American Democracy and Pandemic Security: Strengthening the U.S. Pandemic Response in a Free Society

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Executive Summary

The Covid-19 pandemic imposed unprecedented challenges upon U.S. federal, state, and local officials, and it inspired important and lifesaving successes. Most disturbingly, the pandemic response in the United States featured stark failures in early rapid response, preparedness, execution, and messaging. Leadership was missing in key moments. Those failures eroded confidence not only in public health but also in the ability of leaders and institutions to make decisions that affected every sector of society. The pandemic magnified persistent inequities and exacerbated—and was exacerbated by—polarization, what many now view as a comorbidity that prevented a more unified and effective response. A limited tool kit too often left decisionmakers with blunt, binary, and divisive choices involving stark societal trade-offs: health versus the economy, online versus in-person education, locking down versus lifting restrictions, and individual freedom versus collective responsibility. Compounding the challenge were mixed and confusing messages about what institutions and Americans should do.

And yet, despite enormous challenges, the pandemic yielded important successes. The United States was a global leader in research and development that created multiple safe and effective Covid-19 vaccines and medicines. Government, clinical, and community leaders launched the largest vaccination program in modern history; private sector partners launched the largest public service announcement campaign in U.S. history; and collective efforts from trusted messengers and multiple sectors were ultimately able to vaccinate much of the U.S. population in record time. Targeted, community-based efforts helped narrow racial and ethnic disparities in vaccine uptake. U.S. communities demonstrated resilience in learning how to cope with overwhelmed health systems, shuttered schools and businesses, and restrictions on individual freedoms. 

However, major inequities, deficiencies, and divisions remain in how people judge the legitimacy of community, state, and national responses to public health measures. These divisions continue to plague the ongoing Covid-19 response and will make it highly problematic and uncertain for the United States to respond quickly and effectively in future pandemics. In fact, one could argue that these divisions will make many Americans less willing to embrace measures to address serious public health threats in the future and could lead to a further general erosion in popular confidence in countermeasures such as vaccines, not only for Covid-19 but for other viruses such as measles, for which vaccination rates are declining. Now, entering year four of the pandemic, the United States faces the risk that these societal divisions will harden, becoming more permanent barriers to effective pandemic response and bipartisan action.

Going forward, a bipartisan approach is needed to protect public health and work to preserve individual freedom, drawing on the lived experiences of states and localities that did better at reducing deaths and hospitalizations while navigating impacts on education, the economy, and society. Such an effort will be mindful of the politics that have divided Americans during the Covid-19 response and will engage leaders and institutions reflecting the strength and pluralism of the United States to learn from the past and build a better future. A new, pragmatic consensus is needed that bridges deep divides and is fueled by candor, self-criticism, humility, a determined optimism, and civility. Mistakes stretch across every acre, as do quiet successes. Finding new solutions is the challenge. This report provides a description of the first convening and major findings of the Democracy and Pandemic Security roundtable.

On December 5, 2022, the Brown University School of Public Health Pandemic Center, the Center for Strategic and International Studies (CSIS) Global Health Policy Center, and the COVID Collaborative convened a senior-level roundtable on “Democracy and Pandemic Security.” This document presents a summary of key themes that emerged during the discussion, but it does not necessarily represent unanimous consensus by the meeting participants. 

This report is made possible by general support to CSIS. No external sponsorship contributed to this report.

CSIS Global Health Policy Center

Brown University Pandemic Center

COVID Collaborative