Enlight21

Author: Sue C. | Category: Politics National | Date: 08-24-2020

Why is America Unable to Contain the Pandemic?

As of late September, 2020, America has over 7 million people who have been infected by Covid19, and close to 210,000 deaths.  Thus, the country has earned the distinction of having the highest number of cases and deaths from Covid-19 in the world.

It is however, important to note that despite these high numbers, overall, only approximately 10% of Americans nationawide have been infected; therefore, the country is far from reaching the "herd immunity"  of 60 to 70% that is required to confer a degree of protection among the population at large.  (more)

That means that  to wait for herd immunity to take hold in America, many more people would have to be infected and die.  

A word of warning:  Even if 60 to 70% of Amercians have been infected by Covid19, immunity most like will not last very long, because we now know that antibodies to Covid19 may only  exist for a few months, like most flu viruses.  People will have to be constantly revaccinated if there is a vaccine. And it is highly likely that vaccines may be only about 50% effective, so even vaccinated people may still be vulnerable to infection.

So, all in all, we cannot depend on herd immunity and vaccines.  What is a surer bet is develping an effective containment system.

Brief History of America's Containment Efforts:

After fragmented lockdowns occurring at different times, many states opened up too early and without efficient testing, contact tracing, and quarantining systems in place.  Right now, 47 states have seen increases in infections and hospitalizations since late May, with some experiencing tremendous surges.  Red states (states that Trump won in the 2016 election) like Texas, Arizona, Florida, and North Dakota, South Dakota, Georgia--states that never had complete lockdowns and whose pro-Trump governors were quite nonchalant about preventive measures--are now suffering the brunt of the tremendous upsurge in infections and deaths.    

In other countries such as many in the European Union, opening up occurred at about the same time as the U.S., but only in carefully-planned stages after their curves were flattened, and after testing, contact tracing, and quarantining systems were at least somewhat in place.  Moreover, the vast majority of European Union countries saw leaders at the federal level step in to coordinate country-wide efforts between government agencies and private sector companies to ensure adequate supplies, hospital space, patient care, etc., Furthermore, many western European countries quickly passed national-level legislation supporting economic assistance to citizens, and to facilitate the establishment of critical nationwide testing-tracing-quarantining systems.

In the great majority of American states, however, not only were there very few to NO contact tracing and quarantining systems in place after lockdowns were lifted, but test results, even today, often take a long time, sometimes as long as a week to ten days—rendering these tests virtually useless because those infected would have a lot of time to infect others before they know whether or not they tested positive.  

In other words, unlike many other countries that imposed lockdowns, America completely squandered the multi-week lockdown period as American government officials did not use the time to set up efficient testing-tracing-and quarantining systems and did not carefully plan phased openings.  

The Trump administration’s rush to re-open the economy in June was driven by fears of further economic devastation, and for Trump, a bad economy meant that his chances of reelection would be much diminished. So, it is clear that federal-level government officials, operating under orders from the Trump administration, have chosen to sacrifice American lives for the sake of the economy and Trump’s  reelection chances.

Why the Rush to Reopen?

Government officials making such life and death decisions should know that to present the situation as a choice between the economy and health is a false choice in the sense that the economy CANNOT return to normal functioning with the coronavirus continuing to infect the populace at a furious pace.

There is simply no way the economy will return to anything resembling normal unless the pandemic is contained.

Disregarding science and common sense, the Trump administration has pushed hard for school districts to prepare for in-person classes and has threatened to withhold federal funds unless school districts comply.  So far, most schools, especially those in blue states, are not obeying these orders and are providing remote learning only.  A number of schools in red states—the South and Midwest-- that succumbed to pressure from the Trump administration and tried to conduct in-person classes, have experienced outbreaks and are now scrambling to quarantine the infected, close down temporarily, and provide online classes. 

And public health agencies such as the Center for Disease Control (CDC)--initially pushed aside by the Trump administration because it issued guidelines for reopening that the Trump administration thought were too stringent--are now being forced to comply with the Trump administration’s push to re-open schools by supporting an anti-science approach to public health policy-making.   

This latest switch by the CDC, one done under tremendous pressure, is a perfect example, of the politicization of science.  It is clear that in order to enhance his chances of being reelected, President Trump and his advisors thought that returning to “normal” was imperative, even though forcing “normality” on people by pretending that things are normal is impossible amidst the landscape of death and economic devastation.

