COVID Report Compares Pandemic to War, Reviews Nation’s Response

Dr. Carter Mecher is one of 34 experts with the Covid Crisis Group, based at the UVA Miller Center and led by former 9/11 Commission Executive Director Philip Zelikow, UVA’s White Burkett Miller Professor of History.

The group will release its report, “Lessons from the Covid War,” in book form on April 25 through Public Affairs Books, a part of Hachette Book Group. On Friday at 11 a.m., Mecher will join Zelikow and other group members for a one-hour Miller Center presentation.

Mecher said the book uses the metaphor of war to describe the fight against the virus. The first challenge in war, he said, is to warn the population and prevent attack, including how the virus is transmitted and who it impacts the hardest.

The second challenge is to contain the attack. The third is to defend the community. The fourth challenge is fighting back with medical countermeasures, including vaccines and antivirals drugs.

“I think one of the one of the places where we shined was in the development of vaccine, in Operation Warp Speed. We first learned about this outbreak in January 2020 and within 11 months, we had vaccines.” Mecher said. “That is pretty amazing. That required bringing together the government, public sector and the private sector in a focused effort to develop effective vaccines as quickly as possible.”

The report also provides an opportunity to rethink how the American health care system works, as well as public health care policy.

“When you go to war, you go to war with the army you have not the army you wish you had,” Mecher said. “We found that the operational capability for fighting this war really wasn’t at the federal or national level. It was at the state and local level, across the 2,800 or so state and local health departments.

“But those health departments were built for the challenges of the late 19th century. In a sense, we went to war with the equivalent of 50 state militias. Each one of those health departments is unique and historically understaffed and underfunded,” he said.

Other flaws also worked to the virus’ advantage. The nation’s public health system is separate from its health care system. Worse, the health care system is not a system at all.

“It’s a collection of hospitals and individual health care systems that don’t often work or collaborate in peacetime,” he said. “In addition, both public health and health care are disconnected from biopharma, which is the source of the medical countermeasures, the weapons we need in this war. We had lots of disconnects between our public health system our healthcare system, and biopharma.”

Critical delays in creating reliable tests and a testing regimen meant health officials were “flying blind” in the first few months of the pandemic. Conflicting guidance from the U.S. Centers for Disease Control and Prevention created difficulties and doubt.

“There was confusion in messaging regarding the use of masks. Masks weren’t helpful then they were helpful, stop using masks and then resume using masks,” Mecher said. “We need to do much better to communicate what we know and what we don’t know. It that takes time to understand and learn about the virus and as we do, things are constantly changing. Trying to communicate that change is extremely difficult.”

Mecher, who served as a senior medical advisor for the Office of Public Health at the Veterans Administration and former director of medical preparedness policy for the Homeland Security Council, said he didn’t expect the nation’s collective reaction to COVID-19 casualties.

“One of the things that surprised me is our reaction to mass death. When you get into over a million dead, it becomes mind numbing. It becomes just a number or a statistic,” he said. “We almost shrug our shoulders over it. We’ve talked about herd immunity with the virus and it’s almost like we have a herd immunity to the level of loss that we’ve experienced.”

Mecher said the group hopes its report will help America prepare for future pandemics.

“The lessons we’ve drawn are the result of looking backwards, but it cannot end here,” he said. “What matters is how we change the way future pandemics will be lived, how we experience them, how we assess the threat and how we respond in a timely manner to prevent needless suffering.”