The scale of epidemic of COVID 19 in USA, its incompetence to deal with growing number of newly infected, have done a great damage to the reputation of US as the world superpower. In a contrast to the Asian countries like China, Vietnam or Singapore, the system in the USA has proven to be ineffective in dealing with crisis. Decades of imperial arrogance, belief in American exceptionalism and overconfidence have left the USA incapable of facing its own flaws, in a face of great epidemic. The mandate of Donald Trump as US president, with it chaotic and unorganized decision making, is just a natural metastasis of long decay of the empire. The USA were very unsuccessful in preventing coronavirus epidemic, and there are several factors that have lead to it.
- Disbanding the Global Health Security and Biodefense unit
In May 2018, Trump administration has disbanded The Global Health Security and Biodefense unit, a body established in 2015, responsible for preparing the USA for the great future pandemics[1]. The disbandment of the unit contributed to the bad response of federal government to the COVID 19 epidemic in 2020. The decision was criticized by the experts as move that could have fatal consequences in the future, with USA being vulnerable to epidemics and bioterrorism. In 2018, Kenneth W. Bernard, expert on biodefense and health security policy, in his editorial to Washington post, wrote a warning to Trump administration: “It is time to stop pretending health security is a soft issue just because some want it to be. Epidemic disease — whether natural, accidental or intentional — will predictably recur during this and future administrations, and it will affect whole populations and economies as well as individual lives[2].”
- Neglecting the danger of COVID 19
Since the beginning of COVID 19 pandemic, president Trump has denied the treat that virus could cause to USA, contributing a lot to the disaster that happened. Since February od 2020, Donald Trump has said for almost 22 times to the press, that COVID 19 will miraculously disappear. By the report from New York Times, Trump was apparently warned about COVID 19 by the expert’s community in January and February, but decided to disregard those reports, because of his distrust towards those agencies of the government[3]. The fact that USA got Covid 19 epidemic in election year, has made all polices regarding the epidemic containment part of political election debate, therefor effectively preventing systematic planning of defense against coronavirus. The neglecting of the treat of COVID 19 epidemic, was paired with belief that higher level UV radiation during a warm period of the year, will kill the virus, as Trump outlined on several accessions. In the early weeks of the epidemic, Trump has compared coronavirus to an ordinary flu and describing it as a hoax[4].
- The problem with COVID 19 tests
One of the main reasons that COVID 19 epidemic in USA has managed to reach this extent is the fact that in initial stages of epidemic there was serious problem with lack of testing kits. After the first cases of COVID 19 where detected in January of 2020, there was no testing kits for COVID 19 for week, resulting in piling up of unconfirmed cases. By the end of February of 2020, the World Health Organization has send the tests for COVID 19 to nearly 60 countries. Despite the fact that those tests where proven as reliable by different experts, the USA has refused to use the WHO test, even as an temporary solution, until CDC produces its own version of the test. That was a decision of Trump administration, that was never explained to the public and that had very grave consequences for the USA. When the first diagnostic tests developed by the Centers for Disease Control and Prevention (CDC) where sent to hospitals in early February, there were cases of manufacturing defects in some of the tests[5]. The manufacturing defects caused the mistakes in testing in early phases of the epidemic, causing some of the states to develop its own testing kit. The authorities in New York City, one of the main epicenters of the COVID 19 epidemic, on 28 of February, have declared government-issued tests are faulty and “cannot be relied upon to provide an accurate result.[6]”.By the report of Anne Schuchat, CDC COVID-19 Response Team, on 8th of May, the delay in testing of COVID 19 cases was crucial for the growth of the epidemic because “the epidemic curve presented was likely affected by limited testing, particularly in the early phases of the outbreak”[7]. The failure of CDC to get working caused a three week delay in COVID 19 testing, but it wouldn’t have happened if Trump has not declined to use standardized approved by WHO.
