Joseph V. Micallef is a best-selling military history and world affairs author, and keynote speaker. Follow him on Twitter @JosephVMicallef.
Nine months into the COVID-19 crisis, it may seem premature to speak of lessons from the pandemic.
Reported cases are at record highs, hospitalizations and deaths are rising, although still less than half the peak levels in the spring, and some advisers to President-elect Joe Biden are proposing a second four- to six-week lockdown.
Still, there is room for optimism. Two or more vaccines will soon be deployed. The mortality rate as a percentage of patients stricken continues to decline. Moreover, there are now a variety of therapies that have been proven effective in mitigating the symptoms of the disease.
Historically, the typical viral pandemic lasts for 18 months. During that period, the virus mutates into less virulent forms; more effective therapies are developed; and vaccines of varying effectiveness are discovered. While it may not provide much comfort, nine months into an 18-month cycle, COVID-19, to date, has evolved along a trajectory that is consistent with past coronavirus pandemics.
What that also tells us, however, is that if past experience is a guide, COVID-19 will likely persist, albeit in a less virulent form, for the immediate future, and that it could always reemerge in a more dangerous form at a later point in time.
Moreover, as in the case of past flu vaccines, a COVID-19 vaccine does not mean that you are completely immune to the disease. You can still get infected, and you can still transmit the virus. It just means that your body will be better prepared to handle it; you are more likely to be asymptomatic or have only mild symptoms; and you are less likely to disseminate the virus to others. Moreover, anybody you did infect would also be in a better position to fight off the disease.
There are five lessons that we can draw from our experiences in dealing with the COVID-19 pandemic so far.
1. Everything Is Connected
The degree of global integration, the ease of travel and an increasingly mobile population mean that disease outbreaks in one part of the world will quickly spread globally. The possible exceptions are diseases such as the African hemorrhagic fevers. Their mortality rate is so high that they often burn themselves out before they can spread.
Moreover, it is not just disease outbreaks that are a global issue. The precursors to those outbreaks, in particular human-animal interactions, are also relevant. That means issues such as deforestation in the jungles of central Africa or the Amazon; the wild animal trade, both for pets and meat, like the Asian wet markets or the bushmeat markets in Africa and elsewhere; and the uncontrolled urban sprawl encroaching on rural and wild areas in many third-world countries, have a public health dimension that potentially affects everyone.
If viral disease outbreaks have a high propensity to become global pandemics, then they also present a national security issue. Even a global pandemic does not strike the entire world simultaneously. Where a country and, by extension, its military forces fall in the timeline of a pandemic cycle will have a bearing on its military readiness. That conveys a significant advantage or disadvantage to a party in a potential conflict. Equally relevant is a nation's ability to craft a response -- politically, economically and medically -- that will be supported by its citizens
2. International Collaboration and Cooperation Are Crucial
It goes without saying that a coordinated response among the countries affected is better than a purely national approach. That didn't happen with the COVID-19 pandemic. Instead, most countries acted unilaterally to restrict travel; hoarded medical supplies, such as personal protective equipment and potential therapeutics; and made little effort to coordinate a global response.
Organizations like the World Health Organization (WHO), which presumably should have taken the lead in organizing a coordinated response, failed to do so. It was perceived, both by the Trump administration and other governments, as having aided what appeared to be a Chinese cover-up of the severity of the outbreak and therefore lacked credibility.
The Trump administration's ban on travel from China was denounced by many Democrats as xenophobic, and the issue quickly became politicized when prominent Democratic leaders urged their constituents to ignore the ban. Nor was the U.S. alone in this response. Similar developments occurred in Italy, the U.K. and elsewhere. In retrospect, the travel ban was a correct response, but it would have been far more effective had it been coordinated with other countries.
The U.S. needs a playbook for dealing with the threat of a potential pandemic that reflects a political consensus on how the country should respond and that will not be politicized. Other countries need a similar protocol; ultimately, those protocols should be aligned to produce a coordinated response. Organizations like NATO were largely irrelevant during the pandemic. If you consider that pandemics also have military consequences and represent a national security issue, it would make sense for NATO and similar organizations, in addition to national and international medical organizations, to play a role in formulating and coordinating a multinational response.
3. The Consequences of a Pandemic Fall Unevenly Across Society
Much has been said about "listening to the experts." These experts presumably were medical professionals with relevant expertise in dealing with pandemics. In reality, there never was a consensus among the so-called experts. From the beginning, there were radically different points of view. Given that the country was dealing with a situation that was unprecedented and extremely fluid, the lack of an expert consensus should hardly have been a surprise.
Moreover, it quickly became clear that dealing with a pandemic like COVID-19 required expertise that went beyond medical science. The economic and social consequences fell unevenly across society. Formulating an effective response required expertise in a broad range of disciplines, most of which had little to do with health.
