Democratic politicians have been going on and on of late about the United States’s, and more specifically President Trump’s, rotten response to the coronavirus. But as I had written about New York City and the coronavirus in May, there are factors in play beyond the actions of our leadership.
We are the United States.
We are not China:
Besides being the origin of Covid, China is an authoritarian state, with government control over pretty much everything. We yowl about how President Trump wants to get rid of the free press (not true, but that’s in issue for another day), but in China, there is no free press. Our cell phones surveil us in the name of better advertising; their cell phones surveil them so that miscreants can be thrown in jail. They tell us they’ve had 85,351 coronavirus cases as of this morning: that’s their story, and they’re sticking to it. We’re up to 7.2 million: still number one, although we may be overtaken by India at just under 6 million.
We are not New Zealand:
New Zealand is an island nation, separated from the rest of the world by thousands of miles of open ocean, well aware of how they are biologically separate. They can enforce quarantine at the border, and if cluster of cases pop up, they can apply lockdowns to suppress the infection, with an immediate goal of ending the restrictions and returning to normal.
We are not South Korea:
Korea isn’t isolated, particularly from China. But they were able to mount an effective response to the virus. To do this, they had an agile government and business response, and a culture that respects its government and can accept the notion of continuous, automated surveillance in the name of public health. The result has been effective contact tracing that focuses public health efforts where they’re needed. We were told at the outset of the emergency about Korea’s wonderful testing program. To date, they’ve done enough tests to cover less than 5% of the population. Our figure is over 30%.
We’re not Ghana or Liberia:
The poorer nations of Africa have done better at containing Covid than most of the richer nations of the world. Some of them have more public health experience, having dealt with far deadlier viruses; some of them admit the use of hydroxychloroquine, which is in common use against malaria. But a big factor is that relatively few people travel there, few enough that quarantining and contact tracing really works.
But we’re the United States:
- We’re not an authoritarian state (yet!). We have a free press that can report the truth, except when it’s politically incorrect. They can report what the government says, or not, as they see fit, and shade it with derision when they see fit. They’re also free to exaggerate and spread fear rather than enlightenment: whatever sells newspapers.
- We’re not isolated from the rest of the world. In normal times, thousands of travelers entered and left the United States every day. We initially chafed at the notion of closing the borders before embracing it. This is a big difference, because we let the virus in and let it take root, because…
- We’re not agile. We’ve done about as well as can be expected in making plans and ramping up testing, but we’re collectively pretty rotten about anticipating problems. Governor Cuomo shut down New York in stages, from 13 to 22 March. If he had done it all at once on 13 March, it would have made little difference: people were already staying at home and not going out. (And the virus was already spreading.) If he had done it all at once on 13 February, there might have been a difference, but there was no sense of urgency back then. Moreover, in the absence of a ‘genuine’ emergency, any government proposal that affects people’s livelihoods will be subject to intense lobbying and complaint.
- We’re not trusting of our government, at least many of us aren’t. I’ve written in these pages about the apparent futility of embarking on a contact tracing effort after the virus is already in the community: it appears useful only as practice for some more nefarious form of tracking and control. I’m sure I’m not alone.
- We’ve decided that hydroxychloroquine is a bad idea, even though it has been recognized as effective against other coronaviruses, and has been successfully used against Covid in other parts of the world.
- And another thing: the United States is considerably larger than New Zealand, South Korea, Ghana, or Liberia: large enough that the virus will propagate through the states at different times, at different rates, with different effects. There is no single policy that will work everywhere.
The benefit of hindsight suggests that we might have avoided all this trouble if we had closed our borders and kept everyone else out from, perhaps, sometime in January. But even if we had known what to do back then, and the consequences of inaction, would we have done it?