How the Pandemic Defeated America A virus has brought the world’s most powerful country to its knees. ........... A virus a thousand times smaller than a dust mote has humbled and humiliated the planet’s most powerful nation. America has failed to protect its people, leaving them with illness and financial ruin. It has lost its status as a global leader. It has careened between inaction and ineptitude. The breadth and magnitude of its errors are difficult, in the moment, to truly fathom. .......... Despite ample warning, the U.S. squandered every possible opportunity to control the coronavirus. And despite its considerable advantages—immense resources, biomedical might, scientific expertise—it floundered. While countries as different as South Korea, Thailand, Iceland, Slovakia, and Australia acted decisively to bend the curve of infections downward, the U.S. achieved merely a plateau in the spring, which changed to an appalling upward slope in the summer. “The U.S. fundamentally failed in ways that were worse than I ever could have imagined” ........... almost everything that went wrong with America’s response to the pandemic was predictable and preventable. A sluggish response by a government denuded of expertise allowed the coronavirus to gain a foothold. Chronic underfunding of public health neutered the nation’s ability to prevent the pathogen’s spread. A bloated, inefficient health-care system left hospitals ill-prepared for the ensuing wave of sickness. Racist policies that have endured since the days of colonization and slavery left Indigenous and Black Americans especially vulnerable to COVID‑19. The decades-long process of shredding the nation’s social safety net forced millions of essential workers in low-paying jobs to risk their life for their livelihood. The same social-media platforms that sowed partisanship and misinformation during the 2014 Ebola outbreak in Africa and the 2016 U.S. election became vectors for conspiracy theories during the 2020 pandemic. ........... In 2018, I wrote an article for The Atlantic arguing that the U.S. was not ready for a pandemic, and sounded warnings about the fragility of the nation’s health-care system and the slow process of creating a vaccine. 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. ........... SARS‑CoV‑2 is something of an anti-Goldilocks virus: just bad enough in every way. Its symptoms can be severe enough to kill millions but are often mild enough to allow infections to move undetected through a population. It spreads quickly enough to overload hospitals, but slowly enough that statistics don’t spike until too late. ........... Wild animals harbor an estimated 40,000 unknown viruses, a quarter of which could potentially jump into humans. ............. COVID‑19 is merely a harbinger of worse plagues to come. ........... every recent misstep and foundational sin, every unattended weakness and unheeded warning, every festering wound and reopened scar .......... Bats alone could host thousands of unknown coronaviruses; in some Chinese caves, one out of every 20 bats is infected. .............. such viruses infect a substantial number of people every year. “Most infected people don’t know about it, and most of the viruses aren’t transmissible,” Daszak says. But it takes just one transmissible virus to start a pandemic. .......... Sometime in late 2019, the wrong virus left a bat and ended up, perhaps via an intermediate host, in a human—and another, and another. Eventually it found its way to the Huanan seafood market, and jumped into dozens of new hosts in an explosive super-spreading event. The COVID‑19 pandemic had begun. ............... Our species has relentlessly expanded into previously wild spaces. Through intensive agriculture, habitat destruction, and rising temperatures, we have uprooted the planet’s animals, forcing them into new and narrower ranges that are on our own doorsteps. Humanity has squeezed the world’s wildlife in a crushing grip—and viruses have come bursting out.......... In 2003, China covered up the early spread of SARS, allowing the new disease to gain a foothold, and in 2020, history repeated itself. The Chinese government downplayed the possibility that SARS‑CoV‑2 was spreading among humans, and only confirmed as much on January 20, after millions had traveled around the country for the lunar new year. ............... The World Health Organization initially parroted China’s line and did not declare a public-health emergency of international concern until January 30. By then, an estimated 10,000 people in 20 countries had been infected, and the virus was spreading fast............. 