Is the US prepared to deal with another pandemic or widespread health crisis?

Based on major policy shifts, federal reorganizations, and assessments from epidemiological organizations, the consensus among public health experts is that the United States is generally less prepared to deal with another pandemic or widespread health crisis than it was prior to COVID-19.

While the federal government has pivoted toward direct, bilateral agreements to protect national interests, critics warn that the dismantling of key global and domestic health infrastructures has left the nation highly vulnerable to transnational biological threats.

The current state of U.S. pandemic preparedness is shaped by several critical factors:

1. The Dismantling of Domestic Public Health Infrastructure

Between 2025 and 2026, the federal government underwent a massive restructuring of agencies tasked with managing biological threats:

•CDC Leadership and Workforce Gaps: Following severe funding cuts and workforce reductions, the Centers for Disease Control and Prevention (CDC) has lost an estimated 25% to 30% of its personnel. Furthermore, roughly 80% of senior leadership positions at the CDC lack permanent officials.

•Downsized White House Pandemic Office: The White House Office of Pandemic Preparedness and Response Policy (OPPR), which had 15 staff members at its peak, was heavily scaled back. It currently operates with minimal staffing (referred to by former officials as an "army of one"), which experts argue severely limits the executive branch’s ability to coordinate a rapid federal response to a sudden outbreak.

•USAID Dissolution: On July 1, 2025, the U.S. Agency for International Development (USAID)—which had spent decades monitoring and preventing infectious disease outbreaks at their sources globally—was dissolved. Over 80% of its program portfolio was canceled and 94% of its workforce laid off, with the remaining minimal operations absorbed into the State Department.

2. Withdrawal from Global Surveillance and the "America First" Pivot

Pandemics are transboundary crises, meaning early-warning detection relies heavily on global cooperation. Recent U.S. foreign policy shifts have altered this dynamic:

•WHO Withdrawal: On January 22, 2026, the United States formally completed its legal withdrawal from the World Health Organization (WHO), ending all federal funding, personnel involvement, and committee participation.

•Loss of Early Detection Systems: By leaving the WHO, the U.S. no longer participates in the Global Influenza Surveillance and Response System. Public health organizations warn this severely hinders the U.S.'s ability to monitor global flu mutations and acquire viral samples necessary to formulate effective, timely annual vaccines.

•Bilateral Focus: Under the State Department's America First Global Health Strategy (launched in late 2025), the U.S. has moved away from multilateral aid, instead executing direct, bilateral Memorandums of Understanding (MOUs) with individual nations. The administration argues this model ensures a better return on investment, improves accountability, and allows the U.S. to condition funding on direct, real-time access to other countries' health and pathogen data. However, critics argue a purely transactional, country-by-country model is fundamentally unequipped to contain fast-moving, borderless diseases.

3. Domestic Hospital and State-Level Fragility

Within U.S. borders, state and local health systems remain fragile:

•State-by-State Disparities: The Ready or Not 2026 report by the Trust for America's Health (TFAH) evaluated the nation's emergency health preparedness across 10 key indicators. It placed only 20 states in the "high-performance" tier, leaving the remaining 30 states and Washington, D.C., in "middle" or "low-performance" tiers due to gaps in emergency laboratory capacity, water system safety, and public health funding.

•Staffing Shortages and Burnout: Local health departments and hospitals continue to struggle with clinical workforce exhaustion, high nursing turnover, and limited patient safety margins. This severely constrains their "surge capacity"—the ability of the healthcare system to handle a sudden influx of patients during a crisis.

•Legislative Delays: Key legislative frameworks, such as the Pandemic and All-Hazards Preparedness Act (PAHPA), have faced gridlock and delayed reauthorizations, leaving federal funding for local state preparedness unstable.

4. Public Distrust and Vaccine Hesitancy

Even if the U.S. possesses medical countermeasures (like vaccines and therapeutics), its ability to deploy them effectively is compromised by social and political dynamics:

•The "Infodemic": Deep political polarization and a proliferation of medical misinformation have eroded public trust in scientific institutions.

•Declining Immunization: Rising vaccine hesitancy has driven down routine childhood immunization rates. This is evidenced by a massive measles surge, with over 1,430 cases across 42 jurisdictions, primarily concentrated in pockets with low vaccination rates.

The Current Stress Test

The U.S. public health system is facing a "stress test" from multiple co-circulating threats, including:

•Continuous detections of H5N1 avian influenza in poultry and dairy cattle populations.

•Significant surges in measles outbreaks.

•Local outbreaks of diseases like cyclospora, hantavirus, and screwworm.

While proponents of the current "America First" strategy argue that cutting federal agencies and withdrawing from international bodies reduces bureaucratic waste and protects American sovereignty, most public health professionals warn that these actions have hollowed out the exact systems, databases, and personnel pipelines required to detect and stop the next major pandemic before it reaches U.S. soil.

