Dr. Walensky, why at this point doesn’t the U.S. have a plan for handling COVID-19 and other pandemics?

Everyone seems to still have questions about COVID-19. Parents want to know the rationale behind immunizing their children, businesses want to know the likelihood of future economic disruptions and people generally want an assurance that they can normalize their lives. I can see the confusion on the faces of people parsing whether to wear a face mask as they enter large indoor events.

The problem is that most of these questions can’t be answered because the United States has no defined plan for dealing with COVID 19 moving forward.

The plan should be coming from the Centers for Disease Control based on lessons learned from the pandemic. We have all kinds of plans in the public health sector for dealing with disease outbreaks caused by contaminated food or contagious respiratory diseases like influenza. We even have a plan for containing monkey pox and Ebola. However, we have yet to see a plan for this phase of COVID-19 that explains the need for, and the value of immunization, antiviral drugs and masks, based on individual risk and levels of infection in different areas of the country.

COVID-19 was an important experiment of nature pitting an aggressive infectious disease against the human population. We learned important lessons about the transmission of respiratory viruses, such as the utility of masks versus the uselessness of disinfecting surfaces. Other crucial lessons included the incredible cost of closing schools versus the minimal benefit that this had in preventing viral transmission. We cannot lose those lessons and need to define our future actions base on this knowledge.

Amazingly, people are still relying on simulations of pandemics to make public health decisions! These simulations proved, in the case of COVID-19, to be remarkably uninformative and variable in their accuracy. In contrast, in COVID-19 we have an actual pandemic on which we can base our future actions!

The CDC, by not holding a meeting of all stakeholders to define the consensus best practices for handling COVID-19 and pandemics in general, is an astounding failure.

In the absence of guidance from the CDC it is impossible to make rational personal decisions on how to currently handle COVID-19. 

Parents are reluctant to immunize their children because, while the risks of immunization are well defined, the benefits for the child and society have not been clearly stated. 

Individuals aren’t sure when to wear masks in crowded venues because the threshold levels of infection that make it valuable aren’t defined (and local infection statistics are not easily available). 

Businesses are frightened about economic disruptions because they haven’t been told what the likelihood of this is in a future pandemic. 

Everyone is scared to death about what will happen to education during disease outbreaks since, although the consensus is it was wrong to close schools, no one will promise it won’t be done in the future.

Maybe the CDC and the public health community have become so polarized and politicized that they don’t feel there can be an open dialogue about the outcome of the pandemic. It is possible that after the midterm election the environment might be better for this.

Regardless, I can state unequivocally that we must learn from the COVID-19 pandemic in plotting our plans for handling this and other diseases in the future. The citizens of the United States deserve that from their elected and appointed officials.