It did not have to come to this: if America had had more competent national leadership and less politicization of public health management, pandemic control would have been much more effective.

A look at Taiwan and South Korea

In stark contrast to the lack of national leadership in the U.S., in Taiwan and South Korea, federal government leaders were able to practice successful containment through quickly ramping up  nationwide systems of widespread testing, contact tracing and quarantining.  No extensive lockdowns were mandated in either country.  No widespread economic decline.  And the number of deaths has been extremely low.

As of mid-summer 2020,  Taiwan, an island nation with a population of approximately 24 million, has had only 7 deaths from Covid19 and 443 cases.  Compare this to Florida, which, with a population of close to 21.5 million, is less populated than Taiwan, but has so far seen over 600,000 cases and over 10,000 deaths.  

Same story with South Korea.  With a population of 51 million, there have only been about 12,000 cases and around 300 deaths.  Compare this to Georgia and Texas which have a combined population of about 40 million, The combined number of cases and deaths in the two states: over 850,000 cases and approximately 17,000 deaths.

Not surprisingly, the economies of both Taiwan and South Korea are doing considerably better than those in countries that were locked down.  The Taiwanese government has forecasted a 2% GDP (growth domestic product, a broad measure of all goods and services produced) growth rate for 2020, a number that is much better than the economic forecasts of other developed economies, almost all of which have seen and will continue to see significant GDP shrinkage.  At the end of March, the South Korean economy grew by 1.3% (year on year growth).

Compare these figures to the U.S., which saw a 4.8% decrease in year-on-year growth by the end of March.  Just released figures show a 9.5% decline in GDP  for the second quarter ending in June, the worst economic decline in U.S. history.

Of course both the Taiwanese and South Korean economies are far from optimal at this point because sales of Taiwanese and Korean goods to other countries are predicted to decline.  However, even the most pessimistic economic forecasters agree that both Taiwan and South Korea will fare significantly better than countries that had to undergo lockdowns, because domestic demand will still be relatively robust.  (more)

How did Taiwan and South Korea, Two Vibrant Democracies, do it?

Taiwan’s successful containment of Covid19 reads like a detective novel:

On December 31, 2019, Philip Lo, the deputy director of Taiwan’s Center for Disease Control, woke up at 5:30 am to check Communist Chinese blogs, social media, and news media because they are valuable sources of early information on outbreaks, as he learned the previous year when the first signs of a pneumonic plague appeared on several of these bulletins.

Something caught his eye right away:  There was a new entry from PTT (Taiwan’s Reddit, that gives summaries of texts and posts from medical personnel in China) warning of a mysterious strain of pneumonia.

It took Lo just three hours to send emails to health officials in Beijing inquiring about this strange development.  Lo’s early inquiry on New Year’s eve led to a response (most likely the first official statement released to outsiders by Communist Chinese officials) that very afternoon from Wuhan’s health committee stating that yes, there were 27 cases of a strange type of viral pneumonia.  

It can be said that the world has Taiwan to thank, because without Lo’s official inquiry, the Chinese Communist leadership may have delayed official confirmation of the viral outbreak.  Even then, the Chinese communist leadership was slow to publicize Wuhan’s outbreak to the rest of the world and did not lock down Wuhan completely until January 23, all the while allowing people to fly from Wuhan to other parts of the world.

Lo did not wait for further verification.  After hearing from Communist Chinese officials, he emailed the World  Health Organization (W.H.O.) immediately,  saying that these 27 cases most likely indicated that there was person-to-person transmission of a novel respiratory virus. Oddly enough, WHO officials did not issue notifications to member nations until much later.  

In contrast to the inaction of WHO officials, Lo sprang into action.  His next step that very day was to check to see how many flights arrived each day from Wuhan.   He found that there were 12, and by that evening, a policy was in place to test passengers on all 12 flights from Wuhan daily, and people with fevers were immediately hospitalized.

The next major step Lo and his colleagues initiated was to set up a Central Command Center at the national level under Taiwan’s CDC; 124 action items were established--actions such as setting up an efficient nationwide testing/retesting, contact tracing and quarantining system (including hotel rooms for the infected who could not be isolated at home); ramping up the production of masks, gowns, and other protective equipment; deciding when to ban all travel from China; stopping cruise ships rules, etc.

