1. America has bungled the pandemic. Now what?
In North Carolina, as in much of America, coronavirus cases are on the rise again. Nash County, a largely rural area in the north of the state, hasn’t yet been overwhelmed by the pandemic. But people there are anxious about the persistence of the virus and uncertain about the road ahead, as summer ticks away and autumn begins to glimmer in the distance.
Melody Boyd already lost her father to COVID-19 in April. Interviewed outside a post office in Nashville, the county seat, she says he was 75 and had no underlying health conditions. Now her sister has contracted the virus. She worries about her grandchildren returning to classrooms and wishes politicians would stop pushing so hard to reopen schools.
“I just thought this would have died down by now,” she says. “This feels like our new life going forward, and I thought it would be over by now.”
Laura and Randy Wood opened a coffee shop and café in downtown Nashville on June 1. They say that so far, they’ve exceeded their sales goals and are excited for what the business might be like post-pandemic. But they’d thought the virus would be gone by July, and it isn’t. They have two kids and are nervous about schools and their uncertain future.
“I’m scared for my kids. How will the new normal be?” says Ms. Wood. “What we know of as a childhood, I just feel like that’s been taken away from them – and I don’t think things will be normal again soon.”
Four months after COVID-19 erupted into a crisis in the United States of America, the nation continues to struggle to contain and respond to the virus, as cases skyrocket, the death toll ticks ominously upward, and health officials warn that far from improving, the outlook for August and beyond looks worse.
Most developed nations, including those such as Italy that suffered severe initial outbreaks, have rallied to produce coherent country-wide responses that knocked down their outbreaks. They are now cautiously returning to something resembling normal life, with restaurants, sports, and yes, schools beginning to reopen.
Not the U.S. How did the richest nation on earth – indeed, by some measures the richest and most powerful nation the earth has ever seen – bungle the pandemic so badly?
Bad planning. Poor leadership. Politicization. Inconsistent communication. Unconnected and ineffective action. And more.
“We basically blew it,” says Kenneth Bernard, an epidemiologist who was the lead for public health issues on the National Security Council staffs during the Bill Clinton and George W. Bush administrations.
The point now is to recover, refocus, and keep going, say experts. The greatness of the U.S. has often depended on its ability to rally and improve after initial disaster.
And there is hope for American unity, despite the halting government response, says Elias Zerhouni, director of the National Institutes of Health from 2002 to 2008.
Collaboration in the scientific community has been unprecedented, he says. Scientific and health care workers continue to risk their lives to save patients. Congress moved quickly to pass a massive economic aid bill, though more may be necessary. Entire states have locked down to some degree, sacrificing economic stability for human life.
“That’s the value of courage,” says Dr. Zerhouni. “That’s what makes America great. And it will remain great as long as we have that unselfish behavior.”
A new record
On July 16, the U.S. set a new record for the number of coronavirus cases recorded in a day: 75,600. It was the 11th time in the past 30 days that the daily case number represented a new high.
The upturn began in mid- to late June. It followed a period of almost two months when new daily cases, as measured by a seven-day rolling average, had plateaued between 22,000 and 28,000, according to Centers for Disease Control numbers.
Initially, deaths from COVID-19 did not rise along with case numbers. But that is a lagging indicator of the pandemic, experts note, and the daily death rate has begun to rise in recent days, reaching 977 on Thursday. It has been below 1,000 since the beginning of June, and on some days last month it fell into the 200s.
Among developed countries, the U.S. stands out for its worsening pandemic numbers. Last Sunday, Florida alone reported 15,000 new cases – 3,000 more than all of Europe combined. By early June, more than 20 countries had reopened schools shut by the pandemic, including Denmark, Austria, Singapore, and Australia. In the U.S., President Donald Trump is pushing for schools to reopen, but many parents and teachers remain worried about possible transmission, as trends in most states continue to go in the wrong direction. Several large school districts have already announced that they will be online-only in the fall.
So how did the U.S. get into this mess?
The mistake from which many others flowed, according to Dr. Bernard, was ignoring existing plans after it became clear a pandemic had taken hold in America. Those plans exist, he says – the George W. Bush administration drafted a National Biodefense Plan in 2004. The Obama administration drafted a 57-page checklist following its experience with the Ebola epidemic.
“We had a plan out there. We should have exercised that plan,” he says.
Particularly unfortunate was the denial, early on, that the virus was a major threat. On February 28, President Trump said the coronavirus in the U.S. was “going to disappear.” Other administration officials took his cue and assured the American people it was a problem well under control.
Other White Houses have engaged in this sort of evasion before. Prior to 9/11, a number of administrations downplayed the dangers of terrorism to the U.S. homeland.
But happy talk can itself be infectious. Administration officials should have been planning for the worst-case coronavirus scenario, instead of just hoping things would work out, says Georges Benjamin, director of the American Public Health Association.
“We pretended like it wasn’t going to happen to us and then seemed surprised that it happened to us,” says Dr. Benjamin.
When bad things began to happen – the shortage of masks and other personal protective equipment, the failure of early CDC tests and the testing shortage, the need for more hospital equipment and the rising death toll – the federal government didn’t take centralized action. Instead, it decentralized responsibility to the states, ensuring conflicting and contradictory responses nationwide.
It is important to remember that COVID-19 would have been enormously dangerous and costly under any U.S president. It has ripped through many countries without regard for who leads them. It is an entirely new virus, and public health experts at first had no idea how to treat it. Scientists still haven’t definitively answered many basic questions about its effects, and how it’s transmitted.
And some things have gone right. Communication and cooperation between states within some regions, such as New England and the mid-Atlantic, has been impressive. Initially, the U.S. did flatten the curve of new cases. That’s not easy, points out David Satcher, Founding Director and Senior Advisor at the Morehouse School of Medicine.
But asked about problems in the U.S. response, every expert contacted for this article at some point used the word “leadership.” The U.S. is not in a pandemic due to President Trump’s inconsistencies, poor communication, and disjointed actions, they say. But the president’s moves have in some ways made the pandemic worse, and have contributed to the fact that the nation is now facing an anomalous resurgence in cases, with a return to anything like normal life receding in the distance for entire regions.
“We do not have the kind of leadership that it takes to succeed in dealing with something like this pandemic,” says Dr. Satcher, who served as an Assistant Secretary of Health and Surgeon General of the United States in the Clinton and Bush administrations.
Fighting the tide in Virginia’s Tidewater region
In Hampton, Virginia, the coronavirus trend has been heading in the wrong direction. Cases have tripled since Virginia began reopening at the end of May.
Still, the city – one of the jurisdictions that make up the Hampton Roads coastal area – has had trouble with young people crowding beaches and big social gatherings, says Donnie Tuck, Hampton’s mayor.
Mayor Tuck, a political independent, says he also hears from older people who don’t want to wear masks or social distance because they perceive such orders as government tyranny. He’s received countless emails saying that things should reopen and that prevention measures violate constitutional rights.
Asked whether the response to the pandemic has become a matter of political polarization, he laughs and says, “Oh yeah.”
“You have a polarization, and you have also individuals who believe that ‘I have a right to do any and everything that I want to do,’” Mr. Tuck says.
Experts say that’s another underlying reason why the U.S. response to the coronavirus has not been as organized and cohesive as in other developed nations. Countries such as France have strong central governments and a tradition of collective action. The United States, in contrast, has a culture of individualism.
“In other countries I have seen, [citizens] might push back, but for the most part they trust the leadership to do what they think is in their best interest,” says Mr. Tuck, who was recently elected to a second term.
The Hampton mayor says the Trump administration could have helped with a consistent public health message. It’s not those citizens who are willing to wear masks or stay home who need a nudge from leaders to act in the community’s best interest, he points out. It’s those who are unwilling to face inconvenience – or who believe the whole thing is a hoax – who need convincing.
Yet throughout the crisis, President Trump himself has sent mixed messages that often contradict the advice given by his own administration’s health officials and scientists, point out public health experts.
This has produced a clear credibility problem, according to recent polls. Six in 10 respondents in a new Washington Post-ABC poll say they do not trust what their own president says about the coronavirus outbreak.
Overall, poll ratings for the president’s handling of the crisis continue to deteriorate. According to the Post-ABC survey, only 38% of Americans approve of President Trump’s handling of COVID-19, down from 46% in May, and 51% in March.
How to bounce back
The nation does not need to accept defeat in this battle. America can still fight back. It does not have to hunker down and wait for the arrival of a vaccine or other magic bullet.
As former NIH chief Dr. Zerhouni points out, the United States may be exceptional among developed nations in its still-rising COVID-19 numbers, but it is also exceptional in its ability to rally scientific and technological tools in service of a defined goal.
That kind of multi-faceted response is what helped win World War II. It can work again.
“You only win these battles with logistics, not heroics,” he says.
We’re still learning about the intricacies of the virus day-by-day. But we generally know some basic, effective guidelines for individuals. Social distance, wear masks, wash hands.
“All people need to do is listen. All government needs to do is organize,” Dr. Zerhouni says.
To see how this can work, look back at the example of Ebola, says former NSC official Dr. Bernard.
The Obama administration downplayed the risks at first and ignored existing plans.
“People forget that the beginning of the Ebola outbreak was a mess in the United States. We did not have a coordinated response,” Dr. Bernard says.
But eventually, the CDC began delivering a consistent, televised message on the crisis every day. The president appointed an effective ex-official as an “Ebola czar,” and bickering agencies began operating like a “well-oiled machine.”
This sort of approach is in everyone’s best interest – including, in an election year, President Trump’s, says Dr. Benjamin of the American Public Health Association.
“The health problem is the secret to the economic problem, which is the secret to being perceived as a person in charge of properly managing the outbreak,” he says. “Americans have short memories.”