Since the novel coronavirus began its global spread, influenza cases reported to the World Health Organization have dropped to minuscule levels. The reason, epidemiologists think, is that the public health measures taken to keep the coronavirus from spreading also stop the flu. Influenza viruses are transmitted in much the same way as SARS-CoV-2, but they are less effective at jumping from host to host.
As Scientific Americanreported last fall, the drop-off in flu numbers was both swift and universal. Since then, cases have stayed remarkably low. “There’s just no flu circulating,” says Greg Poland, who has studied the disease at the Mayo Clinic for decades. The U.S. saw about 600 deaths from influenza during the 2020–2021 flu season. In comparison, the Centers for Disease Control and Prevention estimated there were roughly 22,000 deaths in the prior season and 34,000 two seasons ago.
Because each year’s flu vaccine is based on strains that have been circulating during the past year, it is unclear how next year’s vaccine will fare, should the typical patterns of the disease return. The WHO made its flu strain recommendations for vaccines in late February as usual, but they were based on far fewer cases than in a common year. At the same time, with fewer virus particles circulating in the world, there is less chance of an upcoming mutation, so it is possible the 2021–2022 vaccine will prove extra effective.
Public health experts are grateful for the reprieve. Some are also worried about a lost immune response, however. If influenza subsides for several years, today’s toddlers could miss a chance to have an early-age response imprinted on their immune system. That could be good or bad, depending on what strains circulate during the rest of their life. For now, future flu transmission remains a roll of the dice.
Influenza Cases Worldwide, by Region
The World Health Organization tracks influenza transmission in 18 zones. Three of those regions appear here. Only people who get tested for influenzalike illnesses—typically about 5 percent of individuals who fall ill—are tallied.
Creating the influenza vaccine this year has been more difficult than in the past.
Every year, scientists evaluate the strains of influenza that are circulating around the world, and meet to decide which strains to protect against in that year’s vaccine. They look at the strains that are getting people sick, and use that information to predict which strains are most likely to infect people when flu season sets in.
“We met at the end of February to make those recommendations,” said Dr. Webby, referring to the World Health Organization panel that assesses the flu vaccine. “And it was tricