At Dell Med, Fauci on What Comes Next: “A Serious Look” at Pandemic Preparedness

Dr. Anthony Fauci speaking at the Ken Shine Prize Health Leadership virtual lecture (Image via Vimeo)

Last week, the director of the National Institute of Allergy and Infectious Diseases, Dr. Anthony Fauci, joined the Dell Medical School at UT-Austin to discuss what comes after the COVID-19 pandemic. As the recipient of this year's Ken Shine Prize in Health Leadership, Fauci spoke with Dell Med Dean Dr. Clay Johnston and award namesake Dr. Kenneth Shine, a former president of the Institute of Medicine and vice chancellor of health affairs for the UT System, in a virtual lecture on lessons learned from the novel coronavirus crisis.

One year after the first case of COVID-19 in the U.S. was confirmed on Jan. 21, 2020, more than 400,000 Americans have died from the disease, with the global death count surpassing 2 million according to data tracked by Johns Hopkins University. Fauci said the still-growing and "horrible" toll of death and suffering should be a clarion call to rethink our public health investments: "We really do have to take a serious look at pandemic preparedness, including the ability to do massive testing [and] the ability to restrengthen our local public health system, which, almost as a victim of our own success over the years, we've let it attrit."

To Fauci's point, though the U.S. spends more on health care than any other country – some 16.9% of gross domestic product in 2018, according to the Commonwealth Fund – our public health system is chronically underfunded. Analysis by the Trust for America's Health found that from 2003 to 2019, funding for the Centers for Disease Control and Prevention's Public Health Emergency Preparedness program – the main federal funding stream – was reduced by a third, and the National Security Council's Directorate of Global Health Security and Biodefense, authors of the Obama-era pandemic plan famously ignored by his successor, was disbanded in 2018.

Fauci, who will also serve as President Joe Biden's chief medical adviser, believes a robust public health system that can efficiently respond to challenges like disease identification, isolation, contact tracing, and vaccination is critical. "It's really extraordinary that we don't have that now," he said, "and hopefully the terrible experience that we've gone through over the last [year] is going to change that."

Rather than waiting for a crisis to invest in health preparedness, the U.S. could reserve facilities to manufacture vaccines, or engage a public health corps to serve low-access communities even in the absence of a disease outbreak, suggested Fauci. "One of the horrible things is the extraordinary impact this outbreak has had on our economy, to the tune of trillions of dollars," said Fauci. "If you take a small slice of that and say, 'We lost trillions and trillions of dollars here,' maybe a small slice to have a readiness that's there is not wasted money at all. And when you're not responding to an outbreak, there are a lot of other good things that you could be doing in the community from a health standpoint."