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Biden administration needs a national pandemic preparedness strategy

Defeating this scourge will be the President-elect's greatest challenge
- - Wednesday, December 16, 2020

COVID-19 has killed more than 300,000 Americans. And with case counts and hospitalizations soaring, many more deaths are sadly in store.  
Defeating this scourge will be President-elect Joe Biden’s greatest challenge. But he’d be remiss to stop there. He has a unique opportunity to build up our national health care defenses so we’re better prepared to fend off future disease outbreaks.
That’s why creating a comprehensive pandemic preparedness strategy that is agile and reacts quickly ought to be one of his administration’s top priorities. It could save tens of thousands of Americans in the years and decades ahead.
During the current outbreak, many vulnerable Americans have struggled to access affordable care. By one estimate, as many as 12 million Americans lost their employer-sponsored health coverage between February and July. More than 40% of Americans deferred any kind of medical care earlier this year due to fears of contracting the virus. Patients with chronic conditions were also more likely to forego urgent or emergency care during those early months, this was also the case for too many Black and Latino Americans.  
Many of these compounding challenges could be alleviated by making health insurance more affordable to help ensure Americans can get the care they need in future health emergencies.
But by taking some important steps further and crafting an effective pandemic preparedness plan, Mr. Biden must also mitigate the impact of social distancing measures and quarantines. No doubt such actions are absolutely necessary for slowing the spread of infectious diseases, but they also take a toll on Americans’ mental and economic health.
Consider that 40% of Americans reported suffering from some form of mental health or substance abuse problem during COVID-19 induced lockdowns, according to a survey conducted in June. In a separate poll conducted around the same time, a quarter of older Americans reported depression or anxiety.  
Meanwhile, one-in-four Americans have struggled to pay bills during the pandemic, according to Pew Research, and one-third have drawn from savings and retirement plans just to make ends meet.  
Building up our health care infrastructure is similarly vital. Investments in telehealth systems that enable patients to access medical care remotely would improve health outcomes in a crisis. Investments in monitoring and contact-tracing systems would prove similarly useful. COVID-19 caught Americans by surprise and forced us to adapt and innovate on the fly. Next time, we need to be better prepared.
To that end, a forthcoming preparedness plan could create a mechanism for the federal government to identify, assess and monitor health risks that could precipitate another pandemic. One such risk is already well known: antimicrobial resistance. Drug-resistant bacteria and fungi kill 35,000 Americans each year, and with a treatment arsenal that is dwindling in both effectiveness and financial solvency, that annual death toll is expected to skyrocket sooner than anyone would like to imagine.
Addressing this growing threat will require a coordinated federal response that encourages — and rewards — the development of new, more potent antibiotics. Equally as important, that response would also include reforms that discourage antibiotic overuse and misuse.
Today, just a handful of drug companies are investing in antibiotic research and development, and this is because in an effort to stave off widespread resistance doctors only use new antibiotics in dire emergencies. That caution is warranted from a medical perspective, but it means antibiotics developers rarely sell enough doses to recoup their R&D costs. In other words, different incentives are needed to encourage the development of new antibiotics.  
There are real opportunities for Washington to fix this fundamentally broken market. Two bipartisan bills currently under consideration in Congress — the DISARM and PASTEUR Acts — would incentivize both antibiotics research and development as well as stewardship. A Biden administration could urge congressional leaders to send both bills to the president’s desk right away as a key component of a broader effort to prepare the nation for future pandemics.
COVID-19 is far from over, and already, the next pandemic is looming. The difference with antimicrobial resistance is that we know it is coming, and it would be simply negligent not to prepare for and prevent the increasing threats of as best we can. 
The Biden administration could save countless lives by developing and implementing a national pandemic preparedness plan that ensures we are better equipped to handle future outbreaks and health crises.
Kenneth E. Thorpe is a professor of health policy at Emory University and chairman of the Partnership to Fight Chronic Disease.