Among these actions were also rules for enforcing transparency and accountability on the part of government officials, which led to constant daily broadcasts reporting on all aspects of the government’s battle against Covid19.  Such transparency is critical in a crisis situation because gaining the public’s trust is key whenever governments need cooperation from their citizens.

While the quick comprehensive actions of Taiwan public health officials were an indispensable part of the highly successful containment effort, there was another factor at work:  Taiwan happens to have one of the world’s best universal health care systems.  

This meant that sick people could be treated right away without being hindered by financial constraints.  Not only that, but because of Taiwan’s national health care database, officials were able to merge this database with immigration and customs’ database so they were able to track travel information of citizens, notifying those from high-risk areas to self-quarantine.

All in all, if pandemic responses are ranked, Taiwan has done probably the best job in containing the virus

And South Korea is a close second.

South Korea:

South Korea’s Covid19 containment efforts can be directly compared to America’s, if only because they both started at about the same point in time:  Both the U.S. and South Korea had the first confirmed case in late January, within a day of each other.  But that’s where the similarity ends.   

Within days after the first case occurred, the South Korean government was preparing Covid19 test kits and rapidly ramping up mass production capabilities by working with medical supplies companies.  

By mid-February, at around the same time that President Trump was predicting that the virus would “miraculously disappear," the South Korean government was producing hundreds of thousands of test kits. Free drive-through testing centers were set up to reduce contact and to ensure that hospitals would not be inundated.  

By early March, South Korea had already tested close to 150,000 people, a number that was greater than the combined number of tests in the U.S. the U.K., France, Italy, and Japan at the time.  

Most impressive of all was South Korea’s use of cutting edge technology for contact tracing; everyday alerts accessible to all citizens were sent to the entire population, telling everyone how many cases there were and what routes the infected people had traveled.  People whose paths intersected with those of infected people would then present themselves for testing or self-isolate.

For example, in April, a 58 year old man who tested positive was shown to have visited a polling booth and several restaurants.  In 48 hours, over 1,000 people whose routes overlapped with the man’s were located and instructed to self-isolate, thus effectively stopping further transmissions.

To be sure, South Korea has had mini-outbreaks here and there, even recently, but these were quickly pinpointed and clusters identified using the above alert system, after which rapid testing, contact tracing, and quarantining would take place and localized shutdowns would be mandated, if needed.

Universal Healthcare and Previous Experience with Pandemics

It has to be pointed out that like Taiwan, South Korea has a solid universal health care system, so, just like Taiwanese citizens, South Koreans were not constrained by financial worries about medical treatments.  

Furthermore, it must be said that both Taiwan and South Korea “benefited” from the much smaller outbreaks of previous coronaviruses.  

In 2003, a highly contagious coronavirus infection, one that also originated in Communist China—the SARS COV-1 outbreak—hit Taiwan relatively hard; the country ended up with 671 cases and 84 deaths, an experience that scarred Taiwanese public health officials to such an extent that they devised the fundamentals of a rapid pandemic response team, elements of which were quickly re-tooled when Covid19 struck earlier this year.  

While South Korea was largely spared in the 2003 SARS Cov-1 outbreak, the country was jolted in 2009 by MERS (Middle Eastern Respiratory Syndrome), another coronavirus; South Korea ended up with around 200 cases and 36 deaths and had the largest MERS outbreak outside the Middle East.  It was a contagion that depressed economic activity largely because tourists stayed away.  That experience was a shock to South Korean officials, so much so that the government revised its infectious disease law to enable officials to combat infectious diseases more effectively.  

Today, South Korean officials acknowledge that their MERS experience was a big help in their current success at containing COVID 19.

So, does the lack of both universal healthcare and previous experience with outbreaks explain the failure of America’s leaders to develop an effective comprehensive national response to the pandemic? 

What can we conclude about America’s failure and Taiwan’s and South Korea’s success? 

