American Scientist

The COVID Crisis Group formed one year into the pandemic, in early 2021, with the mission to help facilitate the formation of a commission to investigate the United States’ response to “the worst global crisis so far in the 21st century,” as they put it. When no such commission materialized, the group decided to write a book that summarized what they knew would be relevant to such an investigation. “No country went into this crisis with more scientific knowledge or spent more money, yet with such depressing results,” they write of the United States.

When I first heard about the group’s book Lessons from the COVID War, I was impressed to see the names of many experts I had turned to during the pandemic among the list of 33 coauthors, including Harvard University epidemiologist Marc Lipsitch, historian John M. Barry, and Marked by COVID founder Kristen Urquiza. Despite the authors' impressive credentials, they did not rely solely on their own experiences; the report consolidates insights from 195 listening sessions with 274 people involved with the U.S. response. “We cannot offer the kind of exhaustive investigative report that a Covid commission might have produced, interviewing layers of officialdom across the country and around the world, and piecing together thousands of key documentary records,” the authors acknowledge. “What we can offer is our sketch of the whole picture, our sense of how we think the pieces fit together.”

I was initially hesitant about the title likening a disease response to a war, because of the implication of violence and zero-sum thinking—something I’ve noted in a previous review of Eula Biss’s On Immunity. In this case, however, I think the authors make a convincing argument for using this metaphor.

“We think it helps to see this crisis as a war—a global war,” they write. “Some of us who work in healthcare don’t like these sorts of warlike metaphors. Some of us do. Conceiving of this struggle as a ‘war’ does help people think about how to organize collective action against a terrifying danger.

“By the end of January 2020, the U.S. government should have started mobilizing to a war footing against a terrifying pandemic danger. It was not ready to do this. It did not start really trying to mobilize fully until about two months later, and even then in a haphazard way.”

The COVID Crisis Group conceives of this warlike mobilization in four categories of action: “Prevent and warn” (collect intelligence on the enemy); “Contain the attack” (confine the enemy’s spread); “Defend our communities” (provide healthcare and protect people and their livelihoods); and “Fight back” (test, treat the infected, and vaccinate).

Many people have become oversaturated with information about COVID-19. I can relate, even though I’m in a position where I have a responsibility not to look away. At a time when so many of us in the American public faced no-win situations, unclear or ineffective guidelines amid great uncertainty, and impossible choices, many of us became increasingly demoralized and disengaged. For me, at least, Lessons from the COVID War helped me confront and process some of these difficult emotions, by considering what could be learned from this tragedy that continues unfolding to this day. The book documents many missed opportunities: for example, the lack of early testing and tracing, the failure to promote masks from the outset (or even have enough available), and poor information gathering and record keeping to track and respond to risks before they became problems or know where problems were emerging to respond quickly. And the authors' main point is that these opportunities were missed because of systemic inadequacies in governance structures. The disheartening part is that four years after the first outbreak, I still don’t see enough people pushing those in power to implement any changes, which could set our country up to repeat many of the mistakes we made in 2020 in another pandemic.

“The main legislative response to the pandemic, enacted in December 2022, tweaked authorities and added some program funds,” the COVID Crisis Group explains.

“Congress added a new White House office for pandemic preparedness and policy response. That White House office may yet be put to good use, but it was an office that the Biden administration had not sought, and it comes without operational authority or budget power. Such organizational fixes may just compound crisis management confusion.

“Some strategies have been announced, including by the Biden administration. But these ‘strategies' tend to be lists of goals, not road maps for accomplishing them. Had these changes been in place in 2019, they might not have altered the outcomes very much, if at all.”

So much discourse about the pandemic has fallen out along partisan lines that I was wary about this book potentially reinforcing those divides. However, the book is refreshingly nonpartisan, describing complex problems in governance that long predated the Trump Administration (which isn’t to say that the Trump Administration—or the Biden Administration for that matter—is given a pass). Indeed, chapter six, “Communities Improvise with Few Tools,” points out that at the city governance level, Republicans and Democrats often implemented remarkably similar policies (with some notable exceptions), even if they used different rhetoric to describe their approaches. “There is a common view that politics, a ‘Red response’ and a ‘Blue response,’ were the main obstacle to protecting citizens, not competence and policy failures,” the COVID Crisis Group writes. “We found, instead, that it was more the other way around. Incompetence and policy failures, including the failure of executive leadership, produced bad outcomes, flying blind, and resorting to blunt instruments. Those failures and tensions fed toxic politics that further divided the country in a crisis rather than bringing it together.” 

Not everyone agrees that the bipartisanship of the book is a strength. In a critical review of the book, journalist Richard J. Tofel speculates that its oblique approach to politics may be a result of having so many coauthors. That, I suppose, is both the strength as well as a weakness of a book that pulls together so many divergent points-of-view. I found it well worth the read to find out how so many different experts and insiders were processing the pandemic response, as fraught as that process must be.

The book emphasizes that a general lack of trust between people in leadership, even when they shared party affiliation, and slow-to-respond institutions created systemic incoordination. “Veterans of crisis management, whether they are domestic first responders or in the military, understand the value of going into an emergency with people who know each other and have some familiar routines, usually from prior practice,” the COVID Crisis Group writes. “This wasn’t the case in early March 2020. Most of the people [in the White House Task Force responding to the COVID crisis] had no experience working together under pressure.”

A main focal point of the book examines the structure of institutions of governance, a topic that transcends any single administration or party leadership. “What the Covid war exposed, what every recent crisis has exposed—even in Iraq and Afghanistan—is the erosion of operational capabilities in much of American civil governance,” the COVID Crisis Group writes.

How does a country begin to fix such massive problems? The COVID Crisis Group enumerates solutions in each chapter, as they offer a play by play of how the crisis unfolded first in China and then in the United States, and how the U.S. response compares to that of other countries that did not incur the death toll, the loss of in-person school time, nor the economic toll that we did. When relevant in comparison to the United States, they also acknowledge what other countries needed, and where other national governments failed in similar or distinct ways.

For those who are processing the tragedies of the pandemic and want to know what can be done, this book is for you. It gave me the sense of forward momentum that this moment needs. A federal COVID Commission would have had the funding to be even more thorough, but what the COVID Crisis Group accomplished with their limited resources is impressive and far better than nothing. The more people know this history, the less likely we are to repeat it.