The coronavirus has now killed more Americans than the 9/11 terror attacks — and the death toll is poised to rise in the weeks ahead.

Nearly 3,000 people died after terrorists flew planes into the World Trade Center and the Pentagon, and a third plane that had been hijacked crashed in Shanksville, Pennsylvania, on 9/11. According to tallies by both CNN and the New York Times, over 3,000 people in the US infected with Covid-19 have died.

It is, of course, not a neat comparison. Those who perished on 9/11 died instantly or soon thereafter, though many first responders suffered major complications in the subsequent years. Meanwhile, the death toll from the coronavirus has risen since January and has grown substantially in the past few weeks.

Top health officials in the US government, like Dr. Anthony Fauci, predicted on Sunday between 100,000 and 200,000 deaths in the country before the crisis subsides. Dr. Deborah Birx, another medical professional leading the American response, said the following day that Fauci’s figures could pan out even “if we do things almost perfectly.”

President Donald Trump, a longtime New Yorker who only last year changed his official residence to Florida, seems to agree. If the death toll stays around 100,000, then “we all together have done a very good job,” he said during a Sunday press conference.

But one parallel between the coronavirus crisis and 9/11 is that, so far, New York City has borne the brunt of two of the worst crises in recent American history. Steven Kassapidis, an intensive care unit doctor in the city, told the Guardian last week that “9/11 was nothing compared to this.” Current conditions are “Hell. Biblical,” he continued.

With regard to 9/11, he said, “We were waiting for patients to come who never came, okay? Now, they just keep coming.”

That tracks with what Vox’s Jen Kirby and Emily Stewart reported last week:

Officials are frantically trying to find spaces to care for the New Yorkers they expect to become sick. The US Army Corps of Engineers is planning to build field hospitals at now-empty colleges on Long Island, and to remake the Jacob Javits Center, the convention center on the far west side of Manhattan, into a FEMA hospital. De Blasio said Thursday the city is trying to triple its capacity to 60,000 beds by May. That still may not be enough.

The USNS Comfort, the US Navy’s hospital ship, has now docked outside Manhattan for the first time since the 9/11 attacks.

The last time this ship docked in Manhattan was in the aftermath of 9/11. It's getting harder to avoid drawing parallels between the two crises. https://t.co/MkL67H2pkY — Richard Hall (@_RichardHall) March 30, 2020

Of course, the greatest devastation of the coronavirus is likely yet to come, whereas the destruction from 9/11 was immediate.

Another similarity is that President George W. Bush had ample intelligence informing him that al-Qaeda was planning an attack like 9/11, and Trump had multiple government agencies warning the US wasn’t prepared for a pandemic. Yet neither took sufficient steps to try to prevent the respective threats from unfolding. In Trump’s case, his administration was slow to deal with the outbreak, failing to administer tests early and deliver medical equipment to health care workers treating patients.

The sluggish response has already led at least one member of the 9/11 Commission — the government-mandated group that investigated the origins of the attack and the US government’s failures — to call for a similar effort once the crisis is over.

“As with prior catastrophic failures of the government to protect the American public,” John Farmer Jr. wrote on Saturday for ABC News, “the public will demand — and good government will require — an accounting of the actions and inactions that contributed to the world’s — and our nation’s — failure to contain the Covid-19 pandemic.”

Some national security experts have even begun to argue that the US government needs to dramatically rethink what the greatest threats to America really are — moving terrorism down the list and putting global health near the top.

“I can say definitively that the specter of 9/11 has impacted every major political decision tied to US involvement in Afghanistan, with the risk of enabling another such an attack weighing heavily on senior leaders,” Jason Campbell, who from 2016 to 2018 was a top Afghanistan policy official in the Pentagon, told me. “I believe we will see a similar effect when it comes to countering another pandemic.”

Should the US focus more on global health than terrorism?

In a piece for Politico over the weekend, foreign affairs journalist Nahal Toosi compared the US foreign policy community to a high school cafeteria. The popular kids were those who focused on terrorism, among other things, while “the global health specialists would be eating tater tots in the corner with the band geeks.”

The coronavirus may soon flip that hierarchy on its head.

“I think this is a breakpoint, a transformative moment that is going to change institutions,” Stephen Morrison, who leads a global health program at the Center for Strategic and International Studies think tank in Washington, DC, told Toosi. “You’re going to have a hard time to find people [who] argue again that this really is not all that important.”

Campbell, who’s now at the RAND Corporation, echoed that sentiment. “In the coronavirus context, much like with Afghanistan or even counterterrorism more broadly, there is going to be added political risk associated with underpreparing and underfunding,” he told me.

Here again, the case of the 9/11 attacks is instructive.

After 9/11, the US changed a lot about how it would defend against the next major attack. The Bush administration combined 22 government agencies into a single overarching agency: the Department of Homeland Security. It also created the Office of the Director of National Intelligence to better coordinate and understand the intelligence being gathered across the countries’ numerous intelligence agencies.

The 9/11 attacks also led to the rise of the surveillance state, allowing the government to track the movements of people around the world and online, even if they clearly weren’t terrorists.

The Bush administration prioritized tackling terrorism above almost any other threat in its National Security Strategy, and launched a “Global War on Terror” to confront terrorist threats around the world, which some estimates say cost more than $6 trillion.

Today, there are those who say the US government should reform once again.

“Covid-19 marks the final nail in the coffin of the ‘post-9/11 era,’ in which the United States harnessed all elements of national power to confront the scourge of violent Islamic extremism,” the first director of national intelligence, John Negroponte, and Yale’s Edward Wittenstein wrote for USA Today on Monday. “America needs a proactive intelligence agenda that draws on lessons learned from this ongoing pandemic.”

Negroponte and Wittenstein lay out four key elements of such an agenda:

Closer collaboration between intelligence agencies and the global health and scientific communities Increased focus on cybersecurity so connectivity is safeguarded for those in hospitals and working from home during an outbreak Closer monitoring of misinformation that could get people killed Increased use of artificial intelligence to help spot outbreaks before they get too big and to help physicians with diagnoses

However, it’s not like the US government doesn’t have global health security strategies on hand. It actually does, including one from the White House just last year (although it doesn’t feature the word “intelligence” once).

Other experts, like Dr. Angela Rasmussen, a virologist at Columbia University, say the most important change would be more money.

“There needs to be funding across the board for basic research, surveillance, modeling, and experimental work to predict pathogen emergence,” she told me. “This should include a pandemic preparedness plan and a standing committee to oversee this work.” That work would also include ensuring emergency stockpiles of medical equipment are full and ready for use, and also ensure that government agencies know their exact roles in times of crisis.

But some say that, other than a lack of preparation to have the medical capacity needed for an outbreak, the US national security community doesn’t actually need much reform.

Michael Leiter, who led the National Counterterrorism Center from 2007 to 2011, told me that the intelligence community did well predicting this kind of crisis. The fault in this case “falls entirely on the National Security Council, and hence the White House.” It’s not so much that the US needs to restructure its national security apparatus, then. The intelligence system worked, Leiter says. It’s the leaders who failed.

Others agree. “The real problem is not the intelligence community, but rather the policy side who have been warned about a pandemic multiple times,” said Mathew Burrows, a former top intelligence official who wrote the National Intelligence Council’s Global Trends reports. “The various administrations all complain that there are too many threats to track, but that’s life.”

“There is no reason — except bureaucratic inertia — that they could not redesign how they operate in light of a new threat environment,” added Burrows, who’s now at the Atlantic Council think tank in Washington. “This is a huge US failure which goes beyond the stupidity of this administration.”