Long before COVID-19, health experts warned that a major pandemic was inevitable. But lack of adequate preparation left the U.S. vulnerable, resulting in over 1.1 million deaths and 6.2 million hospitalizations.

COVID-19 has taught us just how easily a disease can jump from animals to humans and how quickly it can traverse borders and oceans. Yet, COVID-19 is not the last pandemic we will face—pandemics are likely to become more frequent and more severe due to climate change, increased human encroachment on animal habitats, and a rise in international travel. 

The ability to monitor disease spread in real time before and during outbreaks and to respond quickly, decisively, and equitably is necessary to keep everyone safe. Below we outline some steps the U.S. can take to prepare for the next pandemic.

Preparation is key to avoiding pandemic disaster

In 2010, President Obama expanded a plan for a rapid and efficient pandemic response, first launched under President George W. Bush. Both administrations faced major disease outbreaks and left a playbook to combat future pandemics. 

However, the Trump administration dismantled the program and cut funding for pandemic preparedness initiatives. When COVID-19 made its way to the U.S., the country was unprepared even as the pandemic developed exactly as infectious disease experts had warned for over a decade. 

Over the course of the COVID-19 pandemic, public focus and funding shifted to pandemic surveillance and response. The Biden White House announced in October 2022 a biodefense strategy to prevent and rapidly respond to future pandemics. 

Wastewater monitoring, one of the earliest ways to catch emerging disease outbreaks, increased dramatically in the U.S. during the pandemic. The CDC’s National Wastewater Surveillance System grew from just five SARS-CoV-2 testing sites in 2020 to over 1,200 sites representing about 150 million Americans by 2022. Testing expanded to mpox (formerly monkeypox) in 2022. Now, the CDC is working to expand surveillance to other pathogens, including poliovirus, influenza, and E. coli.   

Bolster surveillance of emerging zoonotic diseases 

Zoonotic diseases—which jump from animals to humans—have been on the rise worldwide for decades, causing major outbreaks of infectious diseases like mpox, Ebola, dengue fever, and the avian (bird) flu.  

Moreover, the spread of zoonotic diseases is worsened by climate change, as natural disasters and shrinking habitats force humans into closer proximity to disease-carrying organisms. Experts believe it’s increasingly likely that the next pandemic will be zoonotic, making disease surveillance in wildlife and agriculture more important than ever. One recent study found that white-tailed deer in the U.S. can carry SARS-CoV-2 and potentially spread it to humans.

One example is the avian flu outbreak that began in early 2022, which has been the deadliest in history, killing hundreds of millions of birds and driving up egg and poultry costs. It demonstrates that even zoonotic diseases that don’t primarily affect humans can have devastating effects.  

Invest in disease prevention and control everywhere

During the summer of 2022, the U.S. stumbled in its response to the unprecedented global mpox outbreak, its first disease response effort since the start of the COVID-19 pandemic. Though thousands faced threats from the disease, health officials delayed the distribution of lifesaving vaccines and initially failed to clearly communicate who was most at risk.  

Mpox is endemic to parts of West and Central Africa and, prior to 2017, was rarely transmitted between humans. The mpox outbreak not only showed that it’s necessary to fight infectious diseases in every part of the world but also that responses must be timely and equitable. For example, while the U.S. and other wealthy countries rapidly distributed vaccines merely months after the outbreak began, others in Africa, Asia, and Latin America still lack access to mpox vaccines. 

Similarly, polio, a disease that has been wiped out in much of the world for decades, now threatens to make a comeback in areas with low immunization rates.   

Over the last few years, the U.S. has witnessed outbreaks of new diseases like COVID-19, nearly eradicated diseases like polio, and diseases that were once confined to specific geographic regions like mpox. These outbreaks show that infectious diseases don’t respect borders. The only way to protect the U.S. against future pandemics is to do everything we can to prevent disease outbreaks around the globe. 

Strengthen existing pandemic response infrastructure 

During the COVID-19 pandemic, the U.S. funded the accelerated development of vaccines, masks, and rapid tests; expanded wastewater surveillance; and launched community-based outreach systems, proving that systems like these are effective at containing disease transmission and saving lives. Because of the pandemic, the U.S. has many tools in place to prevent and control future pandemics. 

The pandemic’s lessons learned also demonstrate the importance of and need for global partnerships and alliances. For example, when the Omicron subvariant began circulating in late 2021, South African researchers were the first to warn the world. 

The Network for Genomic Surveillance in South Africa, one of seven next-generation genomic sequencing sites in the Africa Pathogen Genomics Initiative, is an effort Africa CDC and the World Health Organization launched in 2020 to support continent-wide disease surveillance and public health response. 

Rebuild trust in public health 

False information about COVID-19 and vaccines didn’t only impact COVID-19 vaccination rates; it may also have caused significant damage to the perception of public health initiatives and vaccines as a whole. But inconsistent messaging from public health officials also played a role in losing public trust.

As a result, the current administration is in the unique position of having the pandemic response infrastructure and experience in place, alongside unprecedented resistance to pandemic-related policies. Over half of U.S. states have passed laws to prevent or weaken future outbreak response policies like school closures and mask mandates.

To overcome this resistance, advocates will likely need to organize opposition to anti-pandemic response policies and push their representatives to support evidence-based policies that will keep us all safer when we face the next pandemic. Additionally, monitoring and dispelling misleading information before it ever reaches the broader public will be necessary to avoid the misinformation cycle that shaped the COVID-19 pandemic.