F
orty-five days before the announcement of the first suspected case of what would become known as COVID-19, the Global Health Security Index was published. The project—led by the Nuclear Threat Initiative and the Johns Hopkins Center for Health Security—assessed 195 countries on their perceived ability to handle a major disease outbreak. The U.S. ranked first.
It’s clear the report was wildly overconfident in the U.S., failing to account for social ills that had accumulated in the country over the past few years, rendering it unprepared for what was about to hit. At some point in mid-September—perhaps by the time you are reading this—the number of confirmed coronavirus-related deaths in the U.S. will have passed 200,000, more than in any other country by far.
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If, early in the spring, the U.S. had mobilized its ample resources and expertise in a coherent national effort to prepare for the virus, things might have turned out differently. If, in midsummer, the country had doubled down on the measures (masks, social-distancing rules, restricted indoor activities and public gatherings) that seemed to be working, instead of prematurely declaring victory, things might have turned out differently. The tragedy is that if science and common sense solutions were united in a national, coordinated response, the U.S. could have avoided many thousands of more deaths this summer.
Indeed, many other countries in similar situations were able to face this challenge where the U.S. apparently could not. Italy, for example, had a similar per capita case rate as the U.S. in April. By emerging slowly from lockdowns, limiting domestic and foreign travel, and allowing its government response to be largely guided by scientists, Italy has kept COVID-19 almost entirely at bay. In that same time period, U.S. daily cases doubled, before they started to fall in late summer.
Among the world’s wealthy nations, only the U.S. has an outbreak that continues to spin out of control. Of the 10 worst-hit countries, the U.S. has the seventh-highest number of deaths per 100,000 population; the other nine countries in the top 10 have an average per capita GDP of $10,195, compared to $65,281 for the U.S. Some countries, like New Zealand, have even come close to eradicating COVID-19 entirely. Vietnam, where officials implemented particularly intense lockdown measures, didn’t record a single virus-related death until July 31.
There is nothing auspicious about watching the summer turn to autumn; all the new season brings are more hard choices. At every level—from elected officials responsible for the lives of millions to parents responsible for the lives of one or two children—Americans will continue to have to make nearly impossible decisions, despite the fact that after months of watching their country fail, many are now profoundly distrustful, uneasy and confused.
At this point, we can start to see why the U.S. foundered: a failure of leadership at many levels and across parties; a distrust of scientists, the media and expertise in general; and deeply ingrained cultural attitudes about individuality and how we value human lives have all combined to result in a horrifically inadequate pandemic response. COVID-19 has weakened the U.S. and exposed the systemic fractures in the country, and the gulf between what this nation promises its citizens and what it actually delivers.
Although America’s problems were widespread, they start at the top. A complete catalog of President Donald Trump’s failures to address the pandemic will be fodder for history books. There were weeks wasted early on stubbornly clinging to a fantastical belief that the virus would simply “disappear”; testing and contact tracing programs were inadequate; states were encouraged to reopen ahead of his own Administration’s guidelines; and statistics were repeatedly cherry-picked to make the U.S. situation look far better than it was, while undermining scientists who said otherwise. “I wanted to always play it down,” Trump told the journalist Bob Woodward on March 19 in a newly revealed conversation. “I still like playing it down, because I don’t want to create a panic.”
Common-sense solutions like face masks were undercut or ignored. Research shows that wearing a facial covering significantly reduces the spread of COVID-19, and a pre-existing culture of mask wearing in East Asia is often cited as one reason countries in that region were able to control their outbreaks. In the U.S., Trump did not wear a mask in public until July 11, more than three months after the CDC recommended facial coverings, transforming what ought to have been a scientific issue into a partisan one. A Pew Research Center survey published on June 25 found that 63% of Democrats and Democratic-leaning independents said masks should always be worn in public, compared with 29% of Republicans and Republican-leaning independents.
By far the government’s most glaring failure was a lack of adequate testing infrastructure from the beginning. Testing is key to a pandemic response—the more data officials have about an outbreak, the better equipped they are to respond. Rather than call for more testing, Trump has instead suggested that maybe the U.S. should be testing less. He has repeatedly, and incorrectly, blamed increases in new cases on more testing. “If we didn’t do testing, we’d have no cases,” the President said in June, later suggesting he was being sarcastic. But less testing only means fewer cases are detected, not that they don’t exist. In the U.S. the percentage of tests coming back positive increased from about 4.5% in mid-June to about 5.7% as of early September, evidence the virus was spreading regardless of whether we tested for it. (By comparison, Germany’s overall daily positivity rate is under 3% and in Italy it’s about 2%.)
