> we'll be far better prepared for the next epidemic

I agree. Being in California, it's a standing recommendation to maintain extra supplies in case of impact from wildfire or earthquake. So, I thought I was pretty well prepared. I already stock and rotate extra water, toilet paper, n95 masks, canned food, etc. But, I discovered some holes in my preparedness that I will rectify when the stores are back to normal supply levels -- I will be even better prepared for the next state of emergency.

I'm sure the preparedness will go wide and deep across many government and private organizations. At a minimum, I hope the CDC ensures there are plenty more ventilators ready for the next one.

"At a minimum, I hope the CDC ensures there are plenty more ventilators ready for the next one."

My only thought here is that we don't know that "the next one" will require ventilators. While I'd certainly like to see our national stockpile of PPE and emergency equipment like ventilators improved, I'd like to see the CDC preparing to face a wider-set of the "next one".

I think we should be looking at our manufacturing infrastructure and ability to rapidly ramp-up the production of any life-saving hospital equipment in the face of a sudden need. With a national stockpile that's strong enough to cover the ramp-up period.

You make good points, but while the "next one" may not require ventilators, it's a good bet that ventilators will be needed again. This is not the first respiratory disease pandemic.

To quality as the next one, a disease would have to spread very easily from person to person. And that usually implies airborne. Which usually means it attacks the lungs, which usually needs ventilators.

Diseases that are differently transmitted like Herpes and AIDS can be widespread, but they’re unlikely to be the “next one” because they’re easier to contain.

Depending on how you define a nebulous concept like "the next one", HIV/AIDS already is since it's a pandemic

I think the "next one" means "shut down the world". HIV/AIDS is horrible, but doesn't need us to shut down the world.

Both influenza and coronavirus can cause severe respiratory distress. Both are subject to jumping the species barrier or mutation of existing strains resulting in higher mortality. Both are extremely infectious and very difficult to control. That's reason enough to have a few warehouses full of respirators ready to ship out. At the least we need a better plan for emergency bed space and resuscitation training for conscripted personnel.

> we don't know that "the next one" will require ventilators

Good point. How about, "the next one that needs ventilators". Either way, it is a concrete example of equipment that we can now add to the list of things we need more of to be better prepared next time, or the time after that, etc. There are certainly many more things that should be on that list too.

Specific equipment that we can buy and stockpile is one thing, but manufacturing capability seems even more important to have within our borders so we can keep making N95 masks not subject to foreign interference, in the event of a sustained epidemic.

I mostly agree with you.

One caveat though is that airborne diseases spread much more rapidly and are much more difficult to prevent than other forms of transmission.

Diseases that spread by skin to skin contact (smallpox, for instance) almost universally have visible signs before they're contagious. This makes quarantining easier.

Diseases that spread via contaminated drinking water (cholera) can almost always be stopped by boiling water or iodine tablets. And developed nations have well established ways of ensuring clean drinking water.

Diseases that spread via blood or other bodily fluids (Ebola, HIV) can be stopped by well established sanitary procedures.

Diseases that are not airborne simply don't have the potential to cause the damage covid has already caused, to say nothing of the total damage when it's all over.

Besides this, the world not just the US need standby health personnel in a similar fashion to armies. Soldiers do nothing unless needed, a "health workers" army can do the same.

This being more like a war than business as usual, the correct solution is more like the citizen armies that fought in the world wars, not a standing army.

There is no harm in having more people trained in first aid. I have to do a two day refresher in it every three years for a sports coach licence.

I for one wish courses in first aid beyond the very basic save-a-life stuff were more widely available.

Here in the UK, there used to be training that anyone could take that was offered by the main first aid organisations, lasted 2-4 days, and covered significantly more serious but not necessarily life-threatening conditions. There were a few variations you could do, including things like common sports injuries, conditions you might encounter while in the wild outdoors and how to handle a situation as well as possible if professional help is going to take a long time to arrive, variations on first aid for children and babies, and so on.

Those courses for the general public seem to have all but disappeared now, presumably due to a lack of demand. This isn’t entirely surprising, as they weren’t cheap to do, but if you did have the means to afford it, what is the value of knowing how to help someone recover better from an injury, or preventing a serious condition from maybe becoming a life-changing one, or in extreme cases even saving a life? My wife and I did take a course specifically on first aid for little ones when we were about to become parents, but even finding that wasn’t easy.

The main ways to get more than very basic first aid training here now seem to be through either statutory obligations for first aiders at work (where the courses are widely available and longer but also have to cover the official paperwork you need to do as a first aider at work) or through becoming a much more serious amateur first aider (either joining one of the first aid organisations and in due course going out to work as a volunteer at major events and the like, or through things like sports coaching organisations that have the scale to make special arrangements for first aid training). That leaves quite a large gap in provision for “ordinary” people who just want to know enough to help out in a serious situation, but as far as I’m aware, there isn’t really anybody trying to fill that gap at the moment. I did ask the trainers on that last course I took if there was anything I’d overlooked in terms of more comprehensive general first aid training, and they said that unfortunately the above is about right at the moment.

I don’t know how much first aid training would really help with the current coronavirus situation anyway. It seems like what is needed in this case is more people with nursing skills and the ability to set up equipment like ventilators. But as a more general point, I would strongly support measures to increase general knowledge of first aid within the population, at least for anyone who is willing and able to help when they can. If nothing else, it might free up more of the fully trained professionals to deal with the most serious situations and so help reduce the strain on them.

