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The United States Must Improve Biosurveillance to Answer COVID-19 Questions and Avoid Future Catastrophes

The views expressed are those of the author and do not necessarily reflect the views of ASPA as an organization.

By Nathan Myers
May 18, 2021

As vaccination efforts continue in the United States and around the world, and hopes flourish for a post-pandemic phase, many important policy questions remain. Why didn’t we have better information for decisionmaking? Were national stay-at-home orders necessary? How was a nation with such wealth and resources caught without adequate supplies as hospitals throughout the country had their capacity stretched with patients? And why were our national, state and local leaders not able to work together more productively?

One common factor connecting these questions would seem to be a lack of adequate biosurveillance to facilitate early warnings and situational awareness. A report released by the Bipartisan Commission on Biodefense in March 2021 lends credence to the importance of improving infectious disease surveillance. One of their recommendations was for federal authorities to conduct an assessment of the National Biodefense Integration System, including determining what additional authorities the program needs to collect necessary information from federal agencies for aggregation, analysis and alerts. Along with this, the Commission calls upon the Biden administration to complete and release the implementation plan for the National Strategy for Biosurveillance and to investigate approaches to incentivize the sharing of data.

The Bipartisan Commission report also calls for increased and sustained funding support for the Global Health Security Agenda. Along with supporting biosurveillance activities in the United States, the GHSA could act as an early alert system for international risks. The GHSA would especially be able to serve this function if it is expanded to encompass all countries, as recommended in the report. Another recommendation the Commission makes in the area of biosurveillance is for the U.S. Department of Agriculture to partner with other relevant federal agencies to create a list of notifiable animal diseases, create a reporting system that would extend across all levels of government and increase opportunities for collecting data on animal health. Such a step would help to further ensconce the One Health principle in federal activities beyond the creation of the One Health Federal Interagency Network. This should be done in conjunction with another of the Commission’s recommendations to create an interagency biosurveillance planning committee to facilitate more collaboration between federal authorities, non-governmental stakeholders, and state, local, tribal and territorial officials.

While others will no doubt have their own recommendations, those of the Bipartisan Commission are a good starting point as they address interagency collaboration at the federal level in the U.S., intergovernmental coordination across the United States, strengthening international partnerships and recognizing the interconnectedness of human life, animal life and the overall environment when it comes to emerging diseases. Having more integrated, sensitive and specific early warning systems in the future could not only allow us to detect emerging risks faster, but also to contain and mitigate them in a more targeted manner so as to limit social and economic disruption.

Another well-documented challenge in the early stages of the COVID-19 pandemic was hospitals, long-term care facilities and other health institutions having inadequate supplies of personal protective equipment. Previous articles have noted the potential to use a more resilient form of cooperative procurement in which multiple jurisdictions or organizations would collaborate on a joint agreement with a supplier. Part of such an agreement would be all of the purchasers involved agreeing on prices for items during more routine operations as well as prices during emergencies in which there would be a higher demand and greater urgency. For such a system to function well, it will require reliable information systems to signal when an emergency is developing so that both supplier and purchaser can make the necessary adjustments.

Another state response during the COVID-19 pandemic was to issue executive orders and other mechanisms to make temporary adjustments to state regulations in order to allow retired or out-of-state providers to offer care. While such policy actions have evident utility when one state is experiencing difficulty and seeks help from its neighbors, it becomes more complicated during a national emergency. In order for such sharing of personnel to be useful during a future pandemic, reliable information systems will be needed to identify those areas that have greater need and those that are relatively safe.

One of the major response challenges during the U.S. pandemic response was the fractured and sometimes adversarial relationship between the Trump administration and state leaders, as well as between some governors and city leaders. The creation of the interagency biosurveillance planning committee as recommended by the Bipartisan Commission could help to address such issues by encouraging an on-going dialogue regarding these issues. A significant amount of the conflict was driven by the acquisition and distribution of resources. Having more warning in the future may help to stave off such areas of conflict.

The United States has become very adept at using the collection, analysis and dissemination of information to protect the public from threats ranging from weather events to terrorism. That same expertise must be brought to bear against future infectious disease emergencies. Such a system will not only help us to manage a crisis when it comes, but also could better help the American public manage daily operations in a more efficient manner.

Authors: Nathan Myers, Ph.D. is an Associate Professor in the Department of Political Science and Director of the Master of Public Administration at Indiana State University. His areas of research include public policy, public health emergency preparedness, and the governance of biotechnology. He is the author of “Pandemics and Polarization: Implications of Partisan Budgeting for Responding to Public Health Emergencies.” Myers serves as an academic advisor to the Continuity of Supply Initiative and assistant director of Indiana State’s Center for Genomic Advocacy.

[email protected]; Twitter: nagremye1980

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