On Planning for an Unimaginable Future

Sixty years ago, Thomas McKeown wrote that “all prophecy is hazardous” and that warning seems especially relevant coming off a year like 2020 with the COVID-19 pandemic.The public health community has long warned about the inevitability of another devastating pandemic and the disruptive impact it could have on the entire world. Disruptive health events can change the direction of history. Whether they be the Black Plague, the discovery of penicillin, or the 1918 Influenza pandemic, major “once in a lifetime” health events can change the trajectory of public health and alter the predictions of the future. The entrance of SARS-CoV-2 that caused the COVID-19 pandemic was one such event. Its explosion in our world in December of 2019 has resulted in the most significant disruptive health event in more than 100 years. The United States, despite its wealth, political power, and well-resourced health care system has been devastated by this global pandemic. And its public health system also has failed to contain the disease in any meaningful way.