A MARTÍNEZ, HOST:
Five years ago this week, COVID-19 was declared a pandemic. And as the virus spread, it became apparent how little the world knew about protecting itself from a serious global outbreak. NPR's Gabrielle Emanuel reports that since then, some things have gotten better, others have gotten worse.
GABRIELLE EMANUEL, BYLINE: Erik Karlsson can tell you what's getting better. For years, he's been frustrated by how long it can take from when a disease first strikes to when scientists can identify it and respond.
ERIK KARLSSON: A lot of times we're on the back foot. We're finding things maybe a week or two weeks or even a month later.
EMANUEL: Karlsson is the director of the National Influenza Center of Cambodia. He says COVID highlighted this problem, and he spent the past few years working on how to get disease information in real time.
KARLSSON: What we've done is really put together what we call kind of a lab in a suitcase.
EMANUEL: Open it up and...
KARLSSON: We have a laptop. We have a sequencer, a rice cooker that we use to make gels. We can actually unpack it and have it ready to test in about five minutes.
EMANUEL: They've used it on poultry farms and plan to take it to wet markets and rural hospitals. One swab can test for multiple diseases.
KARLSSON: Dengue plus chikungunya, plus Zika, plus Japanese encephalitis, plus...
EMANUEL: COVID, flu, rabies. And he can get the genetic code. Is this human flu or avian flu, or something entirely new?
KARLSSON: Within 20 minutes, we're already understanding what viruses are in that sample. We are now ahead of the game.
EMANUEL: Advances in disease surveillance are happening all over the world, including here in the U.S. Paul Friedrichs was a chief medical adviser for the military during COVID. He says the Centers for Disease Control and Prevention deserve credit.
PAUL FRIEDRICHS: If you look at where they were in 2019 and where they are today, they've made huge improvements in their ability to see what's happening here in the United States.
EMANUEL: They're doing things like sampling wastewater to see what diseases are circulating.
FRIEDRICHS: Collecting data automatically from electronic health records, from emergency rooms.
EMANUEL: But Friedrich says all that data isn't valuable without this, the public's trust. In fact, that's his biggest concern when thinking about the next pandemic.
FRIEDRICHS: You can have the best surveillance system in the world. You can build the perfect test. And if you just walk out and say I built the perfect test and people don't trust you, they're not going to use it. And then it doesn't matter if it was perfect.
EMANUEL: A Pew Research study found that during COVID, more than a quarter of Americans said they didn't trust scientists to act in the public's best interest. And still today, that public trust remains below pre-pandemic levels. Luciana Borio says she understands why. Borio served in the first Trump White House as director for medical and biodefense preparedness. She says, during COVID, patients told her they couldn't openly express their skepticism about things like vaccines and lockdowns.
LUCIANA BORIO: Anybody opposing the prevailing views, they were ostracized and not invited to the scientific debate.
EMANUEL: Which, she says, made people more distrustful of health authorities. The pandemic also sowed distrust between countries. China didn't share relevant data on COVID. Many low- and middle-income countries watched as wealthier nations got COVID vaccines and medications first. One major effort to fix the issues that emerged is the pandemic treaty. But international negotiations have faltered. And then in January of this year, President Trump pulled out of the talks altogether. Lawrence Gostin at Georgetown Law thought now the whole thing is going to blow up, but it didn't.
LAWRENCE GOSTIN: In a perverse way, President Trump's withdrawal from the negotiations and from WHO has energized much of the rest of the world to get this done.
EMANUEL: As the U.S. now sits on the sidelines, Gostin worries. If there isn't trust and cooperation between nations, he says, it's going to be much harder to protect ourselves in the next pandemic.
Gabrielle Emanuel, NPR News.
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