Is the US prepared to deal with another pandemic or widespread health crisis?
The US is better prepared in some key areas than before COVID-19 but remains incompletely prepared for another major pandemic or widespread health crisis, with significant persistent gaps that experts warn leave the nation vulnerable. Assessments from the Government Accountability Office (GAO), Bipartisan Commission on Biodefense, Trust for America’s Health (TFAH), WHO Joint External Evaluation (JEE), CDC, and others highlight progress alongside unfinished reforms, funding shortfalls, coordination challenges, and risks of backsliding.[1]
Key Improvements Since COVID-19
Biden-era roadmaps touted these as transforming preparedness, and the US has managed responses to mpox, H5N1 (ongoing in animals with limited human cases, mostly mild/occupational), and other threats with better tools than in early 2020.[5]
Persistent Gaps and Vulnerabilities
Overall Assessment
The US has stronger tools, stockpiles, tech platforms, and some institutional memory than in 2019–2020, when it ranked highly on paper (e.g., Global Health Security Index) but underperformed in practice due to execution failures. It can likely handle smaller or contained outbreaks more effectively (as with aspects of H5N1/mpox). However, for a COVID-scale or worse event (novel highly transmissible/pathogenic respiratory virus, or worse), experts across bipartisan commissions, GAO, TFAH, and academic analyses conclude it is not fully prepared. Core issues—sustained funding, unified leadership/authority, resilient public health workforce and infrastructure at all levels, supply chains, trust, and equity—have not been comprehensively fixed. The “on-again/off-again” cycle risks eroding gains.[10]
Preparedness is a continuum, not binary. Full readiness requires ongoing political will, multi-year appropriations matching authorized needs (e.g., reauthorizing/strengthening PAHPA), implementing open recommendations, investing in detection/air quality/MCM platforms, and rebuilding trust. Without these, another crisis would again expose vulnerabilities, though hopefully with fewer initial shortages than 2020. Ongoing threats like H5N1 underscore the urgency.
Citations (10)
- https://www.gao.gov/products/gao-24-107175
Backs: “Assessments from the Government Accountability Office (GAO), Bipartisan Commission on Biodefense, Trust for America’s Health (TFAH), WHO Joint External Evaluation (JEE), CDC, and others highlight progress alongside unfinished reforms, funding shortfalls, coordination challenges, and risks of backsliding.”
evidence, official document, points to no. Claim: Assessments from GAO and others highlight progress alongside unfinished reforms, funding shortfalls, and coordination challenges, leaving the US incompletely prepared.}
- https://bidenwhitehouse.archives.gov/briefing-room/statements-releases/2025/01/14/report-the-biden-harris-administration-roadmap-for-pandemic-preparedness-and-response/
Backs: “BARDA and related efforts advanced mRNA and other platforms for faster vaccine/therapeutic development (aiming toward 100-day capabilities in some strategies).”
evidence, official document, points to yes. Claim: Strategic National Stockpile replenished with far more PPE and ventilators; OPPR established; countermeasure platforms advanced; global health security investments.
- https://www.cdc.gov/washington/testimony/2024/t20241114.htm
Backs: “CDC enhanced modeling/forecasting (e.g., Center for Forecasting and Outbreak Analytics) and lab partnerships (“warm bases” with commercial labs).”
statistic, official document, points to yes. Claim: Electronic case reporting expanded from under 200 facilities to over 45,000; wastewater surveillance and forecasting improved.
- https://www.who.int/publications/i/item/9789240105409
Backs: “The 2024 WHO JEE of US IHR core capacities noted high overall architecture and capacities in many technical areas (often demonstrated/sustainable levels in labs, surveillance, immunization, etc.), with recommendations focused on refining rather than building from scratch.”
evidence, official document, neutral. Claim: WHO JEE noted strong capacities in many areas but recommended extending capacity to state/local levels and addressing workforce and trust issues.
- https://apnews.com/article/pandemic-preparedness-trump-biden-192518a8e1414cf40bafefdc2bf1f5ca
Backs: “Biden-era roadmaps touted these as transforming preparedness, and the US has managed responses to mpox, H5N1 (ongoing in animals with limited human cases, mostly mild/occupational), and other threats with better tools than in early 2020.”
evidence, article, points to yes. Claim: US has managed mpox and H5N1 with better tools than in early 2020.
- https://biodefensecommission.org/reports/the-national-blueprint-for-biodefense/
Backs: “It calls for stronger White House leadership (e.g., codifying National Security Advisor role and a deputy for biodefense), better indoor air quality/pathogen controls, sustained MCM funding (ending “panic-and-neglect”), and replacing ineffective systems like BioWatch.”
attribution, official document, points to no. Claim: Bipartisan Commission on Biodefense says the nation remains dangerously vulnerable, with fragmented efforts and calls for stronger leadership and sustained funding.
- https://www.tfah.org/article/new-report-measures-states-preparedness-for-public-health-emergencies-including-infectious-disease-outbreaks-and-extreme-weather-events/
Backs: “70% goal), limited paid sick leave, and avoidable mortality disparities.”
evidence, article, points to no. Claim: TFAH Ready or Not reports place many states in middle/low tiers; workforce instability, low flu vaccination and limited paid sick leave persist.
- https://www.nejm.org/doi/full/10.1056/NEJMp2406427
Backs: “H5N1 response shows strengths (monitoring, PPE/antivirals, vaccines in stockpile) but also testing/surveillance gaps on farms, variable state readiness, and concerns about scaling if human-to-human transmission emerges.”
evidence, article, neutral. Claim: H5N1 response shows strengths but also testing and surveillance gaps on farms and variable state readiness.
- https://www.stimson.org/2024/prepare-for-the-next-biothreat-now/
Backs: “Recent political shifts (e.g., funding priorities, international engagement) introduce uncertainty, with some reports noting risks of weakened infrastructure.”
background, article, points to no. Claim: Recent political shifts introduce uncertainty and risks of weakened infrastructure; global preparedness is mixed.
- https://biodefensecommission.org/wp-content/uploads/2024/05/National-Blueprint-for-Biodefense-2024_final_.pdf
Backs: “Core issues—sustained funding, unified leadership/authority, resilient public health workforce and infrastructure at all levels, supply chains, trust, and equity—have not been comprehensively fixed. The “on-again/off-again” cycle risks eroding gains.”
evidence, official document, points to no. Claim: Experts conclude US is not fully prepared for COVID-scale event; funding, leadership, workforce, and supply chain issues unresolved.