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Though pandemic preparedness has been a focus of public health planning forcenturies, during which our understanding of infectious disease dynamics hasgrown, our methodologies for managing outbreaks have remained relativelyunchanged. We propose leveraging this history to identify opportunities foractual progress. We contrast current plans with historical outbreak controlmeasures and isolate how the complexities of a modern era yield additionalchallenges in how best to anticipate and mitigate outbreaks. We analyze adiversity of publicly available modern preparedness plans against the contextof a historically-based fictional outbreak control strategy described inDefoe's A Journal of the Plague Year (published 1720). We identify themes inpreparedness planning that remain unchanged from historical settings eventhough they continue to be actively evaluated in planning efforts. Moreimportantly, we isolate critical modern challenges in preparedness planningthat remain predominantly unsolved. These modern, unsolved issues offer bestavenues for meaningful improvement. Shifting our planning efforts to focus onidentified novel issues may greatly strengthen our local- to global- capacityto deal with infectious threats.

Leveraging Insight from Centuries of Outbreak Preparedness to Improve Modern Planning Efforts