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

Is the US Prepared for Another Pandemic? A Mixed and Concerning Picture

Based on current assessments, experts and government watchdogs paint a troubling picture of U.S. pandemic preparedness in 2026—one marked by significant structural weaknesses even as some technical infrastructure remains in place.

Signs of Weakening Preparedness

Federal leadership gaps: The White House Office of Pandemic Preparedness and Response Policy, created after COVID-19 to coordinate federal pandemic response, has been hollowed out. In 2025, Gerald Parker resigned as head of the office, leaving the office with no employees. This left a critical coordination body essentially non-functional.

Withdrawal from international cooperation: The U.S. has stepped back from global health security efforts. In 2025, the administration dismantled USAID, the federal humanitarian agency that played a role in global outbreak prevention and response. In 2026, the U.S. announced its withdrawal from the WHO after almost 78 years of membership.

State-level readiness is uneven: According to the 2026 "Ready or Not" report from Trust for America's Health, states and the District of Columbia fall into three performance tiers: 20 states in the high-performance tier, 17 states and the District of Columbia in the middle-performance tier, and 13 states in the low-performance tier. This means nearly 40% of states (the middle and low tiers combined, though DC and 13 states are explicitly "low") are not well-positioned for emergencies.

Federal coordination problems: A February 2026 GAO report found specific gaps in federal oversight. HHS does not collect or analyze information on jurisdictions' ability to meet the 15 public health and four health care preparedness capabilities and any related gaps. GAO recommended that HHS establish a mechanism to coordinate PHEP and HPP; and that it collect and analyze information on jurisdictions' preparedness capabilities and any related gaps.

Funding instability: Amid deep federal staffing cuts, grant terminations, and other far-reaching changes to the federal public health system, a new report from Trust for America's Health finds wide variation in states' readiness for disease outbreaks, natural disasters, and other health emergencies. Additionally, while a majority of states maintained or increased public health funding in FY 2025, at least 12 states reduced funding—a concerning trend at a moment of heightened federal uncertainty.

Current disease pressures already straining the system: In 2025, the country faced the most severe flu season in nearly a decade, rising measles outbreaks, continued H5N1 avian influenza activity, and a growing number of extreme weather events—all while the federal systems built over decades to help states prepare for and respond to emergencies came under significant strain.

Workforce vulnerabilities: Basic protective measures remain inconsistent. Access to paid sick leave varies widely across U.S. regions—from 98 percent of workers in Pacific states to 67 percent in East South Central states—and gaps are most concentrated among low-wage, part-time, and service-sector workers, even though paid sick leave reduces disease transmission and supports business continuity. Similarly, flu vaccination coverage remains too low in many states, weakening a key foundation of outbreak and pandemic preparedness.

Hospital surge capacity concerns: In fall 2025, only 27 percent of graded hospitals earned an "A" from the Leapfrog Hospital Safety Grade, with wide variation across states—a relevant metric since strong patient safety performance can help hospitals maintain care quality and manage surge capacity during emergencies.

Areas of Relative Strength

Not all the news is negative. Some specialized infrastructure has held up:

The Bottom Line

Public health experts are sounding alarms. As one expert noted regarding a 2026 Ebola outbreak, "The bottom line is we were not ready for this outbreak, and we aren't ready for the next one." The broader consensus among researchers tracking this issue is that there is an "increasing fragility" in the U.S.'s public health system.

The overall picture suggests the U.S. retains pockets of genuine capability—particularly for known, specific threats like Ebola or Marburg through specialized treatment centers—but faces serious systemic vulnerabilities for a large-scale, novel pandemic. These vulnerabilities stem from federal leadership vacancies, withdrawal from international early-warning systems, inconsistent state-level funding and readiness, workforce protections gaps, and coordination problems between federal agencies. Whether the system could mount an effective large-scale response similar to (or better than) the COVID-19 effort is genuinely uncertain, and many public health officials argue preparedness has moved backward rather than forward since 2020-2021.