From the article:
"In May 2018, with leaders in the White House and Congress who had never dealt with a major epidemic, Inglesby and his colleagues at Johns Hopkins University hosted an exercise in Washington DC called Clade X. It featured a respiratory virus that was engineered in a laboratory. One early lesson of this simulation was that travel bans didn’t stop the virus from gaining ground. Infections spread rapidly below the radar because half of the people infected showed few or no symptoms. Medical supplies ran short, and hospitals were overwhelmed. Federal and state leaders issued conflicting messages. More than 20 months passed before a vaccine was available.
Six top-line recommendations emerged from the exercise. These included reducing vaccine production time, and creating a 'robust, highly capable national public health system that can manage the challenges of pandemic response'. Some argue, however, that this emphasis was misplaced in subsequent discussions. Jeremy Konyndyk, a senior fellow at the Center for Global Development in Washington DC, says that members of the biosecurity community have often focused on vaccines, rather than on the complex, systemic deficiencies in the public-health system. They often overlooked the 'middle game' in outbreak responses.
'We have a strong end game once there is a vaccine, and we have a strong opening game if countries contain an outbreak when case numbers are low,' he says. But insufficient attention is devoted to harnessing and coordinating enough health workers and biomedical resources to efficiently test people, treat them, find their contacts and quarantine them. This is precisely the conundrum that the United States finds itself in right now."