The federal government must overcome the fragmentation of the nation’s public health system. The 10th Amendment to the Constitution and many Supreme Court rulings have given state governments primary authority to control the spread of dangerous diseases within their jurisdictions. But the dedicated workers in this patchwork of localities are overburdened and underfunded. The Commonwealth Fund report calls for creating a national public health system that would provide more leadership, resources and direction, perhaps led by a new undersecretary or assistant secretary of Health and Human Services. While it wouldn’t replace the work in states and localities, a national public health system would help ensure state and local health departments gain basic capabilities and resources to protect their communities, however different. The report says that government funding for core public health functions remains “grossly insufficient.”

Every virus or bacteria has a genetic blueprint. With advances in bioinformatics, scientists can use genetic sequencing to identify the variant, spot mutations and chart possible spread among people. This ought to be harnessed into a nationwide — or even global — trip wire for disease among humans, animals and plants. We already rely on early-warning systems to watch for hurricanes and tornadoes; radars and satellites keep watch for ballistic missile threats; prompt warning is critical to intelligence gathering and financial markets. But so far, early-warning systems exist only in fragments for disease. Also, there’s a crying need to build better data-sharing systems to improve the link between genomics (genetic blueprints), health care (what doctors, hospitals and emergency rooms are seeing among people) and epidemiology (the patterns of disease in the population).

The nation’s capabilities to create and manufacture vaccines must be strengthened. Operation Warp Speed showed what can be done.