First of all, Taiwan’s and South Korea’s examples tell us that democracies can be highly effective in containing pandemics, which contradicts Chinese Communist leaders’ claims of superior pandemic management because of the draconian methods they used. Yes, Communist China's tactics were effective, but not only are they unacceptable to anyone who believes in human rights, but the suppression of news—the initial coverup and the silencing of medical workers like Dr. Li in Wuhan--was a major factor in the spread of Covid19 to other parts of the world.

We do not need the iron fist of autocratic governments to control pandemics;  not only is the violation of human rights something that no democratic nations would tolerate but people should never forget that this disregard for human and civil rights--the Chinese Communist leadership’s heavy-handed suppression of information in the early days--was what gave rise to the worldwide Covid19 pandemic.

It is not surprising that Taiwan and South Korea did such good jobs containing the virus.  Both countries are in close proximity to Communist China, and that made them more vigilant. 

Taiwan was hypervigilant, a vigilance that stemmed from its historical distrust of the Chinese Communist regime.  In this case, it served them well.

Therefore, it can even be said that one of the major lessons from this pandemic is that being suspicious of the Communist Chinese government gives countries a huge advantage and that democracies can contain pandemics quite well without trampling on human rights.   

Women Leaders and Superior Pandemic Management

We can even go a step further to say that there is a case to be made for the superiority of democracies—especially those led by women leaders--in the handling of pandemics.  Taiwan has a female president; South Korea’s pandemic effort was orchestrated by a female chief of disease control; Germany, the shining European example of early containment action which resulted in very low infection and death rates, is led by Angela Merkel.  Iceland, with only 10 deaths, Finland with  329 deaths, New Zealand, with 22  deaths, Denmark with 614    deaths, and Norway, with 255  deaths, are all led by women leaders. (more)

Lack of Previous Pandemic Experience:  Comparison of America and European Countries 

What about the lack of previous experience with infectious disease outbreaks, which may have made American leaders complacent, some may ask?  That could be one reason for the U.S’s slow and not very effective response, at least initially.  But before we exonerate the Trump administration, let’s look at other countries that did not undergo the kind of jolting experience with coronaviruses that Taiwan and South Korea did.  

For that, we need look no further than the European Union countries.  As of mid-August, the European Union countries have much lower daily new case numbers of Covid19 than in the U.S.   Before the Trump administration's decision in mid August to not test people who are asymptomatic, the U.S. had approximately 50,000 to 70,000 new cases per day compared to around 10,000 new cases daily for the European Union countries combined.  And the U.S. population (328 million) is smaller than the European Union’s (446 million)

As mentioned above, Germany, and other European countries such as Iceland and New Zealand, have very low overall case numbers and death rates.  Yes, Germany was exceptional in its coronavirus response, having put in place a highly-effective testing, contact tracing, quarantining and patient care system early on, which kept its Covid19 spread well contained.

And yes, countries such as Italy and Spain were hit very hard in March and April and many European countries were locked down from late March until early June. But most European countries used their lockdown periods more fruitfully than  did officials in the U.S.  

While there is no complete consensus about why European nations have not seen the huge upsurge in cases and deaths that the U.S. is experiencing after opening up in June, we do know that except for Sweden, which did not lock down at all, and the UK, which locked down late, most lockdowns in European countries occurred  at approximately the same time--from mid/late March to early June.  

Also, according to Dr. Fauci, European lockdowns were much more thorough as the lockdowns were “to the tune of 95%,”  compared to the 50% lockdowns in the U.S. (more)

Most major European countries also re-opened slowly and carefully after testing, contact tracing, and localized re-lockdown procedures were in place to a certain extent.  

So, it can be said that while the lack of previous experience with pandemic control may have hindered countries at first and helped Taiwan and South Korea initially, the stark contrast between European nations’ ability to flatten their curve after lockdowns and America’s inability to control its galloping transmission rates/deaths despite lockdowns, points to other major factors that  led to such different results.  

     While European nations were largely spared the summer upsurges that spread over the U.S., that does not mean that the pandemic is completely under control  in Europe.  In September, outbreaks are beginning again in Europe due in large part to pandemic fatigue among the young and the fact that pandemic control systems in Europe still leave a lot to be desired, especially when compared to countries like Taiwan and South Korea.  Also, controlling a pandemic across national boundaries, such as in the European Union, is much more difficulty than in a single nation.

