Of an independent task force. They talk about the Global Response to covid19, the role of the World Health Organization and Global Health disparities. From the council on Foreign Relations, this is one hour. Welcome to todays council on Foreign Relations report launch of the independent task force preparing for the next pandemic. Perforce we will be talking about the one we are currently experiencing. Im the host of Weekend Edition sunday. We have more than i think 760 registered for this virtual meeting. We will do our best to get to as many questions as we can. But a little bit about this event. Began in 1995 analyzing issues of critical importance to this Foreign Policy in a nonpartisan way. They are responsible for the content of the new reports and in the task force programs 25th year launching the 78th and id like to welcome you to this discussion called in proving img pandemic. Thus, lessons for covid19. A brief introduction of the panelists. We have Sylvia Burwell the professor at the American University and the former u. S. Secretary of health and Human Services under president obama. Welcome to you. Also joining us is frances townsend, a cochair and former assistant to president bush Homeland Security counterterrorism and vice chairman and general counsel are in chief Administration Officer from the forbes incorporated. Welcome to you. Thomas is a codirector and senior fellow from Global Health economics and Development Director of the Global Health programs. Finally stewart patrick, the senior fellow in governance and director of the International Institution and the Global Governance program. Lets jump right in. Theres a lot to get to. Why issue of the report now in the midst of this pandemic . Sylvia, are you there . Francis, are you there . Shes back. I am back. Why issue the report now in the midst of the pandemic . I apologize i couldnt hear [inaudible] sorry about that. In terms of now we wanted to get the report out as quickly as possible. Information from the report is something we believe is relevant in terms of pandemic. Ms. For the future, which we think is extremely important to focus on and be ready for, but its important for now as we are continuing in the pandemic that we are in and so now as soon we were able to do the assessment with the group of experts, and we want to thank those experts. The four of us are part of this as we were supporting the effort and independent members of the Bipartisan Task force we wanted to get the information out so that it could be used to improve the conditions and the situation both in health and economics in the nation and prepare for the future. Give us the big picture what are the reports about how we are managing this pandemic and how many can we prepare for and prevent the next one . That is the thrust of why we wanted to get the report not only out but couldnt add something to the current pandemic and response as well as preparing for the future. And the fact that another pandemic is inevitable is the key to why i think this report is so important. I want to take the opportunity to thank tom and stuart that did the lions share of the writing here and were able to put together this group of folks and experts some of whom have joined us today. The idea was what could we do better the next time. We had an obligation to protect vulnerable populations who were particularly hardhit. We talk about and sylvia mentioned the Economic Impact of the pandemic. What we found i think everyone agreed was this preparedness is the key to reducing the enormity of that impact on populations and on the economics. What we looked for i look for in ground. The preparedness at the state and local levels and federal levels testing, Contract Tracing and being prepared to do those things in a national and global way is the key to the preparedness and response. Sylvia, and you played a role in the outbreaks such as the george wh administration. How do you think not only the United States the international community, some of the biggest disparities have dealt with the pandemic at this time . I am not sure right now that is what is most helpful. But to assess the things that need to be done better that is what we focused on in the report and i think its clear in terms of the response a National Strategy is needed and would include and approach to testing and Contract Tracing and communications that are scientifically based. I think what we try to focus on are what are the things that can move us forward right now and could make sure we are in good stead for the future. What are the big takeaways you mentioned here is the very idea that there needs to be a plan in place for the next one coming. So generally speaking before we dig in, what does that look like . Certainly at the federal level, you need a single point to coordinate. You look now how many departments. It wasnt just health and Human Services, but all of the expertise that had to be brought to bear across the federal government. The cdc and fda and really it does require a single point of contact in the white house to coordinate the inner agency but also its going to be a global effort and so you also need someone of th at the ambassadorl at the state department to coordinate the international response. I think all of those pieces lead to a quicker more effective and efficient response. Im going to bring tom in right now. There is very Strong Language in the report about [inaudible] before we get to the other part about moving forward and what specifically should be done, there is a lot dedicated to why