Why wouldn’t we create a 9/11 style COVID commission?

A 9/11 Commission was obvious when created in November 2002. To date, COVID-19 has killed 200 times more people than 9/11 across the U.S., and continues to threaten lives domestically and around the globe.

Any event that results in: 

• The deaths of more than 600,000 Americans, deserves a 9/11 style commission.
• A 40% greater likelihood of death depending on race, deserves a 9/11 style commission.
• A failure to effectively protect and care for seniors, and results in over 184,000 nursing home deaths, deserves a 9/11 style commission.
• Months of waiving key protections of the Americans with Disabilities Act, on its 30th anniversary, effectively stripping protections designed to safeguard the civil rights and independence of people with access and functional needs and other disabilities, deserves a 9/11 commission.
• The deaths of over 3,600 American healthcare workers, largely due to insufficient access to effective personal protective equipment (PPE), deserves a 9/11 style commission.
• One in eight ICUs across the country, reaching maximum capacity– simultaneously, deserves a 9/11 style commission.
• Trillions of dollars of economic damage and long-term, elevated unemployment rates, necessitating multiple, multi-trillion dollar stimulus packages, deserves a 9/11 style commission.
• Nationwide school closures, in some cases for over one year, resulting in 55.1 million children out of the classroom, deserves a 9/11 style commission.
• A once in a generation adverse impact on children’s mental health, resulting in a 31 percent increase in mental health-related emergency room visits for youth aged 12 to 17 during 2020 as compared to 2019, deserves a 9/11 style commission.

And any event where: 

• The viral spread of misinformation outpaced government efforts to save lives and inform the public, resulting in thousands of deaths, deserves a 9/11 style commission.
• Public health experts have described national, state, and local government information sharing as inconsistent, incomplete, and inaccessible, deserves a 9/11 style commission.
• Tens, if not hundreds of thousands, of Americans died alone because the vast majority of hospitals, nursing homes, and other health centers would not allow visitors into COVID-19 wards, and had no guidance on how to do so, deserves a 9/11 style commission.
• The White House, CDC, other federal agencies, and states offered divergent and sometimes conflicting public health guidance specific to the same public health emergency, deserves a 9/11 style commission.

What could a 9/11 style commission achieve?

• Document exactly how the pandemic unfolded to better understand the decisions, actions, and policies that lead to significant loss of life and suffering.
• Use those findings to guide recommendations for saving lives and future pandemic response.   
• Prepare for the inevitable: We don’t know when we will experience another pandemic. Other parts of the world experienced outbreaks in recent years (i.e. SARS, MERS, and Ebola, to name a few) and we have been relatively lucky in the U.S. However, as travel increases and becomes more accessible, we must be ready for future public health threats that could be even more deadly than COVID-19.
• Restore public confidence in our nation’s ability to keep our communities and families safe.
• The public must be able to trust treatments and public information provided during health emergencies.
• It is a national security imperative that our nation be able to mobilize, free of partisan bickering or political motivation, in the face of external biological or viral threats.
• Science has saved generations from viral and bacterial infections, cures cancers, and extends life expectancy. We must find ways to depoliticize health and science.

Specifically, a 9/11 style commission could investigate:

• How to prevent and/or reduce disparate/poor health outcomes based on race, geography, and other socioeconomic factors. A commission could identify missing data points that, if collected, could help us improve future responses and save lives. A commission could examine factors that resulted in poor health outcomes during COVID-19 and identify opportunities for improvement. 
• How to prevent supply shortages and cost increases of critical goods after future public health and other types of disasters. How to prevent unnecessary and dangerous competition between states for critical goods. How to protect state budgets and taxpayer dollars from devastating cost increases that may follow future disasters. 
• Use of the Defense Production Act (DPA) by examining how and when it was utilized, and make recommendations for how the Act can be used after future public health emergencies. A commission should also examine policy proposals that would have delegated authority to states, allowing governors limited use of DPA within their respective states.
• How to improve responses to disasters across state lines, reducing fragmentation and inconsistencies, reducing competition between states for critical goods, and strengthening coordination. 
• Instances in which laws like the Americans with Disability Act (ADA) were waived during the COVID-19 disaster and identify ways to improve future responses so the rights of people with access and functional needs and other disabilities are protected.
• How to better protect health care workers after future public health emergencies. Explore ways surge capacity was successful and worked and identify opportunities for improvement in the future. 
• How to protect nursing home and assisted living residents and staff after future pandemics. Identify failures and successes and compile lessons learned.
• How to prevent/reduce food insecurity, especially for those most vulnerable, during future pandemics and other disasters. Examine the “Mutual Aid” networks and how they might be strengthened, and how they compare in function, size, and capability to existing Voluntary Organizations Assisting with Disasters (VOADs), Citizen Emergency Response Teams (CERTs), and American Red Cross volunteer capacity/availability.
• How to strengthen public health infrastructure from hospitals and ICUs, to contact tracing, testing, and other public health services.
• How to improve continuity in education, including strategies for student engagement, connectivity, and support during future pandemics.
• The effectiveness and impact of the Payroll Protection Program (PPP) and other stimulus programs. How could they have been improved?  What lessons learned can we glean for future disasters? 
• Innovations and policy recommendations introduced during the pandemic to improve the public health response.
• Ways to address and mitigate the negative impacts on mental health caused by social isolation and other aspects of the pandemic.
  

If history has taught us anything, we know that a commission alone is inadequate to address these issues. The 9/11 Commission issued 41 recommendations in its first report and many were quickly implemented. Some of these improvements undoubtedly prevented additional terrorist attacks.

However, despite these improvements, four years later, the U.S. was woefully unprepared for Hurricane Katrina when it crashed into the Gulf Coast. Additional reports followed, including one by Congress titled, “A Failure of Initiative.” Only some recommendations were fully implemented and we continue to pay the price.

What is most certain, is that if we fail to come together to examine this crisis and make improvements on all levels of government, we will be doomed to repeat its failures.

Ben Smilowitz is founder and executive director of Disaster Accountability Project and SmartResponse.org, a nonprofit started after Hurricane Katrina.