Lack of Universal Healthcare and Pandemic Control

The lack of universal healthcare could be another probable factor in pandemic control.  Uninsured people (13.8 percent of adult Americans are not insured) may understandably be reluctant to seek care when sick.  But 86% of Americans are insured and the federal government announced in March that testing and treatment for the coronavirus would be free.  So, the lack of universal healthcare coverage is most likely just a secondary factor in America’s runaway pandemic. (more)

The rather minor role of universal healthcare in pandemic control is even clearer when we look at countries with universal health care systems that did NOT respond well, countries such as the UK.  In fact, the UK has both universal health care and a single payer system (same as Taiwan's), a combination that is considered the gold standard of healthcare safety nets. But despite the UK’s universal health care system, its pandemic response was quite poor and slow, even when compared to the responses of other European countries.

So, universal healthcare and single payer systems do not guarantee effective pandemic control.

Some experts have commented on how the disorganized patchwork public-private healthcare system we have meant that there were coordination barriers that did not exist in countries that do not depend on public-private partnerships.  This does not seem to be a significant factor either.  South Korea, for example, is a country with universal health care coverage, but it is a healthcare delivery system based on public-private partnerships.  And everyone knows that such a system did NOT hinder South Korea’s amazingly successful pandemic control efforts. (more) 

If it is not clear that there is a definite relationship between universal healthcare and/or single payer systems on the one hand and pandemic control on the other, then what is clear?

What is clear is that pandemic control was effective wherever there was strong national leadership in the implementation of  a nationwide structure for testing, contract tracing, quarantining and treatment (especially at-home care).

Sure, such systems cannot be established overnight.  But it’s not rocket science either.  

Even countries with few resources—such as Rwanda and other African countries—have done amazingly well.  

John Nkengasong, the director of the Africa Centres for Disease Control and Prevention, said the reason why many African countries were so successful was that “Africa reacted aggressively…“Countries were shutting down and declaring states of emergency when no or single cases were reported. We have evidence to show that that helped a lot.” (more)

Rwanda, for example, has done a superb job controlling the pandemic, much better than Ohio, a state with a similar population size (about 12 million).  The main difference is that national-level officials in Rwanda responded to their first coronavirus cases by tracing, isolating, and testing contacts.  (more)

The Main Reason for America’s Failure:  No National Leadership Due to the Politicization of Pandemic Control

After considering all the evidence, everything points in just one direction when it comes to assigning blame for the out-of-control spread of Covid19 in the United States--the absence of national leadership stands out.  All countries that were able to contain the pandemic to varying degrees had a national policy and a task force that implemented the policy.

The Trump administration did not take responsibility for organizing a coordinated national-level response, but instead, off-loaded the responsibility to individual states and local governments, thinking that the federal government could not be blamed if the fragmented efforts at the state level turned out to be unsuccessful.

The federal government has failed us.  

Because of the lack of a unified policy at the national level, which resulted in NO effective testing-tracing-quarantining-care system, a problem that was compounded by quick re-openings, we are now faced with soaring infection and death rates—the worst outbreak in the developed world.

As mentioned, this is in stark contrast to many other countries that were able to keep their curves flat or declining, countries like Western European nations that also did not experience pandemics in recent decades and are, similar to the U.S., steeped as many are in western capitalist-democratic cultures.

Politicization of Science and Public Health Policy

America’s failure to respond effectively was certainly not from lack of scientific expertise or financial resources.  In fact, the willingness to disregard science or subordinate science to politics was a major part of the problem.  In fact, scientists like Dr. Fauci, a preeminent world expert on infectious diseases, have been shoved aside, so that political considerations--such as what Trump needs to win reelection--dictated pandemic policy-making.  

And once Trump decided that he had to disregard science in order to open up the economy (and more recently, schools), so that a state of  “normalcy,” would somehow return, he basically ignored the pandemic and denied its severity, hoping that by doing that, his reelection chances would improve.  

In a word, the reason for the lack of political will to focus on combating the coronavirus at the national level was because the Trump administration has politicized the pandemic:  Trump is completely focused on what benefits him, especially his reelection chances, not on what would save lives and contain the pandemic.

Politicization of Mask Wearing

Even something as simple as mandating mask wearing--which has been proven to be effective in reducing transmission—has been politicized.  Because President Trump himself never recommended mask wearing until very recently, and often does not wear masks himself, the percentage of Republicans who wear masks (35%)   is substantially lower than the percentage of mask-wearing Democrats (65%).  

