Concerns about an epidemic striking the United States have long preceded the coronavirus. In 2005, President George W. Bush determined that the United States needed a national strategy in case a 1918 flu-level pandemic struck again. His administration created the Pandemic Influenza Plan, an exhaustive 396-page document that was intended to be the government’s playbook for how to respond if a pandemic occurred. The plan received periodic updates, the first coming in 2006, then one in 2009, followed by the most recent one, which began under Obama in 2016 and was published in June 2017.

During the Obama administration, the National Security Council created another pandemic plan, colloquially known as “the pandemic playbook.” Work on the Playbook for Early Response to High-Consequence Emerging Infectious Disease Threats and Biological Incidents began in the wake of the Ebola crisis, and the playbook was completed in 2016. According to four former officials interviewed by Politico, the Trump administration was briefed on its existence in 2017.