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. .................. “By early February, we should have triggered a series of actions, precisely zero of which were taken.” Trump could have spent those crucial early weeks mass-producing tests to detect the virus, asking companies to manufacture protective equipment and ventilators, and otherwise steeling the nation for the worst. Instead, he focused on the border. .................. Travel bans may sometimes work for remote island nations, but in general they can only delay the spread of an epidemic—not stop it. And they can create a harmful false confidence, so countries “rely on bans to the exclusion of the things they actually need to do—testing, tracing, building up the health system” ............... A president who is fixated on an ineffectual border wall, and has portrayed asylum seekers as vectors of disease, was always going to reach for travel bans as a first resort. And Americans who bought into his rhetoric of xenophobia and isolationism were going to be especially susceptible to thinking that simple entry controls were a panacea. ............. the U.S. wasted its best chance of restraining COVID‑19. Although the disease first arrived in the U.S. in mid-January, genetic evidence shows that the specific viruses that triggered the first big outbreaks, in Washington State, didn’t land until mid-February. The country could have used that time to prepare. ........... With impunity, Trump lied. With impunity, the virus spread. ......... Chinese scientists published SARS‑CoV‑2’s genome on January 11 .......... Diagnostic tests are easy to make, so the U.S. failing to create one seemed inconceivable. Worse, it had no Plan B. ......... Water running along a pavement will readily seep into every crack; so, too, did the unchecked coronavirus seep into every fault line in the modern world. ............... In response to the global energy crisis of the 1970s, architects made structures more energy-efficient by sealing them off from outdoor air, reducing ventilation rates. Pollutants and pathogens built up indoors, “ushering in the era of ‘sick buildings’ ” ............... The indoor spaces in which Americans spend 87 percent of their time became staging grounds for super-spreading events. One study showed that the odds of catching the virus from an infected person are roughly 19 times higher indoors than in open air. ............ 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. ............... 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. ............ “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.” .......... a national temperament that views health as a matter of personal responsibility rather than a collective good. ............. At the end of the 20th century, public-health improvements meant that Americans were living an average of 30 years longer than they were at the start of it. Maternal mortality had fallen by 99 percent; infant mortality by 90 percent. Fortified foods all but eliminated rickets and goiters. Vaccines eradicated smallpox and polio, and brought measles, diphtheria, and rubella to heel. These measures, coupled with antibiotics and better sanitation, curbed infectious diseases to such a degree that some scientists predicted they would soon pass into history. But instead, these achievements brought complacency. “As public health did its job, it became a target” of budget cuts .................. 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..................... “We’re designed for discrete disasters” like mass shootings, traffic pileups, and hurricanes, says Esther Choo, an emergency physician at Oregon Health and Science University. The COVID‑19 pandemic is not a discrete disaster. It is a 50-state catastrophe that will likely continue at least until a vaccine is ready. ........... American hospitals operate on a just-in-time economy. They acquire the goods they need in the moment through labyrinthine supply chains that wrap around the world in tangled lines, from countries with cheap labor to richer nations like the U.S. The lines are invisible until they snap. About half of the world’s face masks, for example, are made in China, some of them in Hubei province. When that region became the pandemic epicenter, the mask supply shriveled just as global demand spiked. ............... The supply of nasopharyngeal swabs that are used in every diagnostic test also ran low, because one of the largest manufacturers is based in Lombardy, Italy—initially the COVID‑19 capital of Europe. About 40 percent of critical-care drugs, including antibiotics and painkillers, became scarce because they depend on manufacturing lines that begin in China and India. Once a vaccine is ready, there might not be enough vials to put it in, because of the long-running global shortage of medical-grade glass—literally, a bottle-neck bottleneck. .............. the U.S. could have averted 36,000 COVID‑19 deaths if leaders had enacted social-distancing measures just a week earlier. ............. More than 26 million people lost their jobs, a catastrophe in a country that—uniquely and absurdly—ties health care to employment. ............. In the middle of the greatest health and economic crises in generations, millions of Americans have found themselves disconnected from medical care and impoverished. They join the