Pandemic predictions and preparations prior to the COVID-19 pandemic

Planning and preparing for pandemics has happened in countries and international organizations. The World Health Organization writes recommendations and guidelines, though there is no sustained mechanism to review countries' preparedness for epidemics and their rapid response abilities.^[1] National action depends on national governments.^[1] In 2005–2006, before the 2009 swine flu pandemic and during the decade following it, the governments in the United States,^[2] France,^[3] UK, and others managed strategic health equipment stocks, but they often reduced stocks after the 2009 pandemic in order to reduce costs.

A June 2018 review said that pandemic plans everywhere were inadequate, since natural viruses can emerge with over 50% case fatality rates, but health professionals and policy makers planned as if pandemics would never exceed the 2.5% case fatality rate of the Spanish flu pandemic in 1918.^[4] In the years leading up to the COVID-19 pandemic, several governments ran demonstration exercises (including Crimson Contagion) which proved that most countries would be underprepared.^[5][6] Neither governments nor big businesses took action.^[7] Several reports underlined the inability of national governments to learn from the previous disease outbreaks, epidemics and pandemics. Richard Horton, editor-in-chief of The Lancet, described the "global response to SARS-CoV-2 [as] the greatest science policy failure in a generation".^[8]

Early outbreaks in Hubei, Italy and Spain showed that several wealthy countries' health care systems were overwhelmed.^[9] In developing countries with weaker medical infrastructure, equipment for intensive care beds and other medical needs, shortages were expected to occur earlier.^[9]