The World Needs a Pandemic Plan B

We must prepare to deal with future health crises in a world beset by nationalism and rivalry.

A graphic of the coronavirus casting a shadow over the planet
The Atlantic

There is never a good time for a pandemic, but the coronavirus may have hit the world at the worst possible moment. In the decade before the virus, China had grown more dictatorial and assertive; populist nationalists held power in the United States, India, and Brazil; geopolitical tensions were heightened, not just between Beijing and Washington but within the West itself; and the very notion of objective truth was being called into question.

There would be no muddling through this pandemic. Global cooperation broke down almost entirely, partly because many leaders were hardly on speaking terms. The World Health Organization buckled under pressure from China and became a punching bag for the United States. The couple of bright spots were few and far between.

The pandemic is not yet over and already a number of expert reports are calling for the world to come together, reform the WHO, and prepare for the next pandemic. The past 18 months have raised an unsettling yet vital question: How do we function when we’re broken? The true lesson of 2020 is that we need a plan to deal with enormous global problems in moments of high tension.

COVID-19 need not have been such a painful and costly disease. Indeed, it was not supposed to be this way. In the 17 years since the SARS epidemic of 2002–03, which China initially covered up, Beijing completely overhauled its public-health architecture to guarantee a more transparent, rapid, and effective response. This included empowering the Chinese Center for Disease Control and Prevention, putting in place a new system for reporting data up the chain, and working more closely with the international scientific community, including Americans.

But prior to this pandemic, telltale signs indicated that China might be regressing in its commitment to global public health. For our new book, Colin Kahl and I spoke with four senior officials who were based at the U.S. embassy in Beijing as the coronavirus began to spread, including the person who led the team of dozens of public-health professionals working at the mission in China. They told us that public-health cooperation between China and the international community had been fraying since the years before COVID-19.

The health team’s top priority was to persuade the Chinese government to fully share samples of a strain of bird flu known as H7N9—which experts believed could be the source of the next pandemic—with the WHO Collaborating Center for Influenza, as it was obliged to do, but the effort was unsuccessful. There were symbolic problems too. In 2019, the embassy organized an event to commemorate 40 years of U.S.-China relations and decided to focus on public health. Yet the guest speaker, an official from the Chinese CDC, and other Chinese health officials canceled without explanation the day before the event. It was a harbinger of things to come.

When the coronavirus hit, many of the post-SARS reforms melted away. The head of the Chinese CDC learned about the virus from social media. U.S. public-health professionals stationed at the embassy in Beijing found that their channels of communication had run cold. Some analysts blamed the early secrecy on regional officials who did not want to give Beijing bad news, but once Xi Jinping assumed control, he doubled down on the opacity. Even the much-heralded sharing of the coronavirus’s genetic sequence occurred because a Chinese scientist defied a government order.

This was a moment of revelation for the rest of the world. Reform and engagement that were supposed to have transformed China’s role in global public health had clearly failed. Once it suppressed the virus at home, China also became more assertive in its foreign policy, cracking down on Hong Kong, retaliating against Australia for seeking an international investigation into the origins of the virus, engaging in a deadly border spat with India, and unleashing aggressive “wolf warrior” diplomacy around the world.

For China, the pandemic confirmed its power and capabilities, created more latitude for it to do as it wished, and revealed the inexorable decline of the West. Common threats, such as pandemics, were supposed to bring nations together. Instead, China went its own way.

For years, American allies had worried that the Trump administration would be completely ill-equipped to deal with a major foreign-policy crisis. When that crisis finally arrived, ironically, some senior figures in the White House grasped the severity of the threat long before their European counterparts. The president’s instinctive go-it-alone nationalism and his combative approach with Washington’s purported allies, however, held back any hopes that they could capitalize on this early realization.

Matthew Pottinger, the deputy national security adviser, and a handful of others persuaded Donald Trump to impose a partial travel ban on China on January 29, 2020, but failed to persuade him to prepare for what was coming next. Trump believed that the travel ban was sufficient, and listened to those officials—among them Treasury Secretary Steven Mnuchin and White House Chief of Staff Mick Mulvaney—who told him not to do anything that could disturb the markets. It was better to wait and see, they said. He was also reassured by Xi, who told him on a number of occasions that everything was fine.

The complacency in Europe was worse. In mid-January 2020, the European Commission’s Health Security Committee held a conference call to brief member states on the emerging crisis, but less than half called in. After two Chinese tourists in Rome tested positive for COVID-19 on January 30, the Italian government called an emergency meeting of European Union health ministers, but it took two weeks to schedule. The matter was not even on the EU foreign-policy chief Josep Borrell’s agenda when he visited Washington in mid-February 2020. Trump-administration officials were particularly shocked to see the United Kingdom play down the virus and consider herd immunity a viable option.

In early March, the markets went into free fall. COVID-19 was spreading across Europe and the EU was in disarray as countries closed their borders unilaterally and engaged in a frenetic dash for scarce medical supplies. Trump’s advisers warned that millions could die if he took no further action. So on March 11, the president—who until then had opposed any lockdowns—reluctantly agreed to shut the economy down for three weeks. The dam was breaking, and a national crisis loomed. Trump quickly turned on China, whose leader had assured him that the virus was under control. Trump’s message to his aides, one told us, was blunt: “These guys have fucked us, and they fucked me personally.” It was a visceral reaction that would have profound and lasting consequences.