we are in the place we are now. And i want to start with chinas performance and lack of transparency early on in the pandemic. What are some of the takeaways . Thank you. First, im pleased to be here. Im grateful for your willingness to do this and i want to express my gratitude to sylvia and fran for the job in this task force. Im grateful to have had worked with them and other Task Force Members as well as my colleagues and the large team that is responsible for this large report. So, the report doesnt pull any punches in assessing what has happened globally with this pandemic. The task force is quite clear. China covered up over a crucial two week period in january early cases and delayed sharing Material Information with the who and partners. That contributed to the early spread of the virus domestically in china and internationally the who in terms of its response, lots to say thats heroic about a given the limited resources and authorities, but praising china for its transparency didnt help, and they were a week late in declaring this and international concern. The tendency towards deference manifested itself in and consisteninconsistent commuh Chinese Government claims and unqualified praise for chinas response. Its understandable they have limited resources and authorities and have to work with affected states. Its understandable that they need to maintain a relationship with china. That said, the communications went a bit further than that in the early days of the pandemic where they were praising chinas transparency and that certainly hasnt helped matters. That said, i think what sometimes gets confused by the administration is this is not particular to this pandemic or to china. The who has exercised the same deference in the previous outbreaks with affected member states. Its a member state organization as strong as its members make it. So the u. S. Severed its relationship with the who for now this report makes recommendations about that. Is it worthwhile to maintain and what are the risks of leaving . Absolutely. The who is not a perfect institution. Many of the imperfections in terms of its processes and its bureaucratic nature has been well displayed. However, there is no alternative on the multilateral level to working with who on International Health crises. And ultimately, you know, where who has primarily been doing these, coordinating internationally particularly in low and middle Income Countries, the pandemic hasnt been quite as devastating as people expect and in my view, who deserves some credit for what we have seen in that regard. What countries did better and why . In the report, and im quoting the single most important determinant has been the quality of Political Leadership and execution. Thats right. Lets use an example. The experienced the first case within 24 hours of each other. South korea having learned from its experience with another coronavirus moved quickly, rapidly and aggressively and tested three times as many citizens on a per capita basis than the United States and they deployed Public Health fundamentals. Exhaustively testing, identifying those who were ill, isolating them, tracing their contacts, quarantining the contacts and a high rate of mask wearing. For the most part, not rocket science, but they responded aggressively. Today, south korea with a population of 52,024,000 roughly reported cases, 420 deaths. The United States has 7. 3 million cases of coronavirus and 211,000 deaths. This wasnt inevitable. Preparedness has made a difference and the ability to execute has made a difference in how the nations have done in the pandemic. This brings us to the United States and i will bring stuart in now. The consequences of a failing Political Leadership it also notes that pandemics are not random events as we earlier. They are predictable and they do happen. The United States was unprepared. Why . This is a problem that goes back certainly prior to this administration. Lots of commissions, frankly like this one, have outlined the threats to human life and the economy and the stability of the international pandemics of this sort and get what we found consistently with some of the emergencies that we have theres been very little investment at the National Level in the pandemic preparedness, so a lot of it is just sort of a structural inability of the u. S. Political system to treat the pandemic preparedness as the National Security threat that it is on par with the national defense. Every year we budget about 700 billion on the pentagon and u. S. Military spending and what brought the United States to its knees in 2020 was a packed and i think we need to recognize that. In terms of getting the longterm lack of preparedness weve already pointed to a few of the major failures once the pandemic was upon us the of the comprehensive system of testing and tracing the political leaders whether in the white house or the governors mansions or city halls were flying blind after the trajectory so you either have the blunt force responses to the Public Health emergencies or you wouldnt really know which way it was going. Another thing is the lack of clear Public Health guidance. I think too often much of what we heard from the president on down is a lack of willingness to put science first so its sort of contradictory and sometimes politicized Public Health guidance that doesnt provide american citizens with what they need to know from their leaders which is what is the risk here and what are some common sense precautions you and i can take to protect our families and