No one anticipated that SARS-CoV-2 would erupt in Wuhan, China, and be the worst pandemic since the 1950s but one thing I had long been concerned about was how unprepared the CDC was. Thanks to government becoming more overlords and less public servants - sorry, George Soros and friends, 'no kings' was a problem decades before President Trump was elected - and government employees spent their days grasping for more money rather than helping anyone.(1)
CDC was more interested in a financial power grab for its fiefdom, and now few take them seriously. That is why it is more important than ever we learn lessons from the last outbreak, so we don't end up with something worse from the past, like the Spanish Flu.
A new paper outlines strategies to prepare for the next one. And there will be a next one. The Next Plague got that part right. Nature is out to kill us, only the most clueless environmentalist ever believed in a 'balance of nature' myth, so pathogens will always be evolving. We have beat some back, like smallpox and polio, but coronavirus is in the same family as the common cold, those will always evolve, as will various other viruses, like the monkeypox the authors highlight.
Epidemiology needs to get better also. Their brand was wrecked during the pandemic - those who claimed a miracle drug off-label would not work for COVID-19 were derided while those who claimed schools needed to be shut down for a year were cheered, despite both being different forms of the same stupid guesses - but unless the next president comes in and just starts throwing money at them again, the days of promoting weekly scary chemical and miracle food claims are over.(2)
There are some qualifiers. The paper invokes the usual climate change mumbo-jumbo. Apparently, you can't get past Reviewer 2 today without noting how climate change will make your advocacy issue worse - viruses don't know that and it's not testable. It's also a systematic review using papers chosen using Methodi Ordinatio, which has its own issues, so this paper is not science, it is EXPLORATORY.(3) Some of the recommendations are infeasible because Europe and the United States are hamstrung by activists. The authors would like fewer city apartment buildings because close-contact increases risks but environmentalists want everyone in dense housing so nature can be untouched by icky human hands. Lawyers are going to win that fight. But this is in a magazine called Cities so that was going to be the focus.
Those qualifiers aside, and jargon about inclusivity along with it, they are right in recommending that labyrinths like CDC are not the way to do better in the future. Stay small, perhaps even the state level is too large, since California government said people couldn't get a haircut but could buy a pot brownie on the way to get a tattoo, according to their "science." The county is probably the right size to manage mitigation efforts.(4)
Some of the recommendations are unfeasible. There is no way to increase 'quality of life' in poor neighborhoods any more than government could tell us they will give every home an elite chef.(5) Ironically, one-size-fits-all recommendations are what they oppose, yet nearly half of their solutions are just that. It is pointless to tell poor countries to have better neighborhoods just like it was pointless for the World Bank to tell them they could only get loans for centralized energy if it is solar or wind. Remote bureaucracies block progress doing that sort of thing.
There is no question tools have gotten smarter but bureaucrats remain the same, so there are a lot of challenges in being more prepared. Let's hope some of the lessons from the last one stick when the next comes around.
Citation: Borhan Sepehri, Ayyoob Sharifi, Lessons from COVID-19 for enhanced urban resilience against Mpox and future pandemics, Cities, Volume 168, 2026, https://www.sciencedirect.com/science/article/pii/S0264275125007474
NOTES:
(1) CDC was good at manufacturing new epidemics, like vaping and prediabetes, but somehow needed six weeks to tell us that organic lettuce had E. coli. That is not an agency that can help in a crisis. And COVID-19 proved it right. When COVID-19 first started to hit, CDC career bureaucrats who had long bristled at the presidency of Donald Trump, dug in their heels so hard at his desire to cut travel from China they parroted the World Health Organisation who we now know was parroting...the communist government in China that desperately wanted to hide its role in the outbreak.
When hospitals started asking for tests, CDC refused to send them unless the hospital weirdly first proved a patient had COVID-19. When the White House forced them to send tests they still engaged in sabotage and sent ones with faulty reagents, forcing FDA to issue emergency authorizations to companies that knew what they were doing.
(2) Harvard could find every science graduate student for 200 years with the interest on its endowment from one month, but they are in the business of taking in cash, not spending it, so science has been first out for the door for them during the government review process.
(3) At a meeting with the NIH epidemiology group I requested that they require funded epidemiologists to watermark on the front page for journalists and they laughed. They know it is a problem in academia and journalists often rewrite press releases but they know they can't do anything about that.
(4) The Governor was photographed by outraged employees at The French Laundry in Napa eating with his friends, including two doctors, without a mask on when he told the entire state to wear them on walks outside. His excuse was that Napa didn't have a lot of COVID-19 so he thought it was safe. A government employee that is only thinking about his risk, and not everyone else's should not be making one-size-fits-all decisions for counties.
(5) You'll end up with a very expensive Obamacare-style fry cook.
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