Pandemic Center

American democracy and public health effectiveness are inextricable. American health security depends on maximizing the ability to live in a free, pluralistic society able to coherently manage a public health emergency. In turn, the health of US democracy depends on citizens’ faith and trust in institutions—especially government—to protect them in a crisis such as a pandemic. Given disease threats like mpox or H5N1 avian flu, the looming potential for a worst-case biological crisis begs for a well-prepared nation. Unfortunately, the United States, because of or despite the challenges of the COVID pandemic, is now more politically polarized and less prepared to mount a united response to a major health emergency. That is a collective danger that threatens Americans and imperils the world.

Any effective future response to a biological crisis must protect individual freedom, foster responsibility for one another, and address the unique needs and concerns of every community, including the most vulnerable. Yet pandemic response tools like masking, vaccinations, and social distancing have become flashpoints that pit individual freedoms against collective responsibility. And trust in US governmental institutions has consequently eroded. Confidence in the Centers for Disease Control and Prevention (CDC) dropped nearly 30 points—79 percent to 52 percent—from March 2020 to May 2022.

This steep drop in trust comes at a dangerous time.