Many "white collar" professionals adjusted quickly and relatively smoothly to working from home. Manual, "blue collar" workers often found it impossible to do so. Likewise, the disease's consequences fell unevenly across age groups, income class and ethnicity. Some groups, like the old or the poor, were more vulnerable and were particularly hard hit. Likewise, inner-city inhabitants who relied on public transport to go to work often found it unavailable or dangerous to utilize, even if their jobs remained because they were deemed essential.
A one-size-fits-all public assistance plan in the form of the Payroll Protection Plan only magnified the uneven consequences of the pandemic's effects. Professional firms, such as lawyers and accountants, whose staff could more easily work from home got the same assistance as firms whose staff could not. The self-employed largely fell through the cracks, as did people for whom tips represented a large portion of their remuneration.
Additionally, governors applied their own spin to the federal guidelines, often arbitrarily imposing the same rules on rural parts of their states as they did to major urban centers -- unilaterally deciding which establishments could stay open and which could not, or what items could be purchased and which were prohibited.
In an unprecedented intrusion on private life, some governors insist on dictating how families should celebrate Thanksgiving and Christmas, how many friends and relatives they can invite, how food should be served and where meals can be held.
Mainstream media and social media platforms imposed their own arbitrary designation on who were experts and who were not, and often crushed dissenting opinions, even when they were coming from professionals of equal standing to their own approved experts.
The upshot is that, to be effective, a response to a pandemic has to address the needs and vulnerabilities of all segments of a society. A policy response that ignores groups that are particularly vulnerable, both economically and healthwise, will be difficult to implement because it will lack popular support.
Likewise, rules perceived as arbitrary or poorly thought out, especially when they are imposed on a state-by-state basis at the whim of governors, create widespread noncompliance if not outright revolt, making it virtually impossible to get widespread support or implementation for a pandemic response policy.
If you look at a pandemic policy response through the narrow lens of national security, the inability to craft a response that is perceived as fair or that enjoys public support becomes a significant vulnerability.
4. Health Promotion and Disease Prevention Are a National Security Issue
No, the national security of the United States does not hinge on your ability to forgo that jelly doughnut. But if pandemics pose national security issues, then the state of a nation's health is equally relevant. It has been clear throughout the COVID-19 pandemic that preexisting conditions were a major contributor to the mortality rate. That means issues such as diabetes, obesity and hypertension are more than just health issues. To the extent their prevalence makes a nation more vulnerable to a pandemic, or makes it harder or more expensive to craft a response, then the state of a nation's health can also have broad national security implications. Rapidly aging populations in Europe and North America will only aggravate these risks.
The challenge is how to improve a nation's health without creating a pretext for an unprecedented degree of governmental intervention or control over citizens' private lives.
5. Resilience in Health Care Is Essential
What initially prompted the shutdown in the U.S. was the fear that rapidly rising hospitalizations would overwhelm the ability of hospitals to care for the sick. The risk was that patients who could otherwise have survived might have died from lack of care. Thankfully, that didn't happen. Hospitals in some areas were stretched to the limit but, in the end, anyone who needed hospitalization received it.
You can thank the heroic efforts of medical personnel and the unprecedented effort of American industrial know-how to manufacture critical supplies, as well as the fact that the initial projections of required hospital beds proved to be overly pessimistic.
The U.S. military also played a significant role in providing critical surge capacity by deploying two Navy hospital ships, as well as setting up temporary hospital facilities in many major cities across the country. Much of that surge capacity turned out to be unnecessary, but its availability was an important factor in reassuring Americans that the country could cope with the pandemic.
There was a significant cost, however, to focusing the health care system to deal with the pandemic. A lot of elective surgeries, as well as routine medical visits and screenings, were deferred. Moreover, many clinics and medical personnel, especially in rural areas with low incidence of COVID-19 infections, found themselves closed and their staff unemployed.
The health care industry is a business. Like all businesses, it strives to maximize capacity utilization and operate as efficiently as possible. Empty hospital facilities don't make any economic sense and, in a for-profit health care system, won't be allowed to exist. That means the country needs to have a surge capacity in hospital care. The military played that role brilliantly during the COVID-19 pandemic, and it will remain a key role for it to play in the event of future pandemics.
Notwithstanding that success, there are probably steps that the military can take to be better prepared in the event of future pandemics. The Trump administration has already indicated it wants additional hospital ships built. Moreover, state regulations of medical personnel need to have sufficient flexibility to allow medical staff to move around the country as needed with a minimum of red tape. Likewise, the stockpiling of critical medical supplies must be made a priority and not an issue that can be endlessly deferred because of budget constraints.
Eventually, the COVID-19 pandemic will pass, even if the virus continues to exist and even if it makes resurgences from time to time.
Historically, pandemics have been a generational phenomenon. The next pandemic may be a generation away, or it may be just around the corner.
Given the wide-ranging impact that pandemics can have on the nation's health, economy, political cohesion and military preparedness, it would behoove us to learn from our recent experiences. Next time, and there will be a next time, it could be even worse.
-- The opinions expressed in this op-ed are those of the author and do not necessarily reflect the views of Military.com. Find more information on how to submit your own commentary.
