What can we learn from past pandemics?

A view of the U.S. Capitol Building, as seen reflected on an ambulance in Washington, D.C. AP Photo by Graeme Sloan/Sipa USA

It’s a question on many people’s minds: For a country that is so rich in resources, why was the United States among the hardest hit by COVID-19?

The answer, said Dr. Mark Dybul, co-director of Georgetown University’s Center for Global Health Practice and Impact, lies in the federal government’s response.

Dr. Mark Dybul, left, and Kathleen Sebelius, right, offered insights into how previous U.S. administrations handled pandemics in the past. Courtesy photos.

“It was a lack of preparedness,” he told John Auerbach, an affiliate professor of the practice in health sciences at Northeastern, on Thursday afternoon. “There was not a strong federal response to put in place—the testing, tracing, and quarantine, or what we call TTQ, that is necessary. If you don’t do that, you can’t control an epidemic. It’s that simple.”

Dybul, a former U.S. Global AIDS coordinator under President George W. Bush, was invited to offer insights into how he helped manage previous national health crises, and what lessons could be learned from past pandemics. Joining him for the virtual discussion was Kathleen Sebelius, a former governor of Kansas and former U.S. Secretary of Health and Human Services for President Barack Obama.

The U.S. was initially slow to act, said Sebelius. There was denial among some in the early days of the outbreak. The country failed to ramp up its testing capacity. And even now, there’s hardly any discussion about a framework and timeline for ensuring that everyone in the country gets vaccinated, once a vaccine for the virus is created. But she suggested that it’s not too late.

John Auerbach is an affiliate professor of the practice in the Bouvé College of Health Sciences at Northeastern. Photo courtesy of John Auerbach.

“We still have an opportunity to massively ramp up testing, train, recruit, and deploy the contact tracers,” Sebelius said. “We know how to do this. It’s been done not only nationally but globally very well. This is not something new we have to invent, but we’ve got to hire folks quickly. We have to train them quickly. We have to be able to deploy them quickly.” 

Dybul noted that contact tracing—the process of tracking down people who may have been potentially exposed and advising them to self-isolate to prevent further spreading the virus—was crucial in controlling and ultimately eradicating past pandemics.

“Communities have to be involved,” he said. “If the community is not involved in the response, we will fail. It was true in the HIV epidemic in the United States. It was true in the TB, malaria pandemics, and certainly true of this pandemic.”

Both he and Sebelius also emphasized the importance of leadership and an honest communication strategy supported by science in how previous administrations handled global health crises.

Similar to COVID-19, the 2009 H1N1 “swine flu” pandemic also had the emergence of a new and virulent disease, in this case a flu strain that seemed to be infecting younger people without any underlying health conditions, Sebelius said. The Obama administration responded by trying to get out ahead of the disease, and then leading a successful vaccination campaign.

“We know that if you don’t stop it and if it keeps circulating, it could have come back in a different kind of way,” she said. “But luckily, it was eradicated with this very mobilized global effort where the United States led the way, and led in resources, led in personnel, led in mobilizing a lot of global health partnerships, and that structure is still very much there.”

To protect against an anticipated second wave of COVID-19 in the fall—one that could potentially be deadlier—Dybul said that governments around the world must unite and work together in order to understand where the infections are happening, how the virus is being transmitted, and how it is evolving.

“We have the technology, we have the social structures, we have the political structures to manage this effectively in a global way so that we can be protected against a second wave, even if it’s bad, even before a vaccine,” Dybul said. “That’s something we’ve learned through HIV, TB, and malaria. If you get in there and work together, you can actually prevent catastrophe.”

The program marked the latest installment of Northeastern’s series, “The Civic Experience,” which profiles the cutting-edge leaders who are shaping media, politics, and policy.

For media inquiries, please contact media@northeastern.edu.