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It’s not clear yet whether the coronavirus that has killed more than 800 people and shut down much of China will create an emergency here. But it’s already troubling to see that the United States isn’t well prepared to confront it — or the next outbreak.

Many US hospitals and urgent-care centers would be swamped by a coronavirus outbreak. Two years ago, hospitals were so overwhelmed by a more familiar threat, flu season, that they set up “surge tents” to treat patients.

In recent weeks, the Trump administration has created a task force to address the coronavirus, but communication with state and local health officials has been uneven. Universities and other institutions that house thousands of people “are not getting a lot of useful guidance” on what they should do with, say, someone who displays suspicious but mild symptoms, says Jeremy Konyndyk, who has led several international disaster response teams and now is a senior policy fellow at the Center for Global Development.

The government has to scramble because it has a bad habit of underpreparing, despite the potential for epidemics and pandemics to kill thousands and devastate the economy. For example, the United States has underspent on programs that send public-health experts overseas to help improve medical care in countries where outbreaks often originate and to speedily battle potential epidemics. Funding for such efforts tends to ramp up as a reaction to a specific outbreak like SARS, Ebola, and Zika, only to be dialed back down when the immediate crisis subsides. The US budget for global health security jumped from $500 million in 2014 to $1.3 billion in 2015, at the height of the Ebola scare, according to the Kaiser Family Foundation. Today it has fallen back under $500 million, calling into question the American commitment to international pandemic-prevention projects.

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President Trump has undone some of the processes that his predecessors used to address infectious diseases. In 2018, the White House dissolved a group in the National Security Council that coordinated the government’s responses to epidemics. That same year, declining budgets forced the Centers for Disease Control and Prevention to scale back its work with health authorities in other countries to detect and contain infectious diseases at their sources.

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One country where cutbacks occurred was China. Given the secrecy and obfuscation of Chinese health authorities during this coronavirus outbreak, the CDC probably couldn’t have done much to stop the spread of the virus there, even if it had more resources. But Tom Frieden, who headed the CDC from 2009 to 2017, believes that with more staff and funding in China, CDC researchers could have gotten a head start on vital epidemiological studies. They could have been gathering data on the severity of the disease and how readily it spreads. “This is either going to be somewhat bad, bad, or very bad, and it’s not clear which yet,” says Frieden, who now heads Resolve to Save Lives, a public-health organization. “It’s very frustrating not to know more.”

It’s not as though thoroughly and proactively preparing is impossible. In fact, it would cost the government an additional $905 million a year, according to a commission made up of Republican and Democratic lawmakers, retired military officers, and public-health experts. A report by this group, released in November by the Center for Strategic and International Studies, urged the government to end the “cycle of crisis and complacency” that has left us “woefully ill-prepared to respond to global health security threats.” The funding increase recommended by the commission would, among other things, support programs by the CDC and the US Agency for International Development to assist health authorities in countries where outbreaks are likely to get out of control. The money would also fuel vaccine development and ensure healthy reserves in funds for infectious-disease response operations.

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A spending boost of $900 million wouldn’t be trivial. But being underprepared is generally much more expensive. The SARS epidemic of 2003, which killed nearly 800 people, wiped $30 billion to $50 billion out of the world’s economy. Economists have estimated that a severe flu pandemic could cost $570 billion. And such threats will keep mounting; the worldwide movement of people and goods isn’t going to slow, and global warming will expand the range of insect-borne diseases.

Washington doesn’t take many chances when it comes to other potentially deadly and disruptive threats. The United States spent $175 billion on counterterrorism efforts in 2017. In comparison to that figure, “we might as well be twiddling our thumbs when it comes to pandemic preparedness,” Konyndyk says.

It shouldn’t take a severe outbreak here to change that.


Editorials represent the views of the Boston Globe Editorial Board. Follow us on Twitter at @GlobeOpinion.