Logistics wins wars and beats pandemics
Someday the coronavirus will be behind us. It will be regarded in the same way as we regard the 1918 flu of a century ago. That flu taught the world that the way to stop a disease for which you have neither vaccine nor effective drugs is to isolate those infected from those who are healthy and to preserve the isolation until the disease can find no new hosts who lack antibodies.
During the Cold War, when every scholar discovered nuclear strategy, a proverb took hold in the armed forces: “Amateurs study strategy; professionals master logistics.” Logistics is a dry subject, lacking the glamour of the clash of arms, and the moving of battalions. Logistics deals with anticipating what materiel the combat arms will require and then devising the means to get it to the right place at the right time. Keeping the combat forces properly equipped is critical to success.
COVID-19 has taught us that battling a microbial enemy is an exercise in logistics, no less than a shooting war. The medical personnel, our combat troops, who battle the organism are not immune, so they must be protected with the best armor we can make. Medical armor is not made of steel, but of disposable plastic, of filtration fabrics, gowns and masks, and an array of other things to discriminate the infected from the healthy. Just having the “armor” is not enough; it must be supplied where it is needed before it is needed.
The COVID-19 pandemic shows how much can go wrong when government fails to prepare properly. The United States had a Strategic National Stockpile critical equipment, for medical personnel. But over the years since the warehouses were stocked, demands here and there for PPE, drew down the inventory. Congress refused to restock. President Donald Trump has had more than three years to prepare, but he still blames his predecessor for leaving the cupboard bare. When COVID-19 struck, there was nothing left to draw on.
In 2001 even before the United States was attacked by an anthrax terrorist, then-Sen. Joe Biden recognized American vulnerability to both natural pandemics and bioterrorism. The senator twice introduced legislation to form global disease surveillance teams. His bills passed unanimously in the Senate but died in the Republican House.
Now, more than two months since the magnitude of the pandemic was clear, it is almost impossible for Americans to purchase needed PPE at reasonable prices Medical professionals are sterilizing and resterilizing masks only intended for a single use because they otherwise would have no protection at all. Americans with compromised immune systems cannot find N95 respirators anywhere at any price.
Amazon is rationing its supplies of PPE, selling them only to front-line medical professionals. Walmart only lists surgical masks being sold from strange suppliers, most of them off-shore and at ten times the usual prices.
There is a lesson hidden in this bad news: we must plan, if not for the worse possible case, at least for the very bad ones. An ounce of anticipation is clearly worth a pound of crash procurement. The United States is supposed to have a national stockpile that all localities can draw on. The stockpile must be kept current; if stocks are drawn down to meet a crisis, replacements must be ordered immediately. If that does not happen, resupply will never happen. On a sunny day nobody sees a need to fix the roof.
It has been obvious since the Spanish flu that one day another devastating pandemic would sweep across the earth. Without a vigorous program to identify new pathogens, a program to test potential victims for the microbe and for possible immunity, public health professionals are flying blind. The specifics will depend upon the pathogen they target, but procedures for organizing, testing and contact tracing are much the same no matter the disease. Plans should be made before the event. Not improvised under pressure.
Defeating a novel disease is about epidemic intelligence, planning, and having the right spectrum of medical equipment and personnel before the outbreak. Assets that can be repurposed to fit any contingency and brought swiftly into the battle. Call it epidemic logistics. Before an outbreak, a boring subject compared to the search for treatments and vaccines. But if the stockpile does not already hold the basics, it is too late to order them once the outbreak begins. The major issue today? The Trump administration’s lack of planning, lack of leadership — and excuse making. The Biden disease legislation would have prepared and protected our country.
Peter D. Zimmerman is emeritus professor of science and security in the War Studies Department of King’s College, London and the former chief scientist of the U.S. Senate Committee on Foreign Relations as well as a former science adviser for arms control in the U.S. State Department. He is a fellow of the American Physical Society.