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As the Covid-19 pandemic continues to rage, a new report urges the world not to allow itself to be taken down this road again.

The report, called Epidemics That Didn’t Happen, makes the case for improved pandemic preparedness by highlighting infectious diseases outbreaks that the world was able to contain.

“We’re very focused, as we should be, on Covid now, but the fact is that many epidemics are prevented and more could be prevented, and the next big one must be prevented,” said Tom Frieden, president and CEO of Resolve to Save Lives, a program that works to prevent epidemics and which published the report. “Preparedness works. The next pandemic threat is inevitable, but the next pandemic isn’t.”


The report aims to take advantage of the current context, where the global failure to successfully manage the emergence of the SARS-CoV-2 virus provides daily and stark evidence of why containment is the better and cheaper option. Containment happens through preparedness, which several case studies in the report explain.

If ever there was a teachable moment for the importance of this work, it’s now, Frieden suggested.


Ironically, work on the report predates the pandemic. In 2019, Resolve, which is part of the global not-for-profit organization Vital Strategies, held a worldwide competition, asking for suggestions of events that underscore how preparedness for and quick action in the face of disease outbreaks averted disaster.

They settled on nine case studies, including a rapidly contained outbreak of deadly anthrax among livestock in Kenya and Uganda’s success at containing imported Ebola cases during the prolonged North Kivu and Ituri outbreak on the northeastern border of its neighbor, the Democratic Republic of the Congo. That outbreak, which began in 2018, took nearly two years to get under control, because of violence and distrust of authorities in DRC.  Though the risk of cross-border transmission was real, a strong response by Ugandan health authorities kept the cases to single digits when it did occur.

“This was staying prepared for months on end,” Frieden said of the country’s success.

Though the report was started before the pandemic, a number of Covid-related case studies are included in the report, including a chapter on Vietnam’s success in minimizing Covid-19’s impact on that country.

Frieden is hopeful that having experienced this pandemic, countries will see the benefits of investing in programs aimed at preventing future such disruption.

“The bottom line is that preparedness and response systems can save millions of lives and trillions of dollars, but we need to invest. We need to invest money, we need to invest in technical support, we need to invest in strengthening institutions,” he told STAT. “This is a once-in-a-lifetime opportunity to make the world a safer place.”

  • I appreciate the article and intend to try to read the report and understand it, but I am very concerned that the elephant in the room may be ignored.
    It seems pretty clear that Dr. Li Wenliang and others in Wuhan and Hubei, on their own, if not prevented, would have raised a pretty good warning about this disease before most of the travel associated with Lunar New Year – which is said to be the biggest movement of people in the world. Dr. Wenliang was threatened on Jan. 3, according to Wikipedia, and the authorities did not start to shut down travei until Jan 23 – 20 days of conditions of extreme contagion. Modern social media, if not censored, would have been sufficient to spread the alarm in a free country. I hope this is included in the report.

  • The example of relative successes cited were for locations with limited travel and means. Thus fairly easy to contain versus a new virus in a fully developed country with extensive internal and international travel networks. Identification of a new virus / disease is of course critical, but unless the host nation and others are willing to shut down travel quickly there is little chance at containment. Shutting down internal and / or international travel creates a loss of business, revenue, and jobs. It also creates a political minefield for those making the decisions. When Trump tried to close our borders he was vilified by member of both political Parties (With heavy criticism from the opposing Party). I would submit to you that very few if any politicians or countries will be willing to accept all of the ramifications of restricting travel quickly enough to prevent spread. Human nature is simply working against the concept of containment.

    China did eventually manage to limit travel, but it took draconian methods that most other free countries would not impose. Even now we are seeing such resistance in Ontario Canada with police officers refusing to do random checks of vehicles that are on the road during the current lock down. Add to that the way that Americans feel about this topic….It will never work.

    Do not get me wrong…I have been involved in emergency management as a volunteer for decades. I knew of the State and federal contingency plans for social distancing by shutting down businesses, places of worship, schools, etc.. long before the public ever knew such things existed. Yes, they work. Yes, they are necessary as would be closing off national and international travel. I agree with all of this to a point, but the bulk of Americans and those in other countries never will and politicians will lack the will power to do the unpopular.

    • I am a layman and have no special knowledge at all – but it seems to me, along with the disadvantages of a modern highly mobile society, which make us more vulnerable to epidemics, we have some big advantages which we need to develop.
      Nearly everyone has a cell phone – and, as they say, no matter what the problem “There’s an app for that”.
      I believe social networks, the big ones, but possibly new ones created by apps, where people simply share information on disease – could be the common cold, the flu, VD, and so on – could help a great deal in disseminating info. to avoid contagious disease generally, but in particular, to warn people if something is happening.
      Doctors need to be able to talk to each other – the main thing that allowed the Wuhan virus to spread was suppression of that – but some of that info going directly to the public would be a huge help.
      Perhaps a universal agreement that hospital stats for people admitted with similar symptoms will be made public immediately and people with the app will get a text to let them know when the numbers get unusually high? That would mean the public gets warning about the same time doctors start to get suspicious, I am not sure you could do better than that.

  • Exactly. Too many governments decided that containment wasn’t possible, so they didn’t try. Compare this with fire fighting – also costs to be prepared, but nobody says we can’t afford it or we should just let fires in cities burn themselves out.

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