Learning From the US COVID-19 Response Toward Creating a Healthier Country

Sandro Galea, MD, DrPH; Catherine K. Ettman, AB; Salma M. Abdalla, MBBS, MPH


Am J Public Health. 2020;110(12):1794-1796. 

In This Article

Abstract and Introduction


The United States was hit harder by the coronavirus disease 2019 (COVID-19) pandemic than nearly every other country in the world. As of this writing, the United States has had about 6 million positive COVID-19 cases and more than 200 000 deaths, with one of the highest death rates in the world. Undoubtedly, some of the scope of the pandemic in the United States is idiosyncratic and some is the result of immutable reasons (e.g., population demographics), but much else can be attributed to particular actions and inactions that the United States took before and during the pandemic. Although we still have quite a bit to understand about the pandemic, we suggest that one can—at this moment—draw inference to inform a stronger public health infrastructure that can mitigate the consequences of another future virus.

We offer five suggestions built on observations about the pandemic.

  1. Public health must be able to resist political interference,

  2. The national public health infrastructure must be robust to pandemic threats,

  3. Our underlying health must improve when it is not under acute threat,

  4. Health inequities must be at the forefront of any pandemic response, and

  5. Population health science can help public health practice.