- The mistakes in testing protocol
In the first phase of COVID 19 epidemic in USA, there where severe mistake in strategy of testing protocol. The decision to use only CDC made COVID 19 tests, has severely limited the diagnostic capacity for first few weeks of the epidemic. Because of that, initially the testing was limited to the people that where proven to be exposed to coronavirus. The CDC initially recommended that doctors shouldn’t test everyone with coronavirus symptoms, but only those who have been traveling to the countries with COVID 19 epidemic or had close contact with someone who was tested positive. The requirement of FDA, that advanced laboratories must get a prior FDA authorization, before using its own laboratory developed tests, has contributed additionally to the creation of bottlenecks in coronavirus testing protocol[8]. These regulations, regarding a protocol called emergency use authorization, where made to prevent the faulty tests, but they proved to be useless in case of such fast growing epidemic.
- Unpreparedness of US health system
By the words of Robert Redfield, the head of CDC, the lack of investment in public labs for decades has contributed to the coronavirus crisis in USA[9]. According to figures in report made by Trust for America’s Health, the budget of CDC was cut by 10 percent in period 2010-2019, with cuts hitting the resources for state and local preparedness very bad[10]. Another problem is that US healthcare system was not prepared to face this kind of epidemic. Because there is no such thing as unified national health care system, not all of the the hospitals and labs had similar equipment and it was very hard to synchronize their work. The lack of universal health care, has shown to be a great problem for the USA in face of mass epidemic. Even after there was enough CDC made COVID 19 tests, not all of hospitals in USA had a necessary equipment needed for tests, with chemicals and extraction machines being in short supply[11].
- Lack of nationwide unified strategy
Trump administration has allowed the states to chart their own responses to the coronavirus epidemic, it was done partly because of the need to transfer the responsibility to other levels of the government, but also because of specific way that US political system functions, with federal government doesn’t having the needed jurisdiction over some issues. The lack of nationwide measures that would be imposed on federal level, led to different dynamics of COVID 19 growth in different parts of the country. It was partly done also, because of political differences between democrat and republican run states, and their policies towards the epidemic.
- Price of tests and costs of treatment
As one of the things that contributed greatly to initial spreading of the virus, was the fact a lot people with COVID 19 symptoms where afraid to go to the hospital, because of inflated testing and treatment costs. According to a study by America’s Health Insurance Plans, in March of 2020, the average cost to treat a hospitalized COVID 19 patient is $30,000[12].There are around 28 million of uninsured citizens in USA, a number that has grown for 7 million during the rule of Trump administration[13]. There were in March and April of 2020, some famous media cases of people being heavily charged for COVID 19 testing and treatment.In March, there was a case publicized by Times magazine, of a woman that was uninsured and got charged almost 35 thousand dollars for 7 days coronavirus treatment[14].In March of 2020, an US citizen in Miami was given 3 thousand dollars bill as a price for coronavirus tests in hospital. These known cases, have contributed to lower turnout at coronavirus testing sites at early stages of the epidemic. Later in April, the matter was partly solved, with US administration directing funds from stimulus bill for free tests and coronavirus treatment for uninsured, but then the damage has already been done.
- Reluctance to impose lockdown measures on time
The examples of China, Spain, Italy and other countries facing the COVID 19 epidemic, have shown the importance of lockdown measures in stopping the epidemic. Unfortunately for the USA, those measures where never really imposed nationwide and in longer period of time. Initially in the early phases of the epidemic, Trump didn’t wanted to accept the social distancing recommendations suggested by experts, out of fear that it will harm the US economy. Only in the mid-March, the White house has finally submitted social distancing recommendation for the whole country. Only a week after that, Donald Trump had second thoughts, by speaking out against social distancing regulation saying that “America will again and soon be open for business.[15]” With various governors of the states imposing different and conflicting social distancing guidelines and the start of anti lock down protests, Trump supporting the protesters, the issue of coronavirus lockdown, soon because a political issue. As such, it was a subject of political debate and the opinion of experts was neglected. Early lifting of the lockdown in the US, has created a new peak of coronavirus epidemic at the beginning of the summer.
- Airport screening mistakes
During the first few months of the COVID 19 epidemic in USA, president Trump has repeatedly boasted about his signature move of banning flights from China, as a main obstacle to coronavirus spread. That policy has proven to be full of errors. The ban didn’t include the flights from Hong Kong or Macau, no enforceable quarantine demand and it was too much focused on China. Lack of focus on Europe, has proven to crucial at latter stage, when coronavirus came to USA imported from EU countries. A study of samples of COVID 19 from USA, has proven that it is mostly made out of a strain of coronavirus that was imported from Europe[16]. The airport screening that was mentioned by the White house as a milestone of fight against COVID 19, has proven to be a disaster, with long few hour lines at the airport because of the temperature measurements.
