The Carolinas Pandemic Preparedness Task Force, convened in July 2021 by the North Carolina Institute of Medicine (NCIOM) and the South Carolina Institute of Medicine and Public Health (IMPH), was charged with examining lessons learned during the COVID-19 pandemic and developing consensus around actionable recommendations for a resilient future. The work of the task force was guided by a focus on equity, a cross-sector approach to health and well-being, and attention to the needs of vulnerable and historically marginalized populations, which have been disproportionately impacted by COVID-19.

This report from North Carolina presents 24 recommendations addressing such topics as infrastructure improvements, expanded access to services, and collaborative partnerships. The task force took a “wide-angle lens” approach to the pandemic because of members’ common understanding of the ways that health is embedded within social and political contexts, which have a definitive influence on the health of individuals and populations. The task force recognized that the impact of future pandemics will be determined by such factors as a strong health and public health infrastructure, a well-prepared workforce, a vibrant economy, effective and trusted communications, a robust social services safety net, and adequate access to equipment, supplies, diagnostic tools, and treatments.

The North Carolina task force’s report identifies several areas of specific relevance to our state, including:

• Access to the supplies necessary to effectively control the spread of disease and reduce disease risk, particularly among the most vulnerable (Chapter 3)
• Infrastructure changes to support adaptability (Chapter 4)
• Workforce development that prioritizes retention and strengthening the workforce pipeline (Chapter 5)
• Modernized surveillance and information systems to support data-driven decision-making and clear, effective, and tailored communication (Chapter 6)
• Expansion of broadband infrastructure and addressing digital literacy (Chapter 7)
• System changes to ensure supports and services that exist to be accessed before, during, and after public health emergencies, and clear, effective, and tailored communications about accessible supports and services (Chapters 8 and 9)
• Promote effective coordination and maximize resources by establishing new partnerships and maintaining existing partnerships (Chapter 10)

The recommendations are both attempts to remedy problems that arose during the pandemic and suggestions for permanently adopting emergent solutions that proved successful and should be implemented in a future public health emergency. This report from the North Carolina task force offers policymakers and stakeholders a set of actionable recommendations based on a shared vision and tailored to the needs of North Carolinians. Similarly, the report from the South Carolina task force contains a set of recommendations tailored to the needs of South Carolinians, and the preface to this report highlights the cross-cutting, foundational recommendations shared by both states.

Each report represents a time capsule of the challenges, successes, and lessons learned, and reflects the shared experiences of North and South Carolinians during the first two years of the COVID-19 pandemic.