So President Obama started asking questions about Ebola, seeking more information. Because he asked those questions, a multiagency process was established that began to spin the wheels of a government response that would encompass agencies as diverse as the Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), the State Department, and the U.S. military.

As the first COVID-19 cases began to spread with alarming speed and lethality in China, President Trump evidently did not choose to make the issue a priority. Based on his public comments and Twitter feed, the incoming information that consumed his attention was more likely to come from cable television or political gossip than deep inside his intelligence briefings. Presumably, he also had a certain view of what he’d be doing in early 2020—chiefly, preparing the ground for his reelection campaign—and veering off course to prepare for a pandemic would have undermined those plans. A simple presidential communication of interest in a subject can set the government in motion, but in this case, that signal apparently never came.

One way to guard against presidential disinterest is structure. After Ebola, an office was set up in the White House’s National Security Council to manage global health threats such as pandemics. That office was intended to be a coordinating mechanism, preparing the government to be better able to manage pandemics, at home and abroad. The office also established an advocate for action within a White House where everyone is focused on their own priorities. When the first reports of a strange disease start to appear, personnel become policy: You need people in the building who are going to be worried about a particular issue above everything else. Just as the counterterrorism staff worries about terrorist plots so that a president doesn’t have to, you want a staff that’s worried about an Ebola case in West Africa or a virus in Wuhan, China. Trump shut down that office without explanation in May 2018. Without that resource, information about a potential pandemic likely cycled through the White House, day after day, with no natural home and few advocates for action.

Second, there is the question of whom you turn to when you have a problem. A U.S. president is going to be asked to respond to a huge variety of events that go beyond his expertise—such as oil spills, earthquakes, and outbreaks. The good news is that the U.S. government has leading experts on just about any issue that could emerge, spread across different agencies. So when a public-health crisis broke out in Africa, Obama didn’t rely on people like me—I was relegated to the sidelines, so he could hear directly from experts at the CDC and NIH about what the risks were, what we needed to anticipate, and what decisions might be coming his way.