Citations (15)

1pandorareport.orgNonprofits and think tanks
pandorareport.org
Backs: “Based on major policy shifts, federal reorganizations, and assessments from epidemiological organizations, the consensus among public health experts is that the United States is generally less prepared to deal with another pandemic or widespread health crisis than it was prior to COVID-19.”
2donortracker.orgData and tools
donortracker.org
Backs: “While the federal government has pivoted toward direct, bilateral agreements to protect national interests, critics warn that the dismantling of key global and domestic health infrastructures has left the nation highly vulnerable to transnational biological threats.”
3nih.govGovernment
nih.gov
Backs: “While the federal government has pivoted toward direct, bilateral agreements to protect national interests, critics warn that the dismantling of key global and domestic health infrastructures has left the nation highly vulnerable to transnational biological threats.”
4notus.orgNot yet classified
notus.org
Backs: “Downsized White House Pandemic Office: The White House Office of Pandemic Preparedness and Response Policy (OPPR), which had 15 staff members at its peak, was heavily scaled back.”
5wikipedia.orgEncyclopedias and referencequality 0.83
wikipedia.org
Backs: “USAID Dissolution: On July 1, 2025, the U.S. Agency for International Development (USAID)—which had spent decades monitoring and preventing infectious disease outbreaks at their sources globally—was dissolved. Over 80% of its program portfolio was canceled and 94% of its workforce laid off, with the remaining minimal…”
6forbes.comNews and mediaquality 0.83
forbes.com
Backs: “USAID Dissolution: On July 1, 2025, the U.S. Agency for International Development (USAID)—which had spent decades monitoring and preventing infectious disease outbreaks at their sources globally—was dissolved. Over 80% of its program portfolio was canceled and 94% of its workforce laid off, with the remaining minimal…”
7hhs.govGovernment
hhs.gov
Backs: “Recent U.S. foreign policy shifts have altered this dynamic: WHO Withdrawal: On January 22, 2026, the United States formally completed its legal withdrawal from the World Health Organization (WHO), ending all federal funding, personnel involvement, and committee participation. Loss of Early Detection Systems: By…”
8umn.eduAcademic
umn.edu
Backs: “Loss of Early Detection Systems: By leaving the WHO, the U.S. no longer participates in the Global Influenza Surveillance and Response System. Public health organizations warn this severely hinders the U.S.'s ability to monitor global flu mutations and acquire viral samples necessary to formulate effective, timely…”
9one.orgNonprofits and think tanks
one.org
Backs: “Bilateral Focus: Under the State Department's America First Global Health Strategy (launched in late 2025), the U.S. has moved away from multilateral aid, instead executing direct, bilateral Memorandums of Understanding (MOUs) with individual nations. The administration argues this model ensures a better return on…”
10thinkglobalhealth.orgNonprofits and think tanks
thinkglobalhealth.org
Backs: “The administration argues this model ensures a better return on investment, improves accountability, and allows the U.S. to condition funding on direct, real-time access to other countries' health and pathogen data. However, critics argue a purely transactional, country-by-country model is fundamentally unequipped to…”
11tfah.orgNonprofits and think tanks
tfah.org
Backs: “Domestic Hospital and State-Level Fragility. Within U.S. borders, state and local health systems remain fragile: State-by-State Disparities: The Ready or Not 2026 report by the Trust for America's Health (TFAH) evaluated the nation's emergency health preparedness across 10 key indicators. It placed only 20 states in…”
12halyardhealth.comCompanies
halyardhealth.com
Backs: “Staffing Shortages and Burnout: Local health departments and hospitals continue to struggle with clinical workforce exhaustion, high nursing turnover, and limited patient safety margins. This severely constrains their "surge capacity"—the ability of the healthcare system to handle a sudden influx of patients during a…”
13theguardian.comNews and mediaquality 0.75
theguardian.com
Backs: “Public Distrust and Vaccine Hesitancy. Even if the U.S. possesses medical countermeasures (like vaccines and therapeutics), its ability to deploy them effectively is compromised by social and political dynamics: The "Infodemic": Deep political polarization and a proliferation of medical misinformation have eroded…”
14facebook.comSocial media and video
facebook.com
Backs: “While proponents of the current "America First" strategy argue that cutting federal agencies and withdrawing from international bodies reduces bureaucratic waste and protects American sovereignty, most public health professionals warn that these actions have hollowed out the exact systems, databases, and personnel…”
15donortracker.orgData and tools
donortracker.org
Backs: “While proponents of the current "America First" strategy argue that cutting federal agencies and withdrawing from international bodies reduces bureaucratic waste and protects American sovereignty, most public health professionals warn that these actions have hollowed out the exact systems, databases, and personnel…”