The ones that I have done were through BASP [1], the focus was on what was needed for outdoor pursuits but there were people from a wide range of sports, they were not organized by the sporting body itself.

[1] https://www.basp.org.uk/

Thank you for the interesting link.

This was one of the things that was lost with the decline of scouting. I remember quite a bit of training between life guard training and first aid training for dealing with common injuries in the wilderness, dealing with shock, etc. Yeah I get the religious associations were a problem but there's no good secular counterpart or places willing to host (as most troops/groups met at churches), the organization is slowly changing but I don't think its the only reason its been in decline.

There is a certain cost to it.

Just like a reserve army full of reservists has a serious cost (those people all have to spend weekends training, after all: time that could be spent doing other things), a "health care army" would require people to get regular training to stay up-to-date and in practice. Basic first aid can be useful for anyone, but for having people ready to jump in and become healthcare workers in a crisis, they need a lot more than a first aid refresher once a year I think.

How much extra tax do you think people will be happy to pay -- forever, not just now while we have a pandemic on our hands -- to support this?

You question contains an implication in it that all current other tax spending will not be reduced, and that "pandemic preparedness" will have to be added to the current load.

If this goes really badly in the next couple of weeks or months, that's not going to be a true assumption. A changed nation is going to be looking at its spending priorities and a lot of reassessing will be done. Predicting exactly what the result will be is difficult, but predicting that there could be a lot of change is not.

If we cross the logistic curve's inflection point today, then this may ultimately blow over and be remembered as an inconvenience (and, humans being humans, an overreaction). If this continues on for much longer and kills hundreds of thousands and (based on some of the nasty stuff I've read about) permanently damages the lungs of millions more or other such things, causing disability and long-tail mortality increases for the next 50 years, this will be a generation-defining event comparable to the Great Depression, and the usually-reliable "tomorrow will be mostly like today" prediction methodology will catastrophically break down in the next couple of months.

I guess the implication that the US military and also non discretionary fund won't be reduced based on the last 50 years of data is probably a status quo bet.

given that the US has spent[0] over $5,000,000,000,000 on pointless wars, redirecting even a fraction of that toward a necessary one should be a no-brainer.

[0]: https://www.nationalpriorities.org/cost-of/war/

wars make money, viruses don't. hence why wars are never won or end.

We just added "Space Force" so ya, why not add "Health Force" while we're at it. Health Force could have a number of tasks during non-Pandemic times too. We might even be able to pay for Health Force, at least in part, out of some foreign aid budgets if we send Health Force as part of that aid.

Yeah! Some sort of Center who's job it would be to control diseases. We could call it the Center for Disease Control.

Snark aside, we had a similar situation with SARS. In the immediate aftermath, it's easy to say what needs to be done to prevent the next one. It's far harder to get everyone onboard with paying for something 5 or 10 years down the line when "there's no point" and "why do I have to pay taxes"?

Same as "Why we paying for backups?! We never had to use it!"

I'm happy I don't live in The USA right now. Even the worst hits, I don't have to be afraid of medical bills or if I lost my job. Both are covered by the tax I payed before.

I agree, it would make too much sense to have a program of national service where people were required to undergo training for medical emergencies and disaster response. Having practically every able bodied person qualified as a first responder would pay huge dividends.

This may come across as crass but I legitimately believe that there is a market for "emergency preparedness" as a service. It can deliver a set of basic necessities at sign up and perishable supplies at regular intervals customized for your geographic location, number of family members, storage space etc. While you can do the same by trawling through prepper forums and making monthly trips to Walmart or Costco, it's not as convenient.

What were the holes you discovered?

I think there are much worse issues than just the wildlife trade. I think long-term we're gonna have a lot of issues with antibiotic resistance diseases as a result of overuse in the meat industry [1].

[1] https://www.sciencedaily.com/releases/2019/10/191009132321.h...

I see overuse of antibiotics around me all the time. Just the other day my friend's daughter had bronchitis and readily prescribed antibiotics. A couple of days later when it didn't get any better, she got a stronger shot of the same antibiotic. Then it still didn't get any better and another doctor just decided to change it to another kind. There wasn't any of the "let's wait it out and see if this is viral instead of bacterial" or any testing done. And this isn't a single case. It's the norm with 80% of doctors I hear about.

Part of that is viral things often weaken your body enough for a bacterial infection to come in as well. In some (not all) of the most deadly diseases the problem wasn't the initial infection is was secondary.

> ... there's been so many extinction events, yet life still bounced back each time stronger than before.

Nit: The Great Dying, c. 252MYA, took about 10 million years to 'recover' from (though it depended on region, maybe). And the species that came out were not the same that died. As in, they evolved to fill the old niches. The Great Dying was no joke, nearly everything that had more than one cell went poof, like, 96% of all species.

Not to rain on the parade, but we have to work at this. If we do, we are fine, but just posting internet comments is not going to cut it.

Call your congresscritters or other representatives, tell them what you think.

https://en.wikipedia.org/wiki/Permian%E2%80%93Triassic_extin...

> Not to rain on the parade, but we have to work at this. If we do, we are fine, but just posting internet comments is not going to cut it.

I think posting online is a double-edged sword. On the one hand, "clicktivism" and posting hopeful messages soothes that person; on the other hand, if they are that easily soothed, they panic just as easily.

> Call your congresscritters or other representatives, tell them what you think.

This is important. Fortunately I've always lived in a district where my representatives were almost 100% aligned, but even then it is important to double down on the signal to noise. They love to hear positive feedback as well as negative feedback.

I really needed this optimism, thank you.