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Jul 31, 2020

Pandemic Preparedness Infrastructure: An Action Plan for North Carolina

Executive Summary

The coronavirus pandemic of 2020 exemplifies a worst-case scenario for federal, state, and local disaster preparedness planning and illustrates some of the United States’ fundamental public health infrastructure flaws. While stay-at-home orders and economic shutdowns initially depressed disease spread, they harmed businesses and organizations, threatened individuals’ livelihoods, and negatively impacted community well-being. National standards for COVID-19 management tools and protocols were not available when needed, and state, local, and federal guidance differed, and often conflicted, in ways that confused the public and created economic uncertainty.

Though the coronavirus uniquely impacted and changed the world in 2020, experts acknowledge that disease outbreaks have increased in frequency and magnitude* over two decades. For this reason, we recommend state and federal governments learn from this pandemic and develop stronger preparedness infrastructure(s) for the “never again scenario.” Government officials must prioritize public health preparedness in the same way the federal government prioritizes national defense, cyber security, and natural disaster planning.

As such, the state of North Carolina requires a long-term, comprehensive strategy for developing and maintaining the foundational infrastructure required to prepare for future pandemics. Looking forward, state officials must address one key question: How can North Carolina prevent an economic shutdown during a public health crisis while keeping all residents healthy and safe?

This action plan is designed to help public officials formulate a pandemic preparedness and response infrastructure in the state of North Carolina. We leverage a proven disaster preparedness framework and provide evidence-based recommendations to support strategic planning. Our framework includes the following phases:

  • Threat Awareness (TA)
  • Prevention and Protection (PP)
  • Surveillance and Detection (SD)
  • Response and Recovery (RR)

We developed our recommendations by studying federal, state, local, and even international COVID-19 pandemic responses through July 2020, and identified key stakeholders, benefits, and supporting evidence. Each chapter also provides insights and questions for consideration to help healthcare leaders and state officials identify success stories, best practices, and develop strategies to implement a robust pandemic response infrastructure.

While we all continue to focus on the COVID-19 pandemic and response, public officials across the country must also prepare for future public health crises. In addition to this action plan, we identify a number of recovery playbooks that provide clear steps and strategies for disaster preparedness and recovery. Though this work is difficult, our public officials have a moral and economic obligation to study this crisis, identify points of failure and interdependencies, and go back to the drawing board to ensure we are better prepared next time.

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