COVID-19: Why did the U.S. fail so badly?

Clawing our way out of this pandemic has proven difficult. Just when we thought we were seeing some light, public health experts are warning us about a new variant that may further delay our hope of defeating this virus. So this is a good time to take a hard look at why we have failed so badly in dealing with Covid-19. As of this writing, over 780,000 people have died in the U.S. (CDC Tracker). That is the equivalent of wiping out the entire State of North Dakota. If someone had said in the spring of 2019 that over three quarters of a million Americans would die from Covid 19, you probably would have said they were crazy. But here we are. We, the richest country in the world, have had the highest number of cases and death rates per capita in the world (BBC Report, October 25, 2021).

Why did we perform so badly? Here are just four of the reasons. Information overload from hundreds of sources — many completely erroneous — created profound public confusion. Second, distrust of our institutions has been building for decades and was amplified during the pandemic. Third, there was a spectacular failure of political leadership. This resulted in bad politics and policies which undermined good public health. When you combine these factors with a for-profit healthcare system where access to care, particularly for low-income minority individuals, has been lagging for decades, the results have been catastrophic.

After the SARS Covid virus scare of 2003, the World Health Organization (WHO) established an assessment tool to measure a country’s pandemic preparedness. WHO looked at 29 countries using 19 critical public health factors. They included: surveillance systems, laboratory services, a trained workforce, emergency operations, pandemic response plans, stockpiles of resources, and response capabilities. Under these measures the U.S. received a high score. What WHO failed to look at were political and cultural factors like leadership, trust in government, and access to healthcare. If those were factored in, the U.S. would have scored much worse.

In May 2021, the PEW Research Center examined the question of trust in government from 1958 to 2021. During the Eisenhower/Kennedy Presidencies, 75% of people surveyed said they trusted that the government would do the right thing most of the time. That number has steadily declined to 25% today. Reasons for this abound, but the key point is this: If there is no trust, then communication breaks down. For many Americans, whatever the government said or did to combat Covid-19 was either ignored or not believed. Many Americans have questioned mask wearing, immunizations, lockdowns, and other public health measures — all of which could have saved lives. When many ignored public health advice, we kept spreading the virus.

When trust beaks down, it opens the door to all sorts of misinformation and conspiracy theories.

When people don’t believe the government, then they look for other information sources. With the vast number of media outlets available, misinformation was rampant. Even before the pandemic public health officials were begging sites like Facebook to address rampant vaccine misinformation. Facebook employees were also deeply concerned about the amount of misinformation on their platform. Erroneous information environments like Facebook confused the public and degraded our capacity to deal effectively with the pandemic.

There were other structural issues impeding our efforts. The U.S. is the only developed country without universal healthcare. Yet we spend more than any other country and achieve poorer results. Here are two examples. Even today, the U.S. has a vaccination rate that is not in the top 50 in the world (New York Times Vaccine Tracker, November 29, 2021). This is despite the fact that the U.S. had vaccines available before many of these other countries. Also, minority groups have been at high risk for Covid -19 complications. Yet they have less access to our healthcare system than other demographic groups. Without early detection and treatment, the result was high death rates for these individuals.

Overlaid on this toxic stew was the Trump Administration. Given the current political and cultural environment, no Administration would have an easy time confronting Covid-19. Yet the Trump Administration failed to develop a plan, a nationally organized response, science-based policies, and accurate, effective communication. Compounding this incompetence, former President Trump himself became a primary source of misinformation, falsehoods, and conspiracy theories. In October 2020, researchers at Cornell University analyzed 38 million articles about the pandemic. Mentions of the former President made up 38% of the misinformation conversation. This made the former President the largest driver of falsehoods around the pandemic.

When confronted by a new pandemic threat, the fast-moving Omicron variant, President Biden told the American people “not to panic.” We now have the tools to combat this global challenge: namely, vaccines and various types of testing. The U.S. has shipped more vaccines to needy countries than any other country has done (most recently another 275 billion doses), and his administration is doing everything in its power to get vaccines into the unvaccinated in our own country, including making testing and vaccines free and more accessible. But Biden’s calm presence and persistence in the storm may not be enough to change the tide of the deep-seeded failures of the past several years.

None of these criticisms is meant to demean the people who have worked so tirelessly to fight this pandemic and to save lives. We owe so much to the doctors, nurses, public health officials, researchers and many others who have given their all to combat this pandemic. Unfortunately, we as a country and especially our leaders, have let them down, and we have all paid a price. We need to begin by acknowledging our failures and taking a hard look at fixing them so we never experience another pandemic response like this again. One idea is to convene a bi-partisan commission, similar to the January 6 Commission. This review is long overdue, and we owe it to the more than 780,000 people who have suffered and died in this pandemic.

Tom Deloe is a Gettysburg resident and a member of Gettysburg Democracy for America’s Healthcare Task Force.