5 steps the U.S. should take now to prepare for the next pandemic

Rarely in recent memory has it been this difficult to see beyond the next day. In the United States and around the world, the number of coronavirus cases is rising so quickly that it feels almost impossible to see our way past this crisis — let alone plan for its next phase or the next pandemic.

But that is exactly what we should be doing, and we have no time to waste.

This might seem counterintuitive, like taking steps to prevent a second world war while you’re still fighting to win the first one. But if anyone doubts the importance of preparedness, each day’s news provides further evidence of steps we should have taken: to secure more masks and ventilators; to develop more and better diagnostic tests; to impose social distancing more quickly and fully; and to take more seriously the warnings of experts in global pandemics.

Public anger and disappointment over the nation’s lack of preparedness is understandable. Unfortunately, we can’t go back in time and correct that. But we don’t have to wait for this virus to pass before we start applying the lessons it has taught us. Indeed, we can’t afford to wait.

5 steps we should take now

Already, hospitals are starting to prepare for the challenges ahead. Last week, for example, some doctors and medical teams began discussing how to handle “do-not-resuscitate” orders as a general policy rather than on an ad-hoc, last-minute basis. They know the best time to develop the groundwork for making such decisions is in advance, not when an individual patient is in crisis.

In a similar spirit, here are five practical steps the U.S. should take — today — to get ready for whatever lies ahead.

► Assign the highest level of urgency to the Strategic National Stockpile (SNS) of essential supplies, drugs, medical devices such as ventilators, and personal protective equipment. The SNS is much like the Strategic Petroleum Reserve, the emergency fuel supply our government established after the OPEC oil embargo led to shortages and price shocks. Yet today the SNS is seen mainly as a stopgap — and not even that. Greg Burel, who recently retired as its director, told CBS News this week that the stockpile has long been depleted, and machines such as ventilators have not been maintained. Though Congress just provided funding to increase the stockpile, Burel argued that “it’s going to be hard to prepare for a second wave or for a future need... How do we sustain that further investment?”

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► Move quickly to deal with the predicted long-term shortages in the health care workforce. Simply put, we need more doctors to care for our growing and aging population — not just primary-care physicians, but specialists in critical care, pulmonology, and infectious diseases, psychiatrists, as well as hospitalists. While the number of doctors enrolling in U.S. medical schools has increased by 30% over the past 15 years to help address this shortage, the government should increase its support of graduate medical education (residency training) so we can increase the number of practicing physicians.

► Deploy the entire health care team more aggressively and effectively. This could include allowing non-physicians — specifically, experienced nurse practitioners and physician assistants — to perform a wider range of basic medical procedures and prescribe certain treatments without direct supervision by a doctor. Many states have enacted limited “scope of practice” reforms in recent years, and studies show no reduction of the quality of care. In the past several days, the governors of Michigan and Arizona, among others, have signed executive orders permitting nurses and PAs to work independently and, where appropriate, to diagnose, treat, and manage patients who have COVID-19. These changes will help improve access to care in rural areas and will free physicians to provide other medical services. But these are temporary orders. Long-term policies are essential, including funding and other vital support for the public health workers in our communities.

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► Enlist the capabilities of the nation’s private and non-profit sectors more strategically. We are seeing incredible acts of patriotism by companies that are stepping up production of ventilators or providing free hotel rooms for medical workers. Yet, as we look ahead, the private sector and non-profits, including teaching hospitals, must have a seat at the table — as true partners to the government — when task forces develop plans to address future pandemics.

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► Increase long-term federal investment in medical research. Over the past few years, Congress has strengthened the nation’s commitment by increasing funding for the National Institutes of Health, and the legislation just passed includes additional funding for vaccine development. But we have a long way to go to build up our defenses against an enemy that cannot be stopped by bullets or bombs. Like our national security, this requires resources that only the federal government can marshal. The Centers for Diseases Control and Prevention are badly in need of increased appropriations. Funding for our great research institutions such as the NIH and National Science Foundation, must also be a top priority. These proposals, I recognize, would require new appropriations on a considerable scale. But as we've seen in recent days, Congress and the administration recognize that America's health and economic security are essential investments. Researchers, no less than clinicians, are at the front lines of this fight, and we can never let down our guard again.

Preparedness is not a fixed “one and done” state. It is a continual process, a mindset of constant readiness. To that end, there is much to be done, and it is not too early to act to prepare for the next crisis. If COVID-19 has made one thing clear, it is that we do not have the luxury of time.

Dr. David J. Skorton, a cardiologist, is president and CEO of the Association of American Medical Colleges. Follow him on Twitter: @DavidJSkorton

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This article originally appeared on USA TODAY: 5 steps the U.S. should take now to prepare for the next pandemic