By RICHARD SKOLNIK
Los Alamos

There is a price for everything and, one way or another, the price must always be paid. The economic impact of coronavirus will be exceptional, even if it were to kill only a relatively small number of people. We could save ourselves an enormous amount of economic hardship and ill health if we had invested wisely on a continuous basis in preparedness against emerging diseases. This is a lesson we have foolishly failed to learn from one emerging disease after another, such as SARS and Ebola.

Many Americans don’t understand what we should expect our federal government to do to help protect us from COVID-19. So, let’s put our readiness to address coronavirus in military terms to which most Americans easily relate. This is apt, since there is universal agreement that defense and public health are responsibilities of government.

Imagine that an enemy has told us for years that they are going to invade the US. They then do so. Let’s also imagine that we lacked the political will needed to prepare financially, technically, or socially for the invasion. Thus, at the time of the invasion our military would not have the airplanes, ships, weapons, uniforms, or transport needed to effectively combat the invasion.

This is largely where we are on coronavirus. The recent congressional allocation of emergency funding for coronavirus is years too late and equivalent to emergency funding after an invasion for which we consistently failed to prepare adequately. Thus far, the President has NOT made use of the Defense Production Act.

There is no excuse for US failure to be ready to address COVID-19. Rather, there is a well-known and constant threat that new diseases will emerge and that old diseases will reemerge in different or more widespread ways. Laurie Garrett wrote The Coming Plague 26 years ago. The best-selling global health textbook says: “Public health specialists also believe that the world must be vigilant about the possibility that a major pandemic could arise from a newly emerging or re-emerging infectious disease.” … “there may be only a limited window for action after an outbreak begins, if a pandemic is to be averted”.

There is also an extensive literature on the economic consequences of emerging and re-emerging infectious diseases. They are enormous and have more to do with the perceived risks of a disease than with how many people it kills. SARS only killed 774 people. However, it had economic costs of over $30 billion. Only 177 people died of mad cow disease in the 1990s outbreak. Yet, more than 4 million cows were killed to stem the disease, which also had over $30 billion in economic costs.

The US response to coronavirus to date has been completely inadequate. This is sadly indicated, among other things, by the fact that CDC recently said that healthcare providers could use bandanas if they run of masks. This is what one might expect in failed, low-income states and should be seen as a national disgrace. Compare this response, for example, with the responses of South Korea and Singapore.

We can choose to pay a reasonable price to deal with emerging and reemerging diseases by developing a strong and permanent capacity to detect, prevent, and mitigate against these diseases. Or, we can choose, as others have said, to go back and forth from complacency to panic and back again, while people die, some needlessly, and industries, such as travel and tourism, fall to pieces.

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.