Two years before the novel coronavirus upended the world, a report by a government watchdog warned that the U.S. could have a "fragmented" response to a potential pandemic.
A 2018 report from the Government Accountability Office said federal officials should establish a biodefense coordination team and outline a clear process for joint decision making before a pandemic struck. GAO analysts called a potential pandemic “high consequence, but low likelihood type of event" and acknowledged it could be difficult to get government leaders to prepare in advance.
“The concrete action to close those gaps often doesn't get taken and it isn't tracked later on down the road,” Chris Currie, the head of the Homeland Security and Justice GAO office, told ABC News. “The other thing about this is that you have so many different federal agencies, none of them can really tell each other what to do or how to do it. So when you do these exercises, you identify these gaps. HHS can't tell the Department of Homeland Security that they must close these gaps. So follow up is really difficult."
"You need to do the exercises beforehand so that you don't have the communication and the problems and the shortages that we're seeing today," she said.
The 2018 report was not the first time the government was warned about a potential deadly outbreak.
As early as 2008, there have been similar warnings from local and state governments.
In 2018, Johns Hopkins University conducted a test scenario of how the U.S. government would respond to a new infectious disease from overseas.
Two months after the exercise, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, said the timeline for new vaccines could be accelerated "if we put our mind and our resources to it."
The GAO released another report in February with four recommendations to the Department of Health and Human Services on how to educate and communicate with the public in case of a health emergency. By then, the Trump administration was facing a real-time developing crisis.
Some of the GAO's recommendations -- like HHS staff documenting methods for data collection -- are currently being enacted.
“The GAO has been stating for years [that] you have to know who's in charge of which particular aspect. And you have to figure out before the event occurs. And it's critically important right now,” Denigan-Macauley said.
She went on, “You can't have these disparate agencies and activities at the state and local level all trying to prepare a fragmented nature or something that can be so catastrophic. And if anything good can come of COVID-19 is the fact that maybe now people really understand. You do need that coordination and it needs to have continued focus over time so that we don't forget this."
Currie said "pandemics have been drowned out" by other events like election security and terrorism "for a long time."
He added that it's been "surreal" to watch "many of the things we had predicted" years ago to take place.