millions who have always lived that way. ............... Elderly people, already pushed to the fringes of society, were treated as acceptable losses. Women were more likely to lose jobs than men, and also shouldered extra burdens of child care and domestic work, while facing rising rates of domestic violence. In half of the states, people with dementia and intellectual disabilities faced policies that threatened to deny them access to lifesaving ventilators. Thousands of people endured months of COVID‑19 symptoms that resembled those of chronic postviral illnesses, only to be told that their devastating symptoms were in their head. Latinos were three times as likely to be infected as white people. Asian Americans faced racist abuse. Far from being a “great equalizer,” the pandemic fell unevenly upon the U.S., taking advantage of injustices that had been brewing throughout the nation’s history. ................... “There’s nothing about Blackness that makes you more prone to COVID” ... Instead, existing inequities stack the odds in favor of the virus. ........... A third of the people in the Navajo Nation can’t easily wash their hands, because they’ve been embroiled in long-running negotiations over the rights to the water on their own lands. Those with water must contend with runoff from uranium mines. Most live in cramped multigenerational homes, far from the few hospitals that service a 17-million-acre reservation. As of mid-May, the Navajo Nation had higher rates of COVID‑19 infections than any U.S. state. ................. Americans often misperceive historical inequities as personal failures. ........... Clear distribution of accurate information is among the most important defenses against an epidemic’s spread. And yet the largely unregulated, social-media-based communications infrastructure of the 21st century almost ensures that misinformation will proliferate fast. ............. existing conspiracy theories—George Soros! 5G! Bioweapons!—were repurposed for the pandemic. An infodemic of falsehoods spread alongside the actual virus. ................. Like pandemics, infodemics quickly become uncontrollable unless caught early. But while health organizations recognize the need to surveil for emerging diseases, they are woefully unprepared to do the same for emerging conspiracies. .............. Drawn to novelty, journalists gave oxygen to fringe anti-lockdown protests while most Americans quietly stayed home. ................ Snake-oil merchants have peddled ineffectual silver bullets (including actual silver). Armchair experts with scant or absent qualifications have found regular slots on the nightly news. And at the center of that confusion is Donald Trump................ 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.” ................ Trump is a comorbidity of the COVID‑19 pandemic. He isn’t solely responsible for America’s fiasco, but he is central to it. A pandemic demands the coordinated efforts of dozens of agencies. “In the best circumstances, it’s hard to make the bureaucracy move quickly,” Ron Klain said. “It moves if the president stands on a table and says, ‘Move quickly.’ But it really doesn’t move if he’s sitting at his desk saying it’s not a big deal.” ............... during the three months when some 2 million Americans contracted COVID‑19 and the death toll topped 100,000, the agency didn’t hold a single press conference. .............. the U.S. sleepwalked into the worst possible scenario: People suffered all the debilitating effects of a lockdown with few of the benefits. Most states felt compelled to reopen without accruing enough tests or contact tracers. ........... Despite declaring himself a “wartime president,” he merely presided over a culture war, turning public health into yet another politicized cage match. Abetted by supporters in the conservative media, he framed measures that protect against the virus, from masks to social distancing, as liberal and anti-American. Armed anti-lockdown protesters demonstrated at government buildings while Trump egged them on, urging them to “LIBERATE” Minnesota, Michigan, and Virginia. Several public-health officials left their jobs over harassment and threats. ................ It is no coincidence that other powerful nations that elected populist leaders—Brazil, Russia, India, and the United Kingdom—also fumbled their response to COVID‑19. “When you have people elected based on undermining trust in the government, what happens when trust is what you need the most?” .............. “Trump is president,” she says. “How could it go well?” ......... Many used masks widely; New Zealand didn’t. Many tested extensively; Japan didn’t. Many had science-minded leaders who acted early; Hong Kong didn’t—instead, a grassroots movement compensated for a lax government. Many were small islands; not large and continental Germany. Each nation succeeded because it did enough things right. ............. Yes, having Trump at the helm during a pandemic was worrying, but it