- Lack of protective equipment
Lack of protective equipment in hospitals has contributed to the explosion of the COVID 19 in USA. In March and most of April, there was a serious shortage of PPE in US hospitals, causing the medical personal to improvise and creating huge number of coronavirus transmissions among the medical workers and increase of patient to patient transmissions. The issue was so embarrassing to US healthcare system, that hospitals were threatening and firing medical staff that decided to speak in public about this issue[17]. The main cause for this severe shortage, was the fact that The Strategic National Stockpile, a federal institution dedicated to storing emergency medical supplies, has been almost emptied long before the pandemic. The SNS was underfunded since its creation in 1999, it has been mostly focused on other goods then PPE and its reserves where not big enough to cover the needs of the USA, when COVID 19 epidemic started.
- Rivalries between different agencies
In the initial phases of COVID 19 epidemic, there was a lot of tension between FDA and CDC, as well as between the president Trump and Health and Human services secretary. The source of the tension was differences in vision of how to stop COVID 19 epidemic and the frustration over made mistakes, such as contamination of tests[18], delay in test creation, dispute over FDA regulation[19]. These disputes have prevented the USA from being effective in stopping the epidemic.
COVID 19 epidemic as a proof of a greater systematic errors in US health care system
Besides all of these mentioned causes of coronavirus epidemic in USA, there are other issues, where the US administration was proven as incapable of controlling the epidemic, such as the issue with the lack of ventilators, scarce hospital capacities, the lack of legal power to enforce a curfew, controversy with use of facemasks, lack of intensive care units, entrance of coronavirus into nursing homes and many other issues. The epidemic has just exposed the weaknesses of the system in USA, showing how incompetent and fragile the administration became in last few decades. One of its weakest points is the healthcare system and the fact the USA is the only wealthy country in the world that doesn’t have universal health care system. US health care system with extremely high prices of health care, 28 millions of uninsured citizens, high percentage of mistakes of by hospitals, inaccessibility of many services to general population, will remain an important object of public discontent and one of the proofs that the system in the USA doesn’t work anymore for an ordinary man. The USA is the hardest affected country by COVID 19, with almost 5 million of detected cases, over a 160 thousand dead and 50 thousand new cases every day.
Economic consequences of COVID 19
Inadequate reaction of Trump administration to COVID 19 epidemic, has caused serious economic turmoil for USA and possibly big economic crisis in future. In April of 2020, the unemployment in the USA has reached its historic all time high with 14 percent, worse than the figure during the Great depression. Around 20 million people lost their jobs in a month period[20]. In March of 2020, a record of 3.3 million people have claimed for unemployment benefits. By the assessment of experts, it will take many years for employment in USA to reach its pre epidemic levels. Since the crisis has started, there has been 70 percent increase in use of food banks, with roughly 40 percent of people being first time visitors[21]. In July of 2020, it was announced that the US economy has suffered worse quarter since WW2, with GDP shrinking by 32 percent[22]. By the prediction of the FED, it is expected for US economy to shrink 6,5 percent in 2020[23]. As a consequence of COVID 19 epidemic, the debt of federal government has reached 27 trillion dollars, around 133% percent of US GDP[24].
Socio-economic causes of BLM protests
African American community has been one of the hardest hit by the COVID 19 epidemic and related economic crisis. By the analysis of APM Research Lab, the Afro Americans are dying tree times more out of COVID 19 then the white people[25]. By the claim of one research[26], the Afro-Americans are disadvantaged in access to testing and treatment for COVID 19. There are less good quality hospitals in black neighborhoods and Afro-Americans are more likely to suffer from diabetes or hypertension. Afro Americans have highest COVID 19 death rates, much higher than any other group. With a death rate of 80.4 deaths per 100,000, which means that afro –Americans have 3.7 times higher chance of dying. The economic crisis has also hit hard on Afro Americans, with many of them losing their jobs, because they work disproportionately in so called “essential” jobs, such as taxi driving, food industry, health services. Black Americans are about 13 percent of US population, while owning less than 3 percent of wealth, which means that the crisis is very dangerous for them[27]. The rise of unemployment rates among the Afro Americans, disadvantages in COVID 19 treatments and economic crisis in the USA, have all lead to mass protests against the police brutality under the slogan of “Black lives matter”.