In early 2020, the U.S. government was split on China—one group saw the rivalry through an economic and trade lens; the other saw it as a broader geopolitical struggle. Before the pandemic, Trump was in the first group. In March, he flipped, several officials from both camps told us. One said that the administration accomplished more on China in the following 10 months—through sanctions, regulatory restrictions, and the deepening of alliances—than in the previous three years. The impacts of this shift stretched beyond the Trump administration. Joe Biden’s team also adopted the lens of strategic competition, while European attitudes toward China hardened.

From that point forward, the Trump administration largely saw the pandemic as a symptom of a greater China challenge. The problem was that this worldview began to define, and limit, the pandemic response in general. Secretary of State Mike Pompeo blew up a G7 communiqué over the refusal of other member states to use the term China virus. Trump tried to pull together an in-person meeting of G7 leaders. Five of the other six agreed, but German Chancellor Angela Merkel pulled the plug: She was being personally cautious about travel but also felt that her presence brought out the worst in Trump. When she called to tell him, a furious Trump yelled at her and hung up the phone. According to a senior German diplomat, the two leaders never spoke again.

Differences among the U.S. and its allies really came to a head over the WHO and its dealings with China.

The WHO had previously worked with a secretive China that refused to cooperate with the international community during the SARS epidemic. The director-general at the time publicly confronted China, and it backed down. In 2020, however, the WHO publicly praised China even though WHO officials were privately frustrated and concerned, believing that this was the only way to secure any access or cooperation in the Xi era. Chinese diplomats also lobbied for a delay in the WHO declaring a Public Health Emergency of International Concern, a vital step in organizing an international response.

American officials were furious. They did not expect the WHO to directly criticize China, but they did want Tedros Adhanom Ghebreyesus, the director-general, to accurately describe what Beijing was doing, or even to just say nothing. In January, Trump’s ambassador to the WHO, Andrew Bremberg, warned Tedros that he was putting his “personal and institutional reputation at risk.” But early in the crisis, Trump was also praising Xi, and WHO officials didn’t believe that anyone else had a better plan to secure any cooperation from China.

Once Trump shut down the economy and turned on China, he went after the WHO, announcing that he was considering withholding U.S. funding from the organization. He then preempted his own deadline to withdraw and pulled his country out entirely, in the middle of its negotiations with the WHO on whether or not it would remain. According to one official, Trump decided this on the spur of the moment, just to juice up a speech on China that he felt was otherwise flat. He told Bremberg to keep negotiating, but the world no longer believed that he wanted to stay.

With the U.S. on its way out, China’s obstructionism got to the point where even Tedros snapped. One episode in early 2021 was particularly revealing. The WHO finally placed a team in China to investigate the virus’s origins. On February 27, the team gave a press conference to announce its interim findings. Peter Ben Embarek, the chair of the investigation team, said the theory that the coronavirus had escaped from a lab was “extremely unlikely” and wasn’t “a hypothesis we suggest implies further study.” As an added bonus for Beijing, the investigative team also held open two other explanations pushed by the Chinese government: that the coronavirus might have been imported into China via frozen food, and that a first outbreak could have occurred outside of Wuhan—even outside of China.

Embarek’s statement was widely greeted as a definitive refutation of the Trump administration’s claim that the coronavirus might have escaped from a lab. But, in the WHO headquarters in Geneva, senior officials were stunned. “We fell off our chairs,” one told my co-author and me. Tedros felt that the team did not have sufficient access or underlying data to make an assessment on the lab theory one way or the other, and told the investigators as much. The team was defensive. It felt that even getting a reference to the lab was a victory. The Chinese members of the team had not wanted to include it at all, so the team believed that saying a lab leak was “extremely unlikely,” not impossible, was a win. Tedros, who had previously worked in a lab himself, would have none of it. He told them that they should not have compromised on the language.

On March 30, six weeks after the completion of its investigation, the WHO team released its final report. The lab claim was included: “Introduction through a laboratory incident was considered to be an extremely unlikely pathway,” the report states. Tedros was frustrated; he believed that the report was excellent in many ways but, as he had said, the team should not have drawn this conclusion. Now, as the report was rolled out, he highlighted the inadequacy of Beijing’s cooperation and the limitations of the team’s report. “I do not believe that this assessment was extensive enough,” he said.

Some analysts and experts have dismissed the pandemic as relatively unimportant geopolitically. Richard Haass, the president of the Council on Foreign Relations, has written that it merely accelerated trends that were already under way. But this drastically understates its effect.

If the U.S. and China are to become embroiled in a cold war, future historians could well date its formal start to early 2020, when Beijing refused to cooperate with the rest of the world and Washington responded by going all in on geopolitical competition. The pandemic poses extremely difficult questions about whether global cooperation is even possible in an era of nationalism and rivalry. There are other troubling legacies. The vaccination gap between wealthy democracies and the rest of the world is turbocharging global inequality and could lead to a permanent two-tier world of the “safe” and the “unsafe.”

As the world turns its attention to preparing for the inevitable next pandemic, many may be tempted to urge leaders to just do better—to sign new treaties, to agree to work with one another, and to keep the global good in mind. That would be ideal, no doubt, but we cannot count on it. The world needs a plan B.

The Biden administration must push for reform of the WHO, but it should also create a new alliance of like-minded countries that would operate in parallel to it. Any country could join as long as it agrees to the very strict conditions of membership—including much higher levels of transparency and access for WHO inspectors. When the next pandemic strikes, this alliance could coordinate on travel and trade restrictions, as well as public messaging, financial penalties, and sanctions on countries that fail to cooperate fully with the WHO.

COVID-19 is a warning. The next pandemic could be more lethal and less susceptible to vaccines. We cannot wait for the world to cast aside nationalism and geopolitical rivalries. Try as we might to fix the world order, we must prepare to deal with pandemics in one that remains broken.