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

Leans no

Assessments from public health experts, government data, and non-partisan readiness reports indicate that the United States is at a critical and precarious inflection point.

While the nation has made significant technological and surveillance advancements since the COVID-19 pandemic, its operational and systemic readiness has been severely weakened. A combination of unprecedented federal workforce cuts, the clawback of public health funding, state-level disparities, and a lingering legislative stalemate has left the country highly vulnerable to another widespread health crisis.

1. The Positives: Technological and Structural Progress

The U.S. has successfully implemented several crucial lessons from the COVID-19 pandemic to bolster early detection and coordination:

•Data Modernization: The Centers for Disease Control and Prevention (CDC) has significantly upgraded its data infrastructure. Through tools like the Respiratory Illness Data Channel (RIDC) and the Center for Forecasting and Outbreak Analytics (CFA), the CDC now successfully integrates real-time data from emergency department visits, wastewater surveillance, test positivity, and vaccine uptake to forecast threats.

•Workforce Mobility: State-level administrative barriers have decreased. The Ready or Not 2026 report by the Trust for America’s Health (TFAH) highlighted that 41 states have adopted the Nurse Licensure Compact, allowing nurses to quickly mobilize and practice across state lines during surges.

•Global Cooperation: Nationally and globally, there is a push for better early-warning systems. The U.S. has engaged with the newly adopted WHO Pandemic Agreement and is participating in negotiations for the Pathogen Access and Benefit-Sharing (PABS) system to ensure faster global sharing of viral data and countermeasures.

2. The Vulnerabilities: Severe Federal Workforce and Funding Cuts

Despite technological gains, the physical and financial infrastructure required to execute a pandemic response has contracted:

•Massive Workforce Reductions: Federal health agencies have seen a dramatic decline in staffing. Between late 2024 and early 2026, the CDC lost roughly 27% to 28% of its workforce (approximately 3,600 employees), impacting departments from global health to scientific research. The Food and Drug Administration (FDA) similarly lost 21.6% of its workforce, and the National Institutes of Health (NIH) shrank by over 20%. This loss of specialized expertise cannot easily be replicated by states.

•The "Funding Cliff": Long-term preparedness has been destabilized by funding clawbacks. In 2025, the federal government terminated more than $12 billion in COVID-19-era grants that were actively being used by states to build up laboratory capacities and infectious disease monitoring. Additionally, CDC project grant funding was reduced by over 70% in fiscal year 2025 compared to 2024.

•Targeted Budget Reductions: Proposed federal budgets have signaled deep cuts to front-line defense, including a proposed 52% reduction to the CDC’s Public Health Emergency Preparedness program (the primary federal funding source for local readiness) and the proposed elimination of the Hospital Preparedness Program entirely.

3. The Legislative Stalemate: PAHPA Expiration

Perhaps the most significant structural risk is the lack of stable, long-term authorization for the country’s biodefense programs.

The Pandemic and All-Hazards Preparedness Act (PAHPA)—the literal legislative backbone that authorizes and funds the Administration for Strategic Preparedness and Response (ASPR), the Biomedical Advanced Research and Development Authority (BARDA), and the Strategic National Stockpile (SNS)—expired in September 2023.

Since then, Congress has kept these vital programs running on short-term, temporary extensions. Public health organizations warn that the lack of a comprehensive, five-year reauthorization actively discourages private-sector partners from investing in the decade-long research and development cycles required to create new vaccines, diagnostics, and therapeutics.

4. State-by-State Disparities

Because the U.S. public health system relies on a decentralized, patchwork approach, preparedness varies wildly depending on where a person lives.

The Ready or Not 2026 report categorized states into three performance tiers based on 10 emergency preparedness indicators (including lab surge capacity, state-level funding, and access to paid sick leave):

•High-Tier Performance: 20 states achieved high scores.

•Middle-Tier Performance: 17 states and Washington, D.C. landed in the middle.

•Low-Tier Performance: 13 states remain highly vulnerable.

This means that during a fast-moving health crisis, some states would be able to rapidly scale up laboratory testing and mobilize medical personnel, while neighboring states would likely see their health systems overwhelmed almost immediately.

The Active Stress Test

This fragile system is not just a theoretical concern; it has been actively tested. The U.S. entered 2026 grappling with compounding, concurrent health threats: the most severe seasonal influenza in nearly a decade, the highest number of measles outbreaks since 1991, and ongoing surveillance of H5N1 avian influenza.

While state laboratories have drafted plans to handle surges, they are trying to execute those plans with a depleted federal workforce and unstable emergency funding.

Summary

The United States is biologically and technologically better equipped to detect and track a new pathogen than it was in 2020. However, because of depleted staffing, clawed-back funding, and a stalled legislative framework, the country is structurally and operationally more fragile. If a severe, fast-spreading pandemic were to strike today, the U.S. would likely face severe bottlenecking in healthcare delivery, massive state-by-state inequities, and an administrative apparatus struggling to sustain a coordinated federal response.

