The entire world is collectively reeling under the effects of the COVID-19 infection but the US is now occupying a special place in the discourse - with the highest number of confirmed cases globally.
Apart from its original epicentre in Wuhan, China, the virus has so far hit two other centres hard - Italy, and now New York City in the US.
As of Sunday, 5 April, there are more than 312,000 recorded cases in the US and nearly 8,500 people have died, with 1,344 of those reported on Saturday -- the country's largest single-day death toll, according to CNN.
But how did things get so bad? How did one of the richest countries, with some of the worlds leading medical professionals and healthcare systems, fall so hard?
A mixture of laid-back government action, leadership failures, slow testing and no enforceable social distancing measures spelt disaster - on top of the burden the rest of the world is grappling with too, like a low testing strategy and a dearth in the supply of PPEs for medical professionals.
What went wrong?
1. Trump’s Failure to Get Serious
What was once called the ‘China virus’ by US President Trump has now transformed to the ‘America virus’, say experts.
But why is the mighty global power facing a public health emergency - despite knowing about it?
The ferocity at which the virus spread has alarmed many - but the US’s lackadaisical approach may have been the key to its downfall. An article in The New York Times, which curated interviews with scientists, public health and administration officials, points to the lack of early aggressive testing, technical flaws and failures in political leadership.
One of the key lessons to tackle this virus is to take it seriously early on. Deal with it immediately before it escalates is the mantra. According to the damning NYT article, America squandered a month of precious time and left its people unarmoured for the fight.
The Trump Administration started screening potential COVID-19 cases too late, and Dr Margaret Hamburg, the former commissioner of the Food and Drug Administration, told NYT that their lag created the space for an “exponential growth of cases.”
In the crucial timeline, Trump himself made several misleading public announcements on the virus, from saying, “It’s going to disappear. One day — it’s like a miracle — it will disappear,” on 22 February to “We have tests, and they are beautiful,” on 6 March when in fact they did not have the situation under control or enough tests at all.
Usually, the White House leads the charge on planning for public health issues, like former President Barack Obama did with the Ebola crisis. But instead, President Trump made several claims on testing - which were proven false by health administrators across the nation - and did not actively create a specific planning commission.
Later, Trump asked South Korea for more tests (after claiming they were testing more in 8 days then South Korea was in 8 weeks). But for many healthcare workers and sick citizens, it was a case of too little too late.
2. Slow Testing
While the political administration carries much of the blame, much of it also rests with the country’s leading research institutes.
The US Centres for Disease Control and Prevention (CDC) are globally established, premier institutions - and yet, they failed to deliver a precise test in time.
While China developed its own test and other countries relied on WHO’s testing protocols, CDC insisted on creating their own test. The only problem? It took too long - it was publically announced on 24 January, 3 days AFTER the first case in Washington.
Delays in starting, plus technical difficulties with manufacturing, cost the US dearly. Furthermore, while the CDC floundered, parallel approaches by the government or private players were not pursued as well.
Like India, the CDC restricted who could be tested. They also failed to do enough research to establish community transmission,.
Another misstep? According to the NYT, Dr Stephen Hahn, the commissioner of the Food and Drug Administration enacted harsher regulations that strangled the public healthcare system. In the US, CDC receives priority to develop tests due to “emergency policies”, reported The Washington Post, and hospital labs cannot develop their own tests as they need FDA approval. As a result, hospitals - both government and private - were unable to provide enough diagnostic tests and so the US was deploying less than 100 tests per average per day!
As FIT has explored before in India, more testing - even state-wise - results in more cases.
A slow start and tangled, sluggish bureaucracy further plunged the US into their healthcare disaster.
3. Containment Was too Slow
To combat COVID-19, countries around the world need to do three main things:
- Invest in healthcare infrastructure
- Start testing early and precisely to identify the stage of the virus and hotspots
- Social distancing in the public to contain the spread
Since the US was already behind on testing, social distancing would have only partially worked to contain the spread. Unfortunately, in yet another misstep the US failed to enact strict lockdown measures.
On New York, the worst hit-state with more than 2,000 deaths so far, President Trump wrote on Twitter, "A quarantine will not be necessary," on Saturday, 28 March. He added that he would issue a travel ban for the state - but did not offer specifics.
The US closed off their borders for non-essential travel with Canada and Mexico on 21 March (this allows for trade). It has also banned international travel, specifically for countries that have been hit with the virus including China, Italy and the United Kingdom.
The US president has been accused by critics of “caring more about the economy than lives,” as he had earlier said he wanted to open up the country and ease restrictions around Easter, 12 April.
However, when leading immunologist and infectious diseases expert, Dr Anthony S. Fauci said that America could hit 100,000 to 200,000 deaths from COVID-19, the Trump Administration’s advisory changed to announce that the social distancing measures will be in effect till 30 April, reported CNN.
So far, the federal guidelines urge people to stay home, work from home, avoid bars, group meetings and non-essential travel.
Trump has also been cautioned to tone done flippant comments on the virus. He had earlier said "We lose thousands and thousands of people to the flu. We don’t turn the country of” but was corrected by Dr Fauci who said that COVID-19 was more lethal than the flu.
4.Lack of PPEs for Healthcare Workers
Like in India, the United States too finds itself struggling with a lack of masks, gloves and other personal protective equipment (PPE) for their healthcare workers.
At this moment, across the world, healthcare workers are the soldiers fighting the battle head-on. To send them in unarmoured will only worsen the pandemic.
A CBS report says that doctors and nurses are in dire need, resorting to eBay or pleading on social media.
The CDC guidelines say to reuse N95 masks in a crisis to optimise the use, but since not much is known about the novel coronavirus, healthcare workers worry that re-use will render the masks ineffective. The New York Nurses Association released a statement against the same, but no resolution has been arrived at thus far.
A national survey on Friday, 27 March, showed that 213 city Mayors did not have any way of securing adequate protection wear, reported CNN.
Meanwhile, like in India, the United States too finds itself struggling with a lack of masks, gloves and other personal protective equipment (PPE) for their healthcare workers.
At this moment, across the world, healthcare workers are the soldiers fighting the battle head-on. To send them in unarmoured will only worsen the pandemic.
A CBS report says that doctors and nurses are in dire need, resorting to eBay or pleading on social media.
The CDC guidelines say to reuse N95 masks in a crisis to optimise the use, but since not much is known about the novel coronavirus, healthcare workers worry that re-use will render the masks ineffective. The New York Nurses Association released a statement against the same, but no resolution has been arrived at thus far.
A national survey on Friday, 27 March, showed that 213 city Mayors did not have any way of securing adequate protection wear, reported CNN.
Meanwhile, Trump invoked their Defense Production Act to amp up ventilator supplies to improve the healthcare infrastructure.
The Centers for Disease Control and Prevention (CDC) released new guidelines on Friday, 3 April recommending people to use cloth face coverings. But even this has been debated by the US President, who says he will not enforce it.
Unless the United States can get its act together, toughen leadership and plug the gaps so far, they are in for a rough ride before it gets better.
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