Unfortunately, it is not just your average right-wing Republican citizens that are easily swayed by a science-denying president who thinks the virus will just “disappear.’”  

It’s worse than that:  Republican governors in red states such as Georgia and Texas, the site of the worst surges, have refused to allow other officials such as mayors in their states to mandate mask wearing.  In Georgia, the governor—Brian Kemp--who is a staunch Trump ally, even sued the major of Atlanta when she mandated mask wearing in the city!  

The reason why they acted to support Trump’s anti-science approach is simple:  As political allies of the president, they were afraid to contradict Trump, even if it meant that a lot more people in their states would be infected and die.  

It’s no wonder that the pro-Trump red states are the ones that are suffering the most today. (more)

The politicization gets worse—a pandemic control plan is scratched because of politics.

The politicization at the federal level by the Trump administration was not limited to ignoring science to force re-openings (in order to “normalize” the economy to boost Trump’s reelection chances) and downplaying the scientifically-proven benefits of mask wearing (as part of an attempt to appeal to many poorly-educated Trump supporters who cling to the belief that government should not interfere in their lives)’. 

In order to boost his own profile, Trump has also been confusing Americans by spreading misinformation--propagating non-scientific ideas about using ineffective treatments such as hydroxychloroquine and bleach--which plays well among the undereducated "I can do what I want" segment of Trump’s supporters.

But worst of all is how politics has prevented the formation of a pandemic control task force at the federal level.

Vanity Fair has published a thoroughly-researched article on how Jared Kushner, President Trump’s son-in-law who was tapped with the job of forming a national task force in late March—specifically to ramp up testing and outbreak-prevention surveillance--decided not to go forward with such a comprehensive national plan. (more)

Had the plan been implemented, it would have coordinated the distribution of test kits and put in place a nationwide contact tracing structure.  In other words, had this plan been carried out, America would have joined the ranks of countries that were able to contain the pandemic to a certain extent (perhaps comprable to what happened in European nations during the summer), and many lives would have been saved.

Why was it scratched?

It was all political.   

The decision to not go forward with the plan was dictated by two reasons:

1).  The president was, by that time, interested in downplaying the seriousness of the situation, because he and his advisors thought perceptions of a raging pandemic would hurt his reelection chances.  Therefore, since more testing would lead to more reported cases, that would make it harder for his administration to pretend that everything was improving.  

2) The second reason why the national plan was scrapped is perhaps worse than pretending that the situation was much better than it was.

According to a public health expert who was in close contact with members of the task force led by Kushner, Trump’s son-in-law, said that because the worst-afflicted areas at the time were blue states (New York, Connecticut, New Jersey), or states that Trump did NOT win in 2016, Trump and his allies were counting on being able to blame the blue state governors for their failure to control the pandemic.

The public health expert said: “The political folks believed that because it was going to be relegated to Democratic states, that they could blame those governors, and that would be an effective political strategy.”  (more)

Final Word:  Pity America’s Nonsense

But as was mentioned earlier, despite Trump’s desperate attempts to ignore the ravages of the pandemic, there is no way the economy can return to normal until the pandemic is under control as most people and businesses will not return to their normal ways of functioning until they no longer fear being infected by this horrific virus 

As of late August 2020, approximately close to 190,000 Americans have been killed by Covid19.  The U.S. has 4% of the world’s population but has approximately 25% of the world’s Covid19 deaths and cases. 

Fintan O’Toole, an Irish Times editor, had this to say about America:

Over more than two centuries, the United States has stirred a very wide range of feelings in the rest of the world: love and hatred, fear and hope, envy and contempt, awe and anger. But there is one emotion that has never been directed towards the US until now: pity.  

Instead of wallowing in self-pity, let us close by repeating what Dr. Anthony Fauci said when he finally responded to the White House’s attempts to discredit him:  

Not only did Dr. Fauci call the Trump’s administration’s attack “bizarre” and “divisive,” but he issued a passionate call when he said, “Let’s stop this nonsense.”

Yes, let’s stop the politicization of science and public health policies and put people’s lives first!

