 3,500 people aboard the Grand Princess cruise ship. Troops delivered test kits by helicopter and evacuated the ill to hospitals while the ship circled off the California coast, and quickly transported passengers to bases as far away as Georgia after it docked in Oakland. This barely scratches the surface of what the military can do domestically. It has thousands of beds at scores of bases, rapid construction capabilities and mobile medical facilities, and the largest logistics force in the world. As a combatant commander for seven years, I was consistently amazed at what the military could deploy in a disaster anywhere, including Pakistan after the 2005 earthquake that killed nearly 100,000 people.
Looking ahead, Pentagon planners need to catalog the lessons of the coronavirus and recommend specific actions to train, equip and organize the department for the next pathogen. That means vastly increasing stocks of Hazmat suits — every uniformed member should have one and be trained to wear it in action. It should stockpile the kinds of things that are now in short supply across the country: hand sanitizer, antiseptic wipes, chemical-treatment solutions for surfaces, durable protective masks. The military should increase its ability to immediately construct and transport emergency hospitals, as the Chinese army has belatedly but effectively in Wuhan. Also necessary is the training to ensure that America’s entire global force — 1.3 million active duty and 800,000 National Guard and reserves — is prepared to operate in any type of biologically compromised environment. The lead here should be taken by U.S. Northern Command, which is responsible for the U.S. and Canada, but needs to involve the entire force.
The U.S. needs a similar national effort for the medical establishment. It is clear watching these initial dealings involving large numbers of patients — offloading cruise ships, outbreaks in care facilities for the elderly, infection clusters like New Rochelle, New York, where Governor Andrew Cuomo has called in the National Guard — that the frontline medical personnel are learning as they go. The U.S. has the largest, most advanced care system in the world, but it is not well coordinated. Improving that will require unprecedented federal, state and local cooperation. Ultimate responsibility should fall to the Department of Homeland Security, but perhaps with direct oversight from the surgeon general and informed by a group of experts from the Centers for Disease Control. Curriculums in medical schools and for nurses, physician assistants, medical administrators and the like must have a far stronger focus on pandemic control and emergency response. And like the military, the medical establishment needs to establish a regular sequence of training and exercising these capabilities.
The private sector has work to do as well. What is unfolding now is a kind of “national IT exam” in which we are learning, on the fly, how to run a $22 trillion economy while vast numbers of people need to remain home. Can we effectively teach college, high-school and elementary-school students solely through videoconferencing? How can we deliver online corporate governance and business guidance to our financial institutions, manufacturers and retail businesses? How can we use social media to spread vital information and crack down on rumors and misinformation? And what sort of supplies must be stockpiled for any given business?
All of this is happening in real time, and the reaction so far has been tactical rather than strategic. If we respond quickly with precision-guided quarantines, vastly expanded testing, getting a vaccine into production, and finding drugs to help recovery rates, we may avoid a global economic and health catastrophe and even move on within a few months. But there is a not-inconsequential chance of a far longer period of turbulence. The only thing we know for certain is that this will not be the last time we deal with a health crisis global scope and scale, and there is no excuse for not preparing now for the next version of the coronavirus to come along.
This column does not necessarily reflect the opinion of Bloomberg LP and its owners.
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Bloomberg · by · March 14, 2020