| In late 2019, every infectious-disease expert knew something like the novel coronavirus was coming sooner or later, just as they know today that Covid won't be the last pandemic. A complete plan for the next global outbreak — one that can protect the U.S. from mass death, catastrophic economic damage and (let's hope) incompetent political leaders who squander the public's trust — will have to be more comprehensive. It will likely involve at least five separate areas of research and investment. Most of all, it will require careful preparation. Here are some key areas: Pathogen surveillanceThe world can't eliminate emerging diseases. Too many people live near animals, and there's too much international air travel. If we had a better handle on what was happening pathogenically, we could work to identify the outbreaks that have the most potential to become severe. Imagine a kind of National Weather Service for pandemics that would predict the course of emerging pathogens. These official forecasts would be more authoritative than the hodgepodge of competing disease models out there now, making it easier for governments to undertake potentially unpopular mitigation measures such as closing borders or ordering lockdowns before an outbreak takes hold. Repairing and augmenting the WHOPandemic surveillance and response, almost by definition, are global efforts, which means it's time to consider a new worldwide partnership to oversee them. A muscular global health coalition could provide funding to eliminate "wet markets," where wild animals are sold for food, and to discourage jungle deforestation, which pushes animals (and the viruses they carry) into closer proximity with people. And it could help train more field workers in far-flung places instead of relying on the current ad hoc system, in which a mix of nonprofits, universities, and volunteers, along with the WHO, addresses emerging threats. Genetic sequencingTracking and tracing a virus has typically been thought of as a labor-intensive process that involves building lists of patient contacts and then calling those people one at a time to see who else might have become infected. Gene sequencing, by contrast, offers the tantalizing possibility of tracking a virus's spread with molecular precision. Frequent, intensive viral sequencing would help answer questions such as how widely a given strain spreads within a community like a school and whether the strain might mutate to become resistant to existing vaccines.  Johnson & Johnson said that its single-shot vaccine appears 66% effective in a global trial at preventing moderate to severe Covid-19. Photographer: Cheryl Gerber/Johnson & Johnson Developing more vaccines, fasterVaccines have been the most spectacular success story so far in the current pandemic. There are already two highly effective options on the U.S. market, and a third vaccine from Johnson & Johnson could be cleared within weeks. Still, there's opportunity for improvement. Ironing out distribution and logisticsAdapting logistics in a medical system as large and complicated as that of the U.S. can take months of advance planning and coordination, and databases must be developed to keep track of everything. Not enough of that work happened in 2020, as the Trump administration insisted on having state governments handle testing, acquire and distribute personal protective equipment, and implement vaccine distribution protocols. As depressing as the current situation is, the next pandemic—and there will be a next one—doesn't have to be this bad. Making sure of that will take quite a bit of preparation.--Robert Langreth | 
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