To Sum Up:

Now that we know that democracies can handle pandemics well, and that Communist China’s example is a negative one--of how iron-fisted autocracies can actually help spread the virus because their first instinct is to cover up and threaten those who dare reveal the truth—let’s sum up why America has been unable to contain the pandemic.

1.     No unified national strategy of pandemic containment and still no coordinated testing, contact-tracing, quarantining system and no mask wearing mandates.  Yes, there is testing in most areas of the U.S. , often with results that are much delayed, but there is no systematic contact tracing system.  
2.    The main reason why there is no national strategy at the federal is that the Trump administration has politicized virtually all pandemic-related policies as everything is seen through the lens of how it would boost Trump’s popularity. Trump and his advisors were even against widespread testing, thinking that the more tests there were, the higher the case numbers, which would, in their minds, make it harder to downplay the seriousness of the pandemic. Currently, in late August, the Trump administration is trying again to limit testing; after the tremendous surges in cases and deaths, it was just reported that the Trump administration is, again, pressuring the CDC to issue guidelines restricting testing to only those who show symptoms (more). Clearly, the motive is to keep case numbers down. Science continues to be subordinated to political goals.
3.    A secondary reason--a relatively minor one compared to the lack of a coordinated federal-level infrastructure to combat the pandemic--as to why the U.S. was less able to respond quickly and effectively initially was the lack of a universal health care system.  But, as mentioned earlier, this was not a major barrier to the formation and implementation of a national pandemic control plan.  This is a long-term problem that the 13.5% uninsured Americans face, and although it may have prevented some people from seeking medical help before the government announced that all coronavirus-related healthcare would be free, it was definitely not a major barrier to the implementation of an effective nationwide pandemic control program.

Immediate Steps that Need to be Taken:
How to quash the virus (more):

After examining why America has been unable to contain the pandemic so far and why most developed countries were able to control Covid19’s spread better than what America has done, it is clear that what we need are the following (more):
1.    A new nationwide 4 to 6-week lockdown period that would require ALL states to lockdown at the same time with only 1 person per household that can leave for essential supplies. Mask wearing will be mandated.  The only places that would remain open are essential services.  This lockdown should be able to drive the infection rate down to no more than 1 in 100,000, and when that’s reached and maintained for at least one week in all the states, careful opening up by stages can start.
2.    Use the lockdown period to develop a quick testing/quick reliable results and comprehensive contact tracing and immediate quarantining system.  This should include—as in Taiwan’s example—temporary housing for the infected who cannot quarantine at home without infecting others.
3.    Outbreaks Control teams: Since it is now clear that a vaccine may not quash the virus and that Covid19 could be with us for a long time, we must adopt what other developed nations are doing to successfully contain the virus:  Neighborhoods’ infection rates should be vigilantly monitored, and as soon as areas detect even single digit infections, the outbreaks control team should swoop in to test, contact trace, and quarantine immediately, and if serious enough, impose a localized lockdown.  This is never perfect, but if we look at the blue states (N.Y., N.J. Connecticut) that were hit hard in March and April, their outbreaks control methods have managed to keep the pandemic more contained than in red states. 
4.    A home health monitoring system—like Germany’s—in which government health workers would visit moderately-ill, non-hospitalized patients to make sure their condition has not worsened, and if so, take action to hospitalize them right away.
5.     Consistent science-based daily reports and messaging from   local, state, and federal officials. This is extremely important—transparency, accountability, and adhering to scientific standards will inspire trust and confidence among citizens, which will lead to compliance and a much smoother pandemic control process.  Taiwan’s example should be followed.   

A Caveat:

All of the above pandemic containment measures would be much easier to accomplish if a new national administration sweeps into office in November—a federal government that puts the welfare of American citizens above self-serving political goals.   So, be sure to VOTE by mailing in your ballot as soon as you can, and if you did not get a paper ballot in the mail, be sure to vote in person on November 3rd.  Help get your friends and family to do likewise.  And work for a get-out-the-vote organization.  

Here is a link to the Sierra Club’s national get-out-the-vote operation.

About: Sue C.

Hi All: Like most people in the Bay Area, I'm sheltering at home. I'm trying to use this opportunity to catch up on projects that are on my back burner and trying not to feel too anxious about the worst case scenarios that are circulating.