WHITE SWAN:

2. Establish a global response

"To respond to a pandemic, members of the international community will continue to work together," Bush said. "An influenza pandemic would be an event with global consequences, and therefore we're continuing to meet to develop a global response."

Bush requested $251 million from Congress to help foreign nations train local medical personnel, expand their surveillance and testing capabilities, and detect and contain outbreaks.

In September 2019, the Trump administration stopped funding PREDICT, an initiative under the US Agency for International Development (USAID) that worked with dozens of foreign laboratories -- including the one in Wuhan, China, that identified the novel coronavirus.

The program also trained thousands of people in Asia, Africa, and the Middle East to detect new viruses, according to the Los Angeles Times.

PREDICT was resurrected in April with $2.26 million in emergency USAID funding. But that same month, Trump ordered the US to stop funding the World Health Organization, claiming the organization allowed China to conceal the extent of the contagion.

The US has also pulled back from collaborating on international efforts to combat the pandemic: It didn't send a representative to the Coronavirus Global Response, a virtual summit that raised more than $8 billion for a vaccine, The Guardian reported.

And it has not said if it will attend the Global Vaccine Summit in London on June 4.

"What the United States has chosen in these recent meetings - not to attend, and not to participate - it has chosen instead to begin talking about a sort of go-it-alone approach," Stephen Morrison, director of the Center on Global Health Policy, told the Guardian.

That approach, he added, "fractures the international efforts and creates tensions and uncertainties and insecurities."

3. Strengthen domestic surveillance

"By creating systems that provide continuous situational awareness, we're more likely to be able to stop, slow, or limit the spread of the pandemic and save American lives," Bush said in his pandemic address.

His administration launched the National Bio-surveillance Initiative in 2005, which increased the government's ability to rapidly detect, quantify, and respond to outbreaks in both humans and animals.

It also set up systems to quickly share data between local, state, national, and international public health officials.

In 2018, Trump's National Security Adviser, John Bolton, disbanded the National Security Council's Global Health Security and Biodefense unit, set up by the Obama administration to handle pandemic preparedness.

Bolton tweeted that it was a "streamlining" of NSC structures.

Rear Adm. Timothy Ziemer, the top official responsible for overseeing our pandemic response, left the administration shortly thereafter.

The White House also eliminated the $30 million Complex Crises Fund, which the secretary of state can access to deploy disease experts.

Trump's budget proposals have consistently called for the Centers for Disease Control and Prevention's budget to be slashed by millions of dollars, though Congress has declined those provisions.

4. Stockpile vaccines, antiviral drugs, and medical supplies

Bush warned that, in a pandemic, "everything from syringes to hospital beds, respirators, masks, and protective equipment would be in short supply."

In 2003, the Bush administration placed the country's reserve of vaccines and antitoxins under the control of the Department of Health and Human Services and Homeland Security.

It also expanded the reserve to include medical equipment, like ventilators and personal protective equipment, and renamed it the Strategic National Stockpile.

In his address, Bush asked for $1.2 billion for enough avian flu vaccine to inoculate 20 million Americans and $1 billion to stockpile antivirals like Tamiflu.

The Obama administration utilized the stockpile during the 2009 H1N1 and 2016 Zika outbreaks but did not replenish it. The Trump administration also failed to replace those items despite warnings the stockpile was not prepared for a pandemic, according to NBC.

In February, HHS requested $2 billion to replenish the stockpile, but was rebuffed by the Office of Management and Budget, the Washington Post reported, resulting in a screaming match in the Situation Room between Azar and an OMB official.

The White House ultimately trimmed Azar's request down to $500 million when it was brought to Congress.

Once the virus came to the US, hospitals and state officials sounded the alarm about a lack of protective gear, but Trump called PPE shortages "fake news."

Tweet   @brothersjudd