was tempting to think that national wealth and technological superiority would save America. “We are a rich country, and we think we can stop any infectious disease because of that,” says Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “But dollar bills alone are no match against a virus.” ............... The virus was never beaten in the spring, but many people, including Trump, pretended that it was. Every state reopened to varying degrees, and many subsequently saw record numbers of cases. After Arizona’s cases started climbing sharply at the end of May, Cara Christ, the director of the state’s health-services department, said, “We are not going to be able to stop the spread. And so we can’t stop living as well.” The virus may beg to differ. ............. The country behaved like a horror-movie character who believes the danger is over, even though the monster is still at large. The long wait for a vaccine will likely culminate in a predictable way: Many Americans will refuse to get it, and among those who want it, the most vulnerable will be last in line. ............... In 2019, more Americans were concerned about terrorists and cyberattacks than about outbreaks of exotic diseases. Perhaps they will emerge from this pandemic with immunity both cellular and cultural. ............ A June survey showed that 60 to 75 percent of Americans were still practicing social distancing. ............ Polls in May also showed that most Democrats and Republicans supported mask wearing, and felt it should be mandatory in at least some indoor spaces. It is almost unheard-of for a public-health measure to go from zero to majority acceptance in less than half a year. ....... People of all political bents became more dissatisfied with the Trump administration. As the economy nose-dived, the health-care system ailed, and the government fumbled, belief in American exceptionalism declined. ................ Defiant and largely cloaked in masks, protesters turned out in more than 2,000 cities and towns. Support for Black Lives Matter soared: For the first time since its founding in 2013, the movement had majority approval across racial groups. These protests were not about the pandemic, but individual protesters had been primed by months of shocking governmental missteps. Even people who might once have ignored evidence of police brutality recognized yet another broken institution. They could no longer look away. ............... Pandemics, climate change, the sixth extinction of wildlife, food and water shortages—their scope is planetary, and their stakes are overwhelming. ............ 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. .......... The pandemic has been both tragedy and teacher.
Is This the Beginning of the End of American Racism? Donald Trump has revealed the depths of the country’s prejudice—and has inadvertently forced a reckoning......... He has held up a mirror to American society, and it has reflected back a grotesque image that many people had until now refused to see: an image not just of the racism still coursing through the country, but also of the reflex to deny that reality. Though it was hardly his intention, no president has caused more Americans to stop denying the existence of racism than Donald Trump. .............. these activists weren’t merely advocating for a few policy shifts. They were calling for the eradication of racism in America once and for all. ........... by early June, roughly three out of four Americans were saying that “racial and ethnic discrimination” is a “big problem” in the United States—up from only about half of Americans in 2015 ............. Trump woke up the next morning once again in a state of angry denial. “Those Tweets were NOT Racist,” he tweeted. “I don’t have a Racist bone in my body!” .............. a racist nation had elected a racist president ......... Trump said at a private White House meeting in June 2017, Haitians “all have AIDS” and Nigerians would never “go back to their huts” once they came to the United States. ............. Near the end of his first year in office, Trump wondered aloud at a White House meeting: “Why are we having all these people from shithole countries come here?” He was referring to Haiti, El Salvador, and nations in Africa. He suggested that the U.S. should bring in more people from countries like Norway. ............. In the Trump years, the problem is obvious, and it isn’t Black people’s behavior. ........ a massacring nation that said it cherished life, a slaveholding nation that claimed it valued liberty, a hierarchal nation that declared it valued equality, a disenfranchising nation that branded itself a democracy, a segregated nation that styled itself separate but equal, an excluding nation that boasted of opportunity for all. A nation is what it does, not what it originally claimed it would be. Often, a nation is precisely what it denies itself to be. .................. A critical mass of Americans rejected the South’s claim that enslavement was good and came to recognize the peculiar institution as altogether bad. ............... just as the 1850s paved the way for the revolution against slavery, Trump’s presidency has paved the way for a revolution against racism. ........... I had Stage 4 colon cancer. I had two choices: denial and death, or recognition and life. America now has two choices. ......... Just as the abolitionists of the 1850s demanded the immediate eradication of slavery, immediate equality must be the demand today. ....... the normal in which racist policies, defended by racist ideas, lead to racial inequities .......... The abolition of slavery seemed as impossible in the 1850s as equality seems today. ........... Abolish police violence. Abolish mass incarceration. Abolish the racial wealth gap and the gap in school funding. Abolish barriers to citizenship. Abolish voter suppression. Abolish health disparities. Not in 20 years. Not in 10 years. Now.
America Should Prepare for a Double Pandemic COVID-19 has steamrolled the country. What happens if another pandemic starts before this one is over? ......... Viruses aren’t sporting. They will not refrain from kicking you just because another virus has already knocked you to the floor. And pandemics are capricious. Despite a lot of research, “we haven’t found a way to predict when a new one will arrive” ........ As new diseases emerge at a quickening pace, the only certainty is that pandemics are inevitable. So it is only a matter of time before two emerge at once. ........... The longer this fiasco drags on, the more vulnerable America becomes to further disasters: inbound hurricanes, wildfires, and many other viruses that lie in wait. .......... Several strains of influenza with pandemic potential are lurking in pigs and poultry, and some have repeatedly infected farmers over the past decade. Wild mammals harbor an estimated 40,000 unknown viruses, a quarter of which could conceivably jump into humans. Changing climate and shrinking habitats have brought those viruses into closer contact with people and livestock, while crowded cities and air travel hasten their spread. ........... waning global solidarity is a problem. “Our international laws are based on a bargain that countries will rapidly notify each other [about emerging diseases] and, in exchange, they’ll have protection against the economic impacts of sharing that info” ........ That compact was violated during COVID-19, after China suppressed information about the outbreak and other countries quickly implemented travel bans. The U.S. is now on the receiving end of many such bans. ......... A country that has badly mishandled its own outbreak, that has bought up the world’s stock of important drugs, and that has petulantly withdrawn from global alliances is less likely to receive warnings or support if a new crisis emerges. .......... nations like the U.S., Brazil, Russia, and India, which are stretched and struggling. ............ Currently, the scientific community is hell-bent on studying COVID-19, but basic questions remain unanswered. Why do some people get sick and others do not? What’s the full range of symptoms? Why do some people infect many while many infect no one? .......... While Americans freaked out in May about so-called murder hornets, the worst locust outbreak in 70 years devastated croplands in East Africa and South Asia. While a single case of plague in China made headlines, the Democratic Republic of the Congo was being dog-piled by dangerous viruses: The nation just beat a two-year Ebola outbreak in its war-ravaged east, only to face another Ebola assault on its western flank, along with COVID-19 and the world’s largest measles outbreak. .......... The DRC and many other countries are already living through what is functionally identical to a double pandemic—several infectious disasters, overlaying one another. The U.S. is barrelling toward the same situation. Even without a second pandemic, regular seasonal flu strains are inbound. ............... Other known and preventable diseases will also run amok if the current pandemic continues unabated. The Centers for Disease Control and Prevention reported that in Michigan, the proportion of five-month-olds who are up-to-date on their vaccines fell from 68 percent in May 2019 to 50 percent in May 2020. Childhood vaccinations have also declined in many other states as doctor offices closed or parents canceled appointments. ............ Global programs that fight HIV, malaria, and tuberculosis are being disrupted as workers are reassigned to fighting COVID-19, supplies run out, and labs are inundated. Vaccination programs were suspended in many countries, leading to rises in measles, cholera, and diphtheria. If such initiatives are paused too long, the world could lose decades of ground against polio—a disease that was almost eradicated. “We’ve been very close to the end of polio for a very long time, and we’re not far away from the scenario where it comes roaring back”
