I would really like to post about something other than the many many failures of the United States, but considering how badly we’re actually doing, it’s worth continuing to reflect on.


I read an article today on all the reasons why we lost so badly to this virus. It’s a great article, and I think you should read it. But I want to summarize some of the points here, which overall can be summarized as:

But the COVID‑19 debacle has also touched—and implicated—nearly every other facet of American society: its shortsighted leadership, its disregard for expertise, its racial inequities, its social-media culture, and its fealty to a dangerous strain of individualism.

This article and the points on this list focuses on the Federal government. There are things to say about other levels of government and individuals themselves, but that’s for another time.



Ignorance/Technical Failure

I think we can all very obviously see how willing the people in our government are to be completely ignorant of and disinterested in facts. But to me, at this point it seems like you have to actually work hard to be this ignorant.

Even after warnings reached the U.S., they fell on the wrong ears. Since before his election, Trump has cavalierly dismissed expertise and evidence. He filled his administration with inexperienced newcomers, while depicting career civil servants as part of a “deep state.” In 2018, he dismantled an office that had been assembled specifically to prepare for nascent pandemics. American intelligence agencies warned about the coronavirus threat in January, but Trump habitually disregards intelligence briefings. The secretary of health and human services, Alex Azar, offered similar counsel, and was twice ignored.

A defunded CDC then went on to fumble on testing:

The CDC developed and distributed its own diagnostic tests in late January. These proved useless because of a faulty chemical component. Tests were in such short supply, and the criteria for getting them were so laughably stringent, that by the end of February, tens of thousands of Americans had likely been infected but only hundreds had been tested. The official data were so clearly wrong that The Atlantic developed its own volunteer-led initiative—the COVID Tracking Project—to count cases.

Diagnostic tests are easy to make, so the U.S. failing to create one seemed inconceivable. Worse, it had no Plan B. Private labs were strangled by FDA bureaucracy. Meanwhile, Sabeti’s lab developed a diagnostic test in mid-January and sent it to colleagues in Nigeria, Sierra Leone, and Senegal. “We had working diagnostics in those countries well before we did in any U.S. states,” she told me.



Laziness

I think the single biggest thing that bothers me about the US Federal Government’s response is that when it comes to actually investing in, spending time on, or putting effort into helping American people, they have literally done nothing.

Diagnostic tests are easy to make, so the U.S. failing to create one seemed inconceivable. Worse, it had no Plan B. Private labs were strangled by FDA bureaucracy. Meanwhile, Sabeti’s lab developed a diagnostic test in mid-January and sent it to colleagues in Nigeria, Sierra Leone, and Senegal. “We had working diagnostics in those countries well before we did in any U.S. states,” she told me.

It’s hard to overstate how thoroughly the testing debacle incapacitated the U.S. People with debilitating symptoms couldn’t find out what was wrong with them. Health officials couldn’t cut off chains of transmission by identifying people who were sick and asking them to isolate themselves.



Indifference/Cruelty

There’s a lot to talk about when it comes to America and punishment/prison. I’ll just leave this quote from the article.

The hardest-hit buildings were those that had been jammed with people for decades: prisons. Between harsher punishments doled out in the War on Drugs and a tough-on-crime mindset that prizes retribution over rehabilitation, America’s incarcerated population has swelled sevenfold since the 1970s, to about 2.3 million. The U.S. imprisons five to 18 times more people per capita than other Western democracies. Many American prisons are packed beyond capacity, making social distancing impossible. Soap is often scarce. Inevitably, the coronavirus ran amok. By June, two American prisons each accounted for more cases than all of New Zealand. One, Marion Correctional Institution, in Ohio, had more than 2,000 cases among inmates despite having a capacity of 1,500.

Nursing homes:

Other densely packed facilities were also besieged. America’s nursing homes and long-term-care facilities house less than 1 percent of its people, but as of mid-June, they accounted for 40 percent of its coronavirus deaths. More than 50,000 residents and staff have died. At least 250,000 more have been infected. These grim figures are a reflection not just of the greater harms that COVID‑19 inflicts upon elderly physiology, but also of the care the elderly receive. Before the pandemic, three in four nursing homes were understaffed, and four in five had recently been cited for failures in infection control. The Trump administration’s policies have exacerbated the problem by reducing the influx of immigrants, who make up a quarter of long-term caregivers.

It’s terrible how we treat our old, sick, or misunderstood people.

America’s neglect of nursing homes and prisons, its sick buildings, and its botched deployment of tests are all indicative of its problematic attitude toward health: “Get hospitals ready and wait for sick people to show,” as Sheila Davis, the CEO of the nonprofit Partners in Health, puts it. “Especially in the beginning, we catered our entire [COVID‑19] response to the 20 percent of people who required hospitalization, rather than preventing transmission in the community.” The latter is the job of the public-health system, which prevents sickness in populations instead of merely treating it in individuals. That system pairs uneasily with a national temperament that views health as a matter of personal responsibility rather than a collective good.



A Broken Healthcare System/Attitude

We all know healthcare is bad in this country. But it’s obviously completely broken at this point.