Citations (16)

1tfah.orgNonprofits and think tanks
tfah.org
Backs: “Assessments from public health experts, government data, and non-partisan readiness reports indicate that the United States is at a critical and precarious inflection point.”
evidence, article, points to no. Claim: Expert and nonpartisan readiness reports show the US is at a critical, precarious point in pandemic preparedness.
2bstquarterly.comNot yet classified
bstquarterly.com
Backs: “While the nation has made significant technological and surveillance advancements since the COVID-19 pandemic, its operational and systemic readiness has been severely weakened.”
evidence, article, points to yes. Claim: The nation has made significant technological and surveillance advancements since COVID-19.
3bstquarterly.comNot yet classified
bstquarterly.com
Backs: “While the nation has made significant technological and surveillance advancements since the COVID-19 pandemic, its operational and systemic readiness has been severely weakened.”
evidence, article, points to yes. Claim: The nation has made significant technological and surveillance advancements since COVID-19.
4tfah.orgNonprofits and think tanks
tfah.org
Backs: “A combination of unprecedented federal workforce cuts, the clawback of public health funding, state-level disparities, and a lingering legislative stalemate has left the country highly vulnerable to another widespread health crisis.”
evidence, article, points to no. Claim: Federal workforce cuts, funding clawbacks, state disparities and legislative stalemate leave the country highly vulnerable.
5ourpublicservice.orgNonprofits and think tanks
ourpublicservice.org
Backs: “A combination of unprecedented federal workforce cuts, the clawback of public health funding, state-level disparities, and a lingering legislative stalemate has left the country highly vulnerable to another widespread health crisis.”
evidence, article, points to no. Claim: Federal workforce cuts, funding clawbacks, state disparities and legislative stalemate leave the country highly vulnerable.
6ghtcoalition.orgNonprofits and think tanks
ghtcoalition.org
Backs: “A combination of unprecedented federal workforce cuts, the clawback of public health funding, state-level disparities, and a lingering legislative stalemate has left the country highly vulnerable to another widespread health crisis.”
evidence, article, points to no. Claim: Federal workforce cuts, funding clawbacks, state disparities and legislative stalemate leave the country highly vulnerable.
7cdc.govGovernment
cdc.gov
Backs: “Through tools like the Respiratory Illness Data Channel (RIDC) and the Center for Forecasting and Outbreak Analytics (CFA), the CDC now successfully integrates real-time data from emergency department visits, wastewater surveillance, test positivity, and vaccine uptake to forecast threats.”
evidence, official document, points to yes. Claim: CDC tools like RIDC and CFA integrate real-time data (ED visits, wastewater, test positivity, vaccine uptake) to forecast threats.
8youtube.comSocial media and video
youtube.com
Backs: “Global Cooperation: Nationally and globally, there is a push for better early-warning systems. The U.S.”
background, social or video, neutral. Claim: There is a national and global push for better early-warning systems.
9nih.govGovernment
nih.gov
Backs: “The U.S. has engaged with the newly adopted WHO Pandemic Agreement and is participating in negotiations for the Pathogen Access and Benefit-Sharing (PABS) system to ensure faster global sharing of viral data and countermeasures.”
evidence, official document, points to yes. Claim: The US has engaged with the WHO Pandemic Agreement and PABS negotiations for faster sharing of viral data and countermeasures.
10who.intGovernment
who.int
Backs: “The U.S. has engaged with the newly adopted WHO Pandemic Agreement and is participating in negotiations for the Pathogen Access and Benefit-Sharing (PABS) system to ensure faster global sharing of viral data and countermeasures.”
evidence, official document, points to yes. Claim: The US has engaged with the WHO Pandemic Agreement and PABS negotiations for faster sharing of viral data and countermeasures.
11globalbiodefense.comNews and media
globalbiodefense.com
Backs: “Between late 2024 and early 2026, the CDC lost roughly 27% to 28% of its workforce (approximately 3,600 employees), impacting departments from global health to scientific research. The Food and Drug Administration (FDA) similarly lost 21.6% of its workforce, and the National Institutes of Health (NIH) shrank by over…”
statistic, article, points to no. Claim: The CDC lost roughly 27-28% of its workforce (about 3,600 employees) between late 2024 and early 2026.
12aspph.orgNonprofits and think tanks
aspph.org
Backs: “In 2025, the federal government terminated more than $12 billion in COVID-19-era grants that were actively being used by states to build up laboratory capacities and infectious disease monitoring. Additionally, CDC project grant funding was reduced by over 70% in fiscal year 2025 compared to 2024.”
statistic, article, points to no. Claim: The federal government terminated over $12 billion in COVID-era grants used by states for labs and disease monitoring.
13centerforhealthsecurity.orgAcademic
centerforhealthsecurity.org
Backs: “The Pandemic and All-Hazards Preparedness Act (PAHPA)—the literal legislative backbone that authorizes and funds the Administration for Strategic Preparedness and Response (ASPR), the Biomedical Advanced Research and Development Authority (BARDA), and the Strategic National Stockpile (SNS)—expired in September 2023.…”
evidence, article, points to no. Claim: PAHPA, which authorizes ASPR, BARDA and the Strategic National Stockpile, expired in September 2023.
14bio.newsNews and media
bio.news
Backs: “Public health organizations warn that the lack of a comprehensive, five-year reauthorization actively discourages private-sector partners from investing in the decade-long research and development cycles required to create new vaccines, diagnostics, and therapeutics. ---. 4.”
attribution, article, points to no. Claim: Public health organizations warn that lack of PAHPA reauthorization discourages private-sector investment in vaccines, diagnostics and therapeutics.
15bipartisanpolicy.orgNonprofits and think tanks
bipartisanpolicy.org
Backs: “Because the U.S. public health system relies on a decentralized, patchwork approach, preparedness varies wildly depending on where a person lives. The Ready or Not 2026 report categorized states into three performance tiers based on 10 emergency preparedness indicators (including lab surge capacity, state-level…”
evidence, article, points to no. Claim: A decentralized, patchwork public health system makes preparedness vary widely by location.
16tfah.orgNonprofits and think tanks
tfah.org
Backs: “Because the U.S. public health system relies on a decentralized, patchwork approach, preparedness varies wildly depending on where a person lives. The Ready or Not 2026 report categorized states into three performance tiers based on 10 emergency preparedness indicators (including lab surge capacity, state-level…”
statistic, article, points to no. Claim: Ready or Not 2026 sorted states into high, middle and low preparedness tiers across 10 indicators.