Covid-19 was an unexpected pandemic. Most countries were unprepared for it, but they shouldn’t have been. For several years experts had been predicting that a major pandemic was imminent. Further, in 1969 the World Health Organization introduced the International Health Regulations that required countries develop comprehensive plans to combat large-scale outbreaks of infectious disease. These regulations were strengthened in 2005 (following the SARS epidemic) and again 2016 after a major Ebola outbreak in West Africa. But when Covid-19 struck, ‘pandemic preparedness was limited and disjointed, leaving health systems overwhelmed’ [1–3].