By RICHARD SKOLNIK
Los Alamos

We must learn a number of lessons from COVID-19 to more effectively address the present outbreak and prevent a similar toll from future epidemics. Building on these lessons will also help make the US a fairer and more just society, strengthen our economy, and enhance our national well-being. Below are just a few of the most important things we must learn from

COVID-19 now.

First, we must understand that there is a strong connection between health, our economy, and our overall national well-being. Disease outbreaks have enormous economic consequences, vastly in excess of the numbers of people affected. This outbreak has also led to major social dislocations, including in the way we work, the way we learn, and the way we interact with others.

Second, we must prepare now for future outbreaks. This preparation requires having the leadership and managerial competence in place to urgently implement any necessary public health measures. Studies done before the outbreak of COVID-19 suggested that the US was the best prepared of any country to deal with such an occurrence. The studies, however, failed to include metrics on political will and managerial competence, two areas in which the public health and global health communities have judged the response of the US federal government and many state governments as exceptionally lacking. An example of this is the billions of dollars that the US is paying to laboratories for test results that come back too late to be of public health value – something Bill Gates recently called “insane”.

Third, we need to elevate knowledge of and the stature of public health work and public health action. The behavior of an important share of the US population during this pandemic suggests that too many Americans fail to understand or respect the essentials of public health practice. There is no magic to time tested public health measures, such as handwashing with soap, disease surveillance, testing for disease, contact tracing, isolation, and quarantine.

Fourth, COVID-19 has highlighted, as nothing before it, our failure to achieve universal health coverage and of having an employer-based insurance scheme without an automatic safety net for people who lose their jobs. Not only do we pay more for healthcare to achieve less than almost any other high-income country, but people often lose their coverage when they lose their job. Especially during a pandemic, this puts everyone’s health at risk.

Fifth, we must better protect our health care workers, our elderly, and people in “care facilities”. More than 900 healthcare workers have died in the US of COVID-19. In addition, COVID-19 has been like an “angel of death” in some nursing homes, many of which have a long history of low-quality care of their patients.

We must also dramatically improve efforts to address our exceptional health disparities.

COVID-19 has clearly shown just how much easier it is for some people in the US to protect their health than it is for other people – particularly the poor and people in minority communities. Some people in the US are fortunate enough to be able to work from home, work safely, and largely avoid the virus. Others, disproportionately in minority communities, are not so lucky. They must go to work, often in unsafe conditions, resulting in a disproportionate share of illness, disability, and death related to COVID-19. Many in these communities also suffer from a range of health conditions and a lack of access to healthy foods, a safe environment, and appropriate healthcare, further contributing to the impact of COVID-19.

Our present national trauma is the result of a virus. Until we suppress the virus, we won’t be eating out like before, won’t be traveling like before, can’t educate our children as before, and can’t mix with family and friends as before. Linked to this, jobs will continue to disappear. The sooner we implement the lessons of our struggle with the virus to date, the faster and more fairly we will beat back the virus. In addition, the sooner we implement these lessons, the better prepared we will be to tackle any resurgence of this virus and the next outbreak, as well.

Editor’s note: Richard Skolnik is the former regional director for health for South Asia at the World Bank. He was the director of an AIDS treatment program for Harvard and taught Global Health at the George Washington University and Yale. He is the author of Global Health 101 and the instructor for Yale/Coursera’s Essentials of Global Health.