In the early 2000s, Scott Gottlieb spent years in the FDA working on a “Pandemic Influenza Plan” to prepare the United States for the threat of a global pandemic. Besides developing a response playbook, they also drilled for the event. But then they stopped. After years away, Gottlieb returned as FDA director in 2017 to find that the agency was using the same outdated plan and obsolete tools to face Ebola, Zika, and swine flu. Shortly after he left again in 2019, the coronavirus arrived, and the administration found themselves uninformed about its mounting risk to our public health and our national security, as well as being ill equipped to mount an effective response. They still are overwhelmed and focusing on the wrong things. In An Ounce of Prevention, Gottlieb lays out the reasons why the U.S. was so underprepared for COVID, from failing to enlist the private sector in large-scale manufacturing of testing supplies to resolutely sticking to the narrative that COVID wasn’t a big problem. He warns that if we don’t course-correct on these issues, we will struggle to even distribute a vaccine if one is successfully created.