Testing in the U.S. peaked in July, at about 820,000 new tests administered per day, according to the COVID Tracking Project, but as of this writing has fallen under 700,000. Some Americans now say they are waiting more than two weeks for their test results, a delay that makes the outcome all but worthless, as people can be infected in the window between when they get tested and when they receive their results.
Most experts believe that early on, we did not understand the full scale of the spread of the virus because we were testing only those who got sick. But now we know 30% to 45% of infected people who contract the virus show no symptoms whatsoever and can pass it on. When there’s a robust and accessible testing system, even asymptomatic cases can be discovered and isolated. But as soon as testing becomes inaccessible again, we’re back to where we were before: probably missing many cases.
Seven months after the coronavirus was found on American soil, we’re still suffering hundreds, sometimes more than a thousand, deaths every day. An American Nurses Association survey from late July and early August found that of 21,000 U.S. nurses polled, 42% reported either widespread or intermittent shortages in personal protective equipment (PPE) like masks, gloves and medical gowns. Schools and colleges are attempting to open for in-person learning only to suffer major outbreaks and send students home; some of them will likely spread the virus in their communities. More than 13 million Americans remain unemployed as of August, according to Bureau of Labor Statistics data published Sept. 4.
U.S. leaders have largely eschewed short- and medium-term unflashy solutions in favor of perceived silver bullets, like a vaccine—hence the Administration’s “Operation Warp Speed,” an effort to accelerate vaccine development. The logic of focusing so heavily on magic-wand solutions fails to account for the many people who will suffer and die in the meantime even while effective strategies to fight COVID-19 already exist.
We’re also struggling because of the U.S. health care system. The country spends nearly 17% of annual GDP on health care—far more than any other nation in the Organisation for Economic Co-operation and Development. Yet it has one of the lowest life expectancies, at 78.6 years, comparable to those in countries like Estonia and Turkey, which spend only 6.4% and 4.2% of their GDP on health care, respectively. Even the government’s decision to cover coronavirus-related treatment costs has ended up in confusion and fear among lower income patients thanks to our dysfunctional medical billing system.
The coronavirus has laid bare the inequalities of American public health. Black Americans are nearly three times as likely as white Americans to get COVID-19, nearly five times as likely to be hospitalized and twice as likely to die. As the Centers for Disease Control and Prevention (CDC) notes, being Black in the U.S. is a marker of risk for underlying conditions that make COVID-19 more dangerous, “including socioeconomic status, access to health care and increased exposure to the virus due to occupation (e.g., frontline, essential and critical infrastructure workers).” In other words, COVID-19 is more dangerous for Black Americans because of generations of systemic racism and discrimination. The same is true to a lesser extent for Native American and Latino communities, according to CDC data.
COVID-19, like any virus, is mindless; it doesn’t discriminate based on the color of a person’s skin or the figure in their checking account. But precisely because it attacks blindly, the virus has given further evidence for the truth that was made clear this summer in response to another of the country’s epidemics, racially motivated police violence: the U.S. has not adequately addressed its legacy of racism.
Americans today tend to value the individual over the collective. A 2011 Pew survey found that 58% of Americans said “freedom to pursue life’s goals without interference from the state” is more important than the state guaranteeing “nobody is in need.” It’s easy to view that trait as a root cause of the country’s struggles with COVID-19; a pandemic requires people to make temporary sacrifices for the benefit of the group, whether it’s wearing a mask or skipping a visit to their local bar.
Americans have banded together in times of crisis before, but we need to be led there. “We take our cues from leaders,” says Dr. David Rosner, a professor at Columbia University. Trump and other leaders on the right, including Gov. Ron DeSantis of Florida and Gov. Tate Reeves of Mississippi, respectively, have disparaged public-health officials, criticizing their calls for shutting down businesses and other drastic but necessary measures. Many public-health experts, meanwhile, are concerned that the White House is pressuring agencies like the Food and Drug Administration to approve treatments such as convalescent plasma despite a lack of supportive data. Governors, left largely on their own, have been a mixed bag, and even those who’ve been praised, like New York’s Andrew Cuomo, could likely have taken more aggressive action to protect public health.
Absent adequate leadership, it’s been up to everyday Americans to band together in the fight against COVID-19. To some extent, that’s been happening—doctors, nurses, bus drivers and other essential workers have been rightfully celebrated as heroes, and many have paid a price for their bravery. But at least some Americans still refuse to take such a simple step as wearing a mask.
Souces: https://time.com/5887432/coronavirus-united-states-failure/
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