called HACCP (hazard analysis critical control point) prerequisites such as floors, walls and ceilings, and equipment design and cleaning. For environmental health professionals, the article by Torok et al. (2022) might be help- ful in addressing some of the foodborne illness surveillance issues discussed previously in this article (Wikswo et al., 2022). But a survey of the environmental health workforce (Gerding et al., 2019) seems to suggest challenges ahead because of deficiencies in sta education and work backgrounds. For example, IAFP pub- lished the Procedures to Implement the Hazard Analysis Critical Control Point System (IAM- FES, 1991) and Procedures to Investigate Food- borne Illness (IAFP, 1999) booklets between 1991 and 1999 (there are many other publi- cations about HACCP now), but they might be too technical for the general environmental public health professional. Hartman (2020a) described a wide variety of predictive models and surveillance tools for foodborne diseases. Friedlander and Zoellner (2020) introduced AI concepts for retail food operations. Then in November 2022, the consumer software application ChatGPT (2023) was released, prompting raves (Pelley, 2023) and warnings (Bremmer, 2023) of the generative AI platform. The recommendation, therefore, is for orga- nizations such as FDA, CDC, or the National Environmental Health Association (NEHA) to develop AI models to facilitate foodborne illness outbreak investigations, development of HACCP plans, and food safety root cause analyses (RCA) for state and local health departments and food businesses. (For RCA, see The Pew Charitable Trusts, 2020, and Guzewich, 2021). Some models of this type have already begun to appear. For a gen- eral AI-assisted (i.e., machine learning) RCA (not specifically for food), see Papageorgiou et al. (2022). For an AI-powered HACCP plan builder, see https://bitrebels.com/busi ness/ai-powered-haccp-plan-vs-consultant/ and https://www.fooddocs.com/haccp-plan (information only, not an endorsement). Furthermore, Hartman (2025) describes the development of AI applications for retail food. COVID-19 According to Halperin et al. (2021), COVID-19 is the second major respiratory viral pandemic in just over one decade and the third corona- virus pandemic within two decades. These
authors also predict that more pandemics are likely in the coming years, whether from new coronaviruses or from other pathogens. CDC has reviewed this history (Jernigan, 2018). We have seen that misconceptions and conspiracy theories abound regarding COVID-19. There might be no way to change people’s minds about matters such as vac- cinations or masks after their minds have been made up, so the best hope for the next pandemic might be to intercede with school children beforehand. Dr. Michael Jensen, a domestic terrorism expert at the University of Maryland, has pointed out that the Proud Boys—the right-wing extremist group that helped push the January 6, 2021, attack on the U.S. Capitol—started as a protest against mask mandates and business closures. He contrasts the law enforcement responses to terrorism with a public health response that might begin in schools and might focus on combating misinformation and extremism with critical thinking skills (Young, 2023). Such a public health response could include attitudinal inoculation, which involves sug- gesting that an attempt to change the audiences’ beliefs or attitudes might be coming, followed by the issuing of information to refute such an attempt (Braddock, 2019). Research along these lines is underway at PERIL (www.ameri- can.edu/spa/peril), a research lab at American University that is doing the kind of early inter- vention work Dr. Jensen was referring to. NEHA could begin to prepare people for the next pandemic through school curricula and professional in-services. A national pub- lic health agency such as the National Insti- tutes of Health, CDC, or the World Health Organization should begin now to study ways that the public might be convinced to toler- ate the types of measures that were successful in limiting the spread of viral respiratory dis- eases during the COVID-19 pandemic. Llanos-Soto et al. (2023) listed four fed- eral laws aimed at relieving economic pres- sure due to COVID-19. A uniform inspection report form should be devised (Table 1), and data systems, such as the recommendations in Table 3, should be put in place. One of the references in Torok et al. (2022) describes critical thinking skills, which would also help address and eradicate many of these conspiracy theories (Willingham, 2008). Moreover, some of the former COVID-19 pandemic mandates have been institution-
Lessons to Learn
alized. For example, physical distancing in many o¥ces has become permanent, result- ing in a possible commercial real estate and banking crisis (“Why Empty O¥ces,” 2023) and a disruption of related services. There are several things Emanuel et al. (2022) called for that have not happened. For example, we have no tracking for at- home COVID-19 test results, and no national paid sick and family medical leave. A risk threshold to trigger mitigation strategies could be implemented, but no agreement has been reached regarding such a threshold. The threshold could be based on surveil- lance conducted by CDC (2025) through its COVID Data Tracker. Additionally, individual states and cities should conduct their own real-time surveil- lance for respiratory diseases, preferably using common definitions. Including case DC (e.g., be rst, be right, be empathetic, and give practical advice; have successes and publicize them) • No lockdowns (e.g., keep schools open for education and the economy; do not stay at home, outdoors is not a risk; better, smarter lockdowns and closures could have prevented one half of COVID-19 deaths in the U.S.) Source: Lessons we need to learn according to Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention (GZERO WORLD, 2022). • Need a renaissance in our public health system (e.g., invest in it; align world, federal, state, city, and county responses; engage with all communities) • Need a robust primary health system (e.g., prompt detection, diagnosis, and treatment; get up-to-date with vaccinations) • Need a resilient population (e.g., control chronic diseases such as hypertension; diabetes control; curb tobacco use; rebuild the public’s trust and our “common platform of understanding”) • The Centers for Disease Control and Prevention (CDC) needs to reestablish its identity as separate from our government in Washington,
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September 2025 • Journal of Environmental Health
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