Five years ago, the first case of COVID-19 was identified in New York City (NYC). Shortly after, the city was in the midst of an unparalleled crisis, one that would upend daily life, devastate communities, and test our collective resilience. At this inauspicious anniversary, we must ask ourselves: What did we learn from this experience? And what will we do differently to ensure we are better prepared for the next health emergency?
Much has been written about the heroic healthcare and essential workers who put their lives in the balance to serve others. Similarly, discourse has focused on the struggle for the hearts and minds of the population, the push and pull between accurate information versus disinformation and misinformation. However, less attention has been given to the critical role of mutual aid societies, the plight of businesses of all sizes, the suffering of those who felt isolated and disenfranchised, and the wrenching decisions that policy makers had to make in a time of uncertainty.
Over the past few years, the NYC Preparedness & Recovery Institute (PRI), formerly the NYC Pandemic Response Institute, has been conducting a comprehensive review of NYC’s COVID-19 response, with a focus on a whole of society approach. This has included an analysis of hundreds of reports and journal articles, interviews with key individuals involved in the COVID-19 response, and discussions with more than a hundred New Yorkers from diverse backgrounds on lessons that can enhance the city’s preparedness for and response to future public health crises. To ensure that the recommendations address New Yorkers’ most pressing concerns in public health emergencies, we are currently gathering community feedback to refine the review.
At this point, we present key interim insights to help strengthen NYC’s preparedness for future public health emergencies.
Support an inclusive emergency response network.
During COVID-19, many New Yorkers relied on government efforts bolstered by community-based, volunteer-led mutual aid. For future threats, this grass-roots network must be strengthened, especially within historically marginalized neighborhoods. This means integrating local businesses and organizations into government response structures with well-defined roles; funding for hyperlocal, neighborhood-based response efforts led by trusted community members; and fostering long-term, collaborative relationships between government officials and local leaders. Well-resourced community networks, connected to the citywide response system can speed up neighborhood recovery across all boroughs.
Protect essential workers.
Essential workers are the backbone of emergency response, yet there is no clear, standardized definition of who qualifies. We need a consistent framework that considers exposure risk, job necessity, and socioeconomic factors. Such a definition can enable the right health and safety protections, fitting eligibility criteria for assistance programs, and consideration for hazard pay, overtime compensation, and enhanced sick leave policies during crisis events.
Enhance scale-up planning at healthcare facilities.
The healthcare system was unprepared for the flood of COVID-19 cases, swiftly depleting essential resources and staff capacity. Historically disinvested communities were further challenged with fewer facilities in their neighborhoods. Preparedness should be increased across the healthcare system to flexibly surge staff and space capacities, link facilities into stronger networks, and standardize use of routine data indicators and protocols during health emergencies. These measures will help hospitals manage strained resources and better meet future public health crises.
Rebuild public trust.
Public trust in health authorities hindered the COVID-19 response due to inconsistent messaging, unclear guidelines, inadequate language access, and suboptimal engagement of specific groups. Historical racism and marginalization further deepened skepticism. Restoring confidence requires strong partnerships with trusted community organizations, local primary care providers, and healthcare systems. A systematic outreach approach that prioritizes open dialogue and multilingual, culturally relevant communication can help rebuild credibility in public health emergency response.
Guard against prejudice and violence.
Emergencies can intensify societal divisions, leading to increased hate crimes, xenophobia, and discrimination against vulnerable communities, often defined by racial or immigrant backgrounds. Partnering with local organizations is essential to monitor and prevent hate crimes, promote public education, and establish mechanisms to identify discrimination and support affected communities.
Leverage corporate sector expertise.
The corporate sector plays a critical role in stabilizing the economy during and after emergencies. To help minimize economic fallout in communities, an advisory group from key industries (e.g., finance, legal, engineering, technology) should be established to provide guidance, technical support, and legal expertise on government and civil society response. This group can help design equitable emergency procurement systems, improve access to global supply chains, strengthen collaboration with the insurance industry, and monitor and mitigate negative economic impacts.
Promote small business resilience.
Small businesses have more limited access to capital and economies of scale, and are especially vulnerable during emergencies. Leveraging and expanding multi-sector partnerships, such as the Small Business Resource Network, can ensure better representation of historically marginalized small businesses. These partnerships can address critical challenges, including caps on delivery fees, temporary suspension of personal liability guarantees, streamlined regulatory processes, and the dissemination of best practices to help businesses withstand crises.
Safeguard food and housing security.
Emergencies deepen food and housing instability, disproportionately harming communities long affected by systemic disinvestment. To address food insecurity, we must establish preparedness plans for supply disruptions and invest in sustainable local solutions like community gardens and food banks to combat food deserts. For housing, clear coordination mechanisms, including the use of converted hotels and vacant office buildings, along with real-time data sharing on shelter availability, can improve transparency and accountability in resource distribution.
Increase access to high-speed broadband and digital devices.
Reliable internet access is essential during emergencies when individuals and families must shift to remote work and learning. Expanding existing citywide broadband initiatives to underserved residential communities and homeless shelters is critical. Partnerships among schools, nonprofits, and businesses can ensure equitable access to remote education and work opportunities, helping to prevent learning disruptions and economic losses across all communities.
The next public health emergency is inevitable. New York City’s strength lies in its adaptability, even in the face of adversity. To protect all New Yorkers, we must invest in equitable systems, structures, and support networks that not only respond to crises but also promote the well-being of all communities, securing our collective future.