If it wasn¡¯t clear enough during the COVID-19 pandemic, it has become obvious during the monkeypox outbreak: The United States, among the richest, most advanced nations in the world, remains wholly unprepared to combat new pathogens.

The coronavirus was a sly, unexpected adversary. Monkeypox was a familiar foe, and tests, vaccines and treatments were already at hand. But the response to both threats sputtered and stumbled at every step.

¡°It¡¯s kind of like we¡¯re seeing the tape replayed, except some of the excuses that we were relying on to rationalize what happened back in 2020 don¡¯t apply here,¡± said Sam Scarpino, who leads pathogen surveillance at the Rockefeller Foundation¡¯s Pandemic Prevention Institute.