communities. I think those things have been lacking. Also before we moved to some of the recommendations, and an important point that the response was slow and the government seemed to have known much earlier on what was going on and yet it wasnt until midmarch that actually anything was mobilized. Again im not sure that i personally can add much more to the revelations involved in the book and other press reports in this regard, but the task force does make the point and has charts if interventions had occurred say one week or even two weeks earlier that there would have been a lot lower loss of life and the discussion of the korea case i think is highly indicative here. We have a death rate that is 80 times that of south korea and infection rates 50 times greater, and ge yet the first infection was within a day of when the United States had its first. So it suggests while china and the who have some answering to do, theres obviously failures in the way the United States responded. You mentioned that a central role of communication and chain of command disseminating information and how that really struggled here. So, moving forward, how should the federal government better work with state and local entities to convey information. Whose responsibility is it to ensure Accurate Information is being shared with the public . As a real imperative to try to get some level of clarity about the role and responsibility the federal government, State Government and municipal authorities so we dont have what one of the casting members described as a caricature and articles in the confederation of the Pandemic Response where you have sort of 50 flowers of th at the state ll blooming and people are adopting quite different approaches. So we call for the executive branch to do a study in terms of trying to remove some of those ambiguities including overuse of the stockpile which became something of a political football as you recall early on in the pandemic. Im going to bring sylvia back in because weve got a little bit of time before we open up to questions about the horrific death rates among indigenous populations from the United States in this disease and as well as you know essential workers and the elderly. How can we better protect the vulnerable . As we think about the vulnerable populations in the country, we need to focus on two things. The here and now in terms of where we are in the pandemic and things that can be done right now to help. Some of that is about making sure we have the right data and information. Some of it is about communicating clearly the scientific information to the populations to make sure that they know and have the tools that they need to prevent it. The third thing on the policy things you can do to make a difference. We know that these populations and vulnerable populations have certain types of determinants that may prevent their ability to prevent the spread. For example, we know certain populations may be living close together. So, how do you provide policy options for people if they need to isolate so they dont spread the disease further to their family if they dont have the ability to do that in their own home. We have a focus on the longerterm issues that have created some of that disparity and in equity that we see. The underlining Health Conditions of people of color in the nation and minority populations result from years of structural issues and so thats the other thing as we come out of the pandemic, we need to focus on why is it that there are more and more of the preexisting conditions that make this disease worse in the population and whether that is access to healthcare. We know the number of uninsured is another place there is an equity in the country. The Affordable Care act made great progress against that but its not enough to exist. We also know there is an equitys when, in terms of who participates in the trials for drugs, for vaccines, for all kinds of things. So there are issues now and then in the longerterm that need to be focused on so the next time this happens we are not in the same place and as we move through that we do everything we can to take care of some of the inequities. Fran, id like to ask you your thoughts. The report talks about being the need to provide a safety net for the country. Picking up on where sylvia left off. What you find is if you look across the 50 states, the capability in each of the states is quite different. And nowhere is it adequately funded or staffed. This is where the federal government can really provide sort of funding. If we funded this i think that it was stewart that referred to the budgeting. If we believe that this is a National Security threat, we need to fund it like it is, not just talk about it. And when we look at the impact we realize why its so important to have a comprehensive federal Health Security budget that is a funded and regularly supported replenished part of our federal procurement system. The Strategic National stockpile is kind of the and equity among the state that can be the central procurer of ppe so there is an adequate supply even in the states where the Public Health system is weaker than other parts of the country. Part of the federal governments responsibility here is to be able to even out the inequities that exist among the states. Back to the role about the responsibilities. The federal government isnt going to be more solvent and the states have a responsibility to prepare themselves or to identify their shortfalls that the federal government can help them. Im going to bring you