Hiding Our Heads in the Sand - Why the US is Unprepared for Pandemics and Disasters

Kim BellardThere are so many stories about the coronavirus pandemic -- some inspiring, some tragic, and all-too-many frustrating. In the world's supposedly most advanced economy, we've struggled to produce enough ventilators, tests, even swabs, for heaven's sake.

I can't stop thinking about infrastructure, especially unemployment systems.We'd never purposely shut down our economy; no nation had. Each state is trying to figure out the best course between limiting exposure to COVID-19 and keeping food on people's tables. Those workers deemed "essential" still show up for work, others may be able to work from home, but many have suddenly become unemployed.

The U.S. is seeing unemployment levels not seen since the Great Depression, and occuring in a matter of a couple months, not several years. As of this writing, there are over 22 million unemployed; no one believes that is a complete count (not everyone qualifies for unemployment), and few believe that will be the peak.

Many unemployment systems could not manage the flood of applications.

It's not surprising. Any system might struggle to handle such sudden increases in volume. Some seemed purposefully intended to fail (that'd be you, Florida!). Not having robust enough systems might have seemed a viable political strategy when unemployment was low, but less so with such widespread unemployment.

The word that has been repeatedly used to describe unemployment systems is "antiquated." Many are still mainframe systems based on COBOL, dating as far back as the 1960's. COBOL was a very popular language in its day and is still in widespread use, but it is not the language of choice in modern systems. It's 

There had been precious little money spent on upgrading the systems to more modern architectures, or even to retaining the programmers who could keep them running. When making budget decisions, it often seems like there will always be time to modernize...until there isn't. Like in a pandemic.

Michele Evermore of the National Employment Law Project told Vox: "It's really not a sexy item to fund UI [unemployment insurance] administration. The only times any improvements have ever happened with UI has been because a recession exposed holes in the coverage." We've found the holes now, and they are big ones.

But we should not be surprised. We're a nation that likes to push its problems into the future. All that emergency COVID-19 spending? Trillions of dollars of deficit spending, on top of existing annual trillion dollar deficits, deficits that some future generations will have to deal with.

We're a nation that tends to underfund public pensions, at the local, state, and federal levels. We're a nation whose infrastructure -- e.g., roads, bridges, railroads, dams, water and sewer systems-- is rated D+ by the American Society of Civil Engineers. And, as the COVID-19 pandemic is making so very evident, we're a nation that has been extremely shortsighted in funding public health.

A new report from the Trust for America's Health minces no words. President and CEO John Auerbach charges:

COVID-19 has shined a harsh spotlight on the country's lack of preparedness for dealing with threats to Americans' well-being. Years of cutting funding for public health and emergency preparedness programs has left the nation with a smaller-than-necessary public health workforce, limited testing capacity, an insufficient national stockpile, and archaic disease tracking systems - in summary, twentieth-century tools for dealing with twenty-first-century challenges.

More than half a century of computer systems running COBOL. National Museum of History.Similarly, Julie Bosman and Richard Faussett warned in March: "A widespread failure in the United States to invest in public health has left local and state health departments struggling to respond to the coronavirus outbreak and ill-prepared to face the swelling crisis ahead." The Association of Schools and Programs in Public Health claims we have a shortage of 250,000 public health workers -- you know, the kind of people we need now to do hot spot analysis and contact tracing.

Tom Frieden, formerly of the CDC, warns: "We need an army of contact tracers in every community of the US to be ready to find every contact and warn them to care for themselves and stop spreading it to others." Unfortunately, as Brian Castrucci of the de Beaumont Foundation told Time: "We waited until the house was on fire before we started interviewing firefighters."

Oh, now we're seeing why we need to invest in public health. Now we see why we need to invest in better UI systems. Now we see why things like the federal emergency stockpile and the Defense Production Act are important. It's not like we didn't know that pandemics could happen and how devastating they could be; we just chose to not be prepared.

We've been hiding our heads in the sand.

We'll get through this pandemic. Not all of us, and not without too many of the rest us suffering in many ways. We're told that we're probably not going back to "normal," at least not anytime soon, that we'll have to adjust to a "new normal." I just hope that the new normal includes a more clear-eyed perspective on being prepared for when pandemics and other catastrophes do strike.

We may never be fully prepared for when emergencies do hit, but we certainly can do better than we've done so far with this one.

Attribution

This article was authored by Kim Bellard and first published in his blog, From a Different Perspective.... It is reprinted by Open Health News with permission from the author. The original post can be found here.