What Have We Learned From COVID?

Special Guests: Michael Osterholm

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This week on Facing the Future, Bob Bixby was joined on the show by Dr. Michael T. Osterholm, Director of the Center for Infectious Disease Research and Policy at the University of Minnesota. He also served as one of thirteen COVID-19 advisors on President-elect Biden’s pandemic advisory board in 2020. Osterholm provided insights into where we currently stand with COVID-19 and what lessons we can learn to better prepare for the next pandemic. Concord Coalition Chief Economist Steve Robinson and National Field Director Phil Smith joined the conversation.

Since Dr. Osterholm’s last two appearances on the show, COVID-19 has slowed in intensity across the nation, but the budget implications of this pandemic and lessons learned for the next one persist. Pandemic spending increased the deficit three-fold between 2019 and 2020, started a short but sharp recession, and eventually led to our most recent bout of inflation. 

Osterholm had this to say about the state of COVID-19 in the United States today, “It’s fair to say that we’re still in a COVID world. It’s still a challenge for us, but it’s a very different world than we had in the first two to three years of the pandemic. We now have a sufficient amount of immunity in the population that lasts for at least some months. That has meant that we are seeing many fewer infections and a big reduction in the number of deaths. This virus continues to change much faster than the flu, which means that it can, in fact, still be a challenge in the future.”

“I think it’s actually a challenge to talk about how many people are vaccinated,” said Osterholm, when asked about the information we have on immunization, “The data we have shows not how many doses of vaccine you’ve had, but when you got your last dose. More recently, doses have had a much higher level of protection, and so the challenge you have is keeping things current. From my perspective, it’s all about the clock ticking. When did I last get it?”

On the topic of vaccines, Osterholm expressed concern about how polarizing the issue has become among the American people, “Based on some very conservative studies, we estimate that maybe as many as 300,000 people in this country are alive today because they got vaccinated. At the same time, there are a number of people, almost an equal number of people who didn’t get vaccinated, who died unnecessarily, and that has been demonstrated over and over again.” Osterholm also considered the impact of this polarization outside of the COVID-19 context. “What we’ve been able to determine over the course of the pandemic is a sizeable number of the public have said, ‘I’m not going to get the vaccine for myself or my kids or any of the vaccines that matter’, because it’s not about safety but ‘don’t tell me what in the hell to do,’” he said.

Moving to the budget, Osterholm mentioned the example of PEPFAR (President’s Emergency Plan for AIDS Relief). “It was one of the most successful public health policies ever enacted and was really the very best of our country. Well, the world followed us. They saw what could be done. But today, we almost did not get PEPFAR reauthorized. Economists can do all the studies showing that the cost benefit of this type of a program is remarkable. Outside of making the scientific case for vaccines’ importance worldwide, you invest pennies and you get back dollars in return.”

Robinson asked about long COVID and its potential effects on disability benefits between Social Security and Supplemental Security Income (SSI), which the U.S. already spends $20 billion a year on. Osterholm estimated that, “up to 6 percent of the U.S. workforce are experiencing long COVID symptoms of some kind, which is a pretty high impact situation. Some may have ongoing symptoms that are still able to work but others are not. This is clearly an area of great research need. We are very concerned that the federal government, particularly the NIH, wasted a tremendous amount of money in those first two years with the appropriations they had, with very little return on investment for what was happening with long COVID.” Osterholm provided a positive outlook, though, acknowledging that, “we really now have a much more aggressive and comprehensive effort in place to look at long COVID.”

Reflecting on the past four years, Osterholm presented a metaphor for how we figure out the next pandemic. “Imagine you are an individual who has been challenged to run a hundred-yard dash. You train and train for that and the day you go to run it, they say, ‘oh by the way, I forgot to tell you it’s a marathon.’ Well, that’s what pandemics are like,” Osterholm said. “We came into COVID with the idea that the first two months would be bad, but then it’ll be done and over with. And as you saw, COVID was a three-year minimum pandemic.”

Concluding his remarks, Osterholm provided the steps to prepare for the next pandemic. “I’m willing to take a look at what public health did and didn’t do, not to blame, but to say, ‘Okay, what did this teach us about the future?’ A book I have coming out next year is an attempt to go through, from my perspective, what are the areas we could have and should have learned from? How do you then translate that into action? How do you translate that into dollars and cents?” 

“The pandemic clock is ticking, and any investment we put in that right now will pay off big dividends.”

Hear more on Facing the Future. Concord Coalition Executive Director Bob Bixby hosts the program each week on WKXL in Concord N.H., and it is also available via podcast. Join us as The Concord Coalition team discusses issues relating to national fiscal policy with budget experts, industry leaders, and elected officials. Past broadcasts are available here. You can subscribe to the podcast on Spotify, Pandora, iTunes, Google Podcasts, Stitcher, or with an RSS feed. Follow Facing the Future on Facebook, and watch videos from past episodes on The Concord Coalition YouTube channel.


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