In hindsight, we could have prepared more seriously, reacted more quickly, communicated more effectively, protected one another more actively and so on. But the next time there’s a public-health threat, we will do better. Right?
Not necessarily. Knowing the many ways that we mishandled COVID-19 is a bit like knowing the number of pages in a textbook to study before an exam. It gives us an idea of the task ahead but not how difficult the work will be. True preparation means studying the problems and working out solutions. There’s a lot of material to cover from this pandemic. And we have no idea when the next test is coming.
TIME’s science and health team, with guidance from the University of Washington Alliance for Pandemic Preparedness, set out to make a study guide of sorts. In late May, TIME sent a list of about 50 initiatives that could mitigate the next health crisis to experts who could expect to be involved. We asked them to score each strategy’s priority and feasibility on a scale of 1 to 5. Seventy-three responses came back from thought leaders in public health, infectious disease, immunology, hospital administration, data and technology, environment and climate, health inequity, supply chains and biosecurity. A third of them were outside the U.S., spanning 16 countries.
The responses offer a blueprint for a more prepared world. At the top of the list was bolstering vaccine research and manufacturing—rated by experts as the most urgent and highest-impact initiatives. Improving systems that track and alert the world to new diseases also scored high. What’s more, these proposals also produced high feasibility scores, meaning experts saw either few barriers to implementation or strong momentum to overcome the challenges.
Other initiatives look tougher to accomplish. Ranked as high priority but less feasible were expanding health care access, distributing vaccines fairly and other strategies addressing inequalities that have exacerbated COVID-19’s toll on vulnerable populations.
Leadership and communication strategies were ranked as fairly high priority and moderately feasible, while on the other end of the spectrum, land-use and live-animal-trade strategies were deemed not very effective and also not very likely to happen.
The above chart shows the average rating for each strategy but does not in every case indicate consensus. A number of the strategies received both high and low scores. Some of those differences surely follow from differences in the disciplines the experts range across.
To capture that essential context, five health leaders previously recognized as TIME100 influencers analyzed the most significant findings in the links below. The points they make not only underscore what we already know—that we could have managed COVID-19 better—but also where to look for the right answers.
Project editor: Elijah Wolfson
Survey design and data analysis: Emily Barone
Contributors: Seth Berkley, Julie Gerberding, Sunita Narain, Rajesh Panjabi and Leana S. Wen
Survey content and outreach: Emily Barone, Jamie Ducharme, Alex Fitzpatrick, Stephen Kim, Jeffrey Kluger, Tara Law, Ciara Nugent, Mandy Oaklander, Alice Park, Dan Stewart, Chris Wilson, Lucas Wittmann, Elijah Wolfson and Justin Worland; with special thanks to Peter Rabinowitz and Judith N. Wasserheit at the University of Washington
Survey participants: Omar Abdi, Liz Agbor-Tabi, Fernando Aith, Danny Avula, John M. Barry, Oni Blackstock, Martin Blaser, Rhea Boyd, Dennis Carroll, Bonnie Castillo, Jagan Chapagain, Nicholas A. Christakis, Francesca Colombo, Eric Dickson, Jeffrey Engel, Nir Eyal, Josep Figueras, Tom Frieden, Tunji Funsho, Lauren Gardner, Julie Gerberding, Monica H. Green, Amita Gupta, Li Yang Hsu, Yanzhong Huang, Chikwe Ihekweazu, Adam Kamradt-Scott, Nancy Kane, Gagandeep Kang, Morgan Katz, Annette Kennedy, Julie Khani, Philip J. Landrigan, Heidi J. Larson, Ramanan Laxminarayan, Thomas Lee, Joanne Liu, Howard Markel, Linsey Marr, Clay Marsh, Jonna Mazet, Lisha McCormick, Michael Mina, David M. Morens, Sunita Narain, J. Alexander Navarro, Brooke Nichols, John N. Nkengasong, Raj Panjabi, Park Neung-hoo, Chaun Powell, Jonathan D. Quick, Megan Ranney, K. Srinath Reddy, Elena Rios, Adolfo Rubinstein, Joni L. Rutter, Nada R. Sanders, Quentin Sandifer, Tara Kirk Sell, Jaime Sepúlveda, Jeffrey Shaman, Shi Zhengli, Alex Tabarrok, Eloise Todd, Chris Walzer, Judith Wasserheit, Andy Weber, Leana S. Wen, Yoon Tae-ho and Emily Zylla
Editorial producers: Paulina Cachero and Nadia Suleman
Visual editors:Katherine Pomerantz and Whitney Matewe
Copy editors: Helen Eisenbach, Mark Hokoda, Anny Kim, Megan Rutherford, Sarah Rutledge and Jennifer Schiavone