Compared with the average wealthy nation, America spends nearly twice as much of its national wealth on health care, about a quarter of which is wasted on inefficient care, unnecessary treatments, and administrative chicanery. The U.S. gets little bang for its exorbitant buck. It has the lowest life-expectancy rate of comparable countries, the highest rates of chronic disease, and the fewest doctors per person. This profit-driven system has scant incentive to invest in spare beds, stockpiled supplies, peacetime drills, and layered contingency plans—the essence of pandemic preparedness. America’s hospitals have been pruned and stretched by market forces to run close to full capacity, with little ability to adapt in a crisis.



Inequality/Racism

Of the 3.1 million Americans who cannot afford health insurance, more than half are people of color, and 30 percent are Black. This is no accident. In the decades after the Civil War, the white leaders of former slave states deliberately withheld health care from Black Americans, apportioning medicine more according to the logic of Jim Crow than Hippocrates. They built hospitals away from Black communities, segregated Black patients into separate wings, and blocked Black students from medical school. In the 20th century, they helped construct America’s system of private, employer-based insurance, which has kept many Black people from receiving adequate medical treatment. They fought every attempt to improve Black people’s access to health care, from the creation of Medicare and Medicaid in the ’60s to the passage of the Affordable Care Act in 2010.

Inequality and Racism

As of early July, one in every 1,450 Black Americans had died from COVID‑19—a rate more than twice that of white Americans. That figure is both tragic and wholly expected given the mountain of medical disadvantages that Black people face. Compared with white people, they die three years younger. Three times as many Black mothers die during pregnancy. Black people have higher rates of chronic illnesses that predispose them to fatal cases of COVID‑19. When they go to hospitals, they’re less likely to be treated. The care they do receive tends to be poorer. Aware of these biases, Black people are hesitant to seek aid for COVID‑19 symptoms and then show up at hospitals in sicker states. “One of my patients said, ‘I don’t want to go to the hospital, because they’re not going to treat me well,’ ” says Uché Blackstock, an emergency physician and the founder of Advancing Health Equity, a nonprofit that fights bias and racism in health care. “Another whispered to me, ‘I’m so relieved you’re Black. I just want to make sure I’m listened to.’ ”



Tech Companies/Media/Misinformation

Technology is powerful. Technology in the hands of companies operating under America’s brand of capitalism is very very bad.

Sure enough, existing conspiracy theories—George Soros! 5G! Bioweapons!—were repurposed for the pandemic. An infodemic of falsehoods spread alongside the actual virus. Rumors coursed through online platforms that are designed to keep users engaged, even if that means feeding them content that is polarizing or untrue. In a national crisis, when people need to act in concert, this is calamitous. “The social internet as a system is broken,” DiResta told me, and its faults are readily abused.

The media made things worse of course:

In March, a small and severely flawed French study suggested that the antimalarial drug hydroxychloroquine could treat COVID‑19. Published in a minor journal, it likely would have been ignored a decade ago. But in 2020, it wended its way to Donald Trump via a chain of credulity that included Fox News, Elon Musk, and Dr. Oz. Trump spent months touting the drug as a miracle cure despite mounting evidence to the contrary, causing shortages for people who actually needed it to treat lupus and rheumatoid arthritis. The hydroxychloroquine story was muddied even further by two studies published in top medical journals—The Lancet and the New England Journal of Medicine—that claimed the drug was not effective and was potentially harmful. The papers relied on suspect data from a small analytics company called Surgisphere. Both were retracted in June.



A very obviously unfit and mentally broken President

No one should be shocked that a liar who has made almost 20,000 false or misleading claims during his presidency would lie about whether the U.S. had the pandemic under control; that a racist who gave birth to birtherism would do little to stop a virus that was disproportionately killing Black people; that a xenophobe who presided over the creation of new immigrant-detention centers would order meatpacking plants with a substantial immigrant workforce to remain open; that a cruel man devoid of empathy would fail to calm fearful citizens; that a narcissist who cannot stand to be upstaged would refuse to tap the deep well of experts at his disposal; that a scion of nepotism would hand control of a shadow coronavirus task force to his unqualified son-in-law; that an armchair polymath would claim to have a “natural ability” at medicine and display it by wondering out loud about the curative potential of injecting disinfectant; that an egotist incapable of admitting failure would try to distract from his greatest one by blaming China, defunding the WHO, and promoting miracle drugs; or that a president who has been shielded by his party from any shred of accountability would say, when asked about the lack of testing, “I don’t take any responsibility at all.”



Recovery

This pandemic is showing America that we have a lot to do to get better. We all need to accept and understand just how far we really have to go so we can start making some real changes.

COVID‑19 is an assault on America’s body, and a referendum on the ideas that animate its culture. Recovery is possible, but it demands radical introspection. America would be wise to help reverse the ruination of the natural world, a process that continues to shunt animal diseases into human bodies. It should strive to prevent sickness instead of profiting from it. It should build a health-care system that prizes resilience over brittle efficiency, and an information system that favors light over heat. It should rebuild its international alliances, its social safety net, and its trust in empiricism. It should address the health inequities that flow from its history. Not least, it should elect leaders with sound judgment, high character, and respect for science, logic, and reason.