We need to seriously change our approach to indoor air quality.
Just as we expect clean water from our spigots, we should have cleaner air moving through our buildings. Better filters, more outdoor air intake and new technologies to diminish pathogen burden should all be part of the plan — these things are key for future pandemics and for lessening the toll of viruses overall. The Biden administration made substantial funding available for schools to increase ventilation, but many schools have not made these investments. The administration also began an effort to improve indoor air in buildings across the country, but most of the implementation of that plan depends on local decision makers, building owners and operators, and better building codes.
We need stronger research oversight and lab safety.
It is still not clear what caused the Covid pandemic, and resolving that uncertainty would require new information and data. But even without knowing what the proximal cause of Covid was, we should resolve nationally — and internationally — to operate labs with lethal and contagious viruses in the safest possible ways.
We need strong government oversight of that kind of work, with a framework that balances proposed benefits with major risks. A White House and National Institutes of Health review of these policies is underway now, and there are many important changes that if adopted would make U.S. policy and practice much safer and more effective on these issues.
These efforts are part of the larger set of actions and programs needed to prevent accidental or deliberate events from starting major epidemics and pandemics. That work should include requirements for monitoring or preventing the laboratory synthesis of deadly or extinct viruses; a strong national capacity to attribute a novel pathogen to its origin; commitment to support the Biological Weapons Convention, the international treaty that bans biological and toxin weapons; and vigorous scrutiny and oversight of the practice of extracting from remote ecosystems viruses that may have pandemic potential and have never been introduced to people or studied in a lab.
The C.D.C. needs a reset.
The C.D.C. has essential national pandemic preparedness and response responsibilities as the nation’s top national public health agency. But the pandemic revealed many of its challenges, including early testing mishaps, complicated public guidance and an inability to collect some key data that national leaders and the public needed. The agency needs new authorities to gather data quickly, new abilities to contract, retain and recruit talent, and new capacity to deploy people and funding to state and local public health organizations around the country that will need that assistance.
The C.D.C. needs to operate rapidly in crisis, both in the United States and internationally. Currently, its budget is broken into about 160 programs that aren’t allowed to be changed during pandemics — this must change. Some changes are in the C.D.C.’s control; others will require legislative solutions (like giving it more authority and funding).
***
These are not the only efforts needed — we also need stronger local public health capacity, stronger support to community organizations doing on-the-ground response work and more — but they are a critical start. And there are upcoming opportunities to act on them.