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About: Abstract The emergency alert that appeared on my phone read “SCDU Activation,” indicating Emory University Hospital's Serious Communicable Diseases Unit had just been pulled into the battle against COVID-19. As part of this unit,I've donned PPE and participated in countless training exercises, and prepared other clinicians to safely care for people with highly pathogenic infectious diseases.What followed the activation alert, however, was a dynamic interplay between deliberate biosafety methodologies and rapid, reflexive critical care interventions as my teammates and I navigated a novel, burgeoning health threat that called for a whole-system response.As this pandemic continues to exact a grave toll on healthcare workers, our families and our communities, politicians have asked, “How could we have seen this coming?” “As a pandemic preparedness researcher, my question to them is, “How could you not have seen this coming?” This perspective piece argues that despite the many missed opportunities to prepare for this crisis, the greatest opportunities lie ahead of us if we choose today to invest in pandemic preparedness for tomorrow.

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