Conclusion
Irresponsible and unorganized handling of the COVID 19 crisis will have long term consequences for the USA, by contributing to further loss of US imperial power and the creation of multi polar world. The inadequate response to COVID 19 has exposed the flaws of the USA and deep structural errors within its system. The international reputation of USA, as world leading power, is in the long run jeopardized by examples of clear mishandling of the crisis.
[1]https://www.reuters.com/article/uk-factcheck-trump-fired-pandemic-team/partly-false-claim-trump-fired-pandemic-response-team-in-2018-idUSKBN21C32M
[2]https://www.washingtonpost.com/opinions/the-white-house-signals-that-bioterrorism-and-disease-dont-matter–again/2018/05/22/5a5b0c0c-5dd1-11e8-b2b8-08a538d9dbd6_story.html?itid=lk_inline_manual_21
[3]https://www.washingtonpost.com/national-security/us-intelligence-reports-from-january-and-february-warned-about-a-likely-pandemic/2020/03/20/299d8cda-6ad5-11ea-b5f1-a5a804158597_story.html
[4]https://news.yahoo.com/trump-identifies-another-hoax-the-coronavirus-152649383.html
[5]https://www.wsj.com/articles/manufacturing-defect-in-some-early-cdc-test-kits-being-probed-11583119414
[6]https://www.independent.co.uk/news/world/americas/coronavirus-tests-new-york-us-cases-kits-trump-cdc-results-a9365921.html
[7]https://www.cdc.gov/mmwr/volumes/69/wr/mm6918e2.htm
[8]https://jamanetwork.com/journals/jama/fullarticle/2762951
[9]https://www.msn.com/en-us/news/politics/coronavirus-response-hurt-by-lack-of-funding-for-public-health-labs-cdc-director-tells-congress/ar-BB110nKZ
[10]https://www.tfah.org/report-details/2019-funding-report/
[11]:https://www.theatlantic.com/health/archive/2020/03/why-coronavirus-testing-us-so-delayed/
[12]https://www.ahip.org/estimating-the-cost-of-covid-19-treatment-for-u-s-private-insurers/
[13]https://www.vox.com/2019/1/23/18194228/trump-uninsured-rate-obamacare-medicaid
[14]https://time.com/5806312/coronavirus-treatment-cost/
[15]https://www.bbc.com/news/world-us-canada-52009108
[16]https://www.cato.org/blog/two-supertypes-coronavirus-east-asian-european
[17]https://www.bloomberg.com/news/articles/2020-03-31/hospitals-tell-doctors-they-ll-be-fired-if-they-talk-to-press
[18]https://www.politico.com/news/2020/03/01/health-officials-probe-coronavirus-cdc-118523
[19]https://www.propublica.org/article/the-fda-is-forcing-the-cdc-to-waste-time-double-testing-some-coronavirus-cases
[20]https://www.washingtonpost.com/business/2020/05/08/april-2020-jobs-report/
[21]https://www.ft.com/content/fe657560-854d-4cbc-8ccd-b376483d034a
[22]https://www.theguardian.com/business/2020/jul/30/us-gdp-economy-worst-quarter-covid-19-unemployment
[23]https://www.axios.com/federal-reserve-economic-projections-coronavirus-291e02eb-179b-449b-9b18-4a3bcf4598bb.html
[24]https://www.thaienquirer.com/15479/opinion-inconvenient-truths-about-us-debt-explosion/
[25]https://www.apmresearchlab.org/covid/deaths-by-race
[26]https://khn.org/news/covid-19-treatment-racial-income-health-disparities/
[27]https://www.npr.org/2020/06/03/868469779/black-americans-bear-the-brunt-of-the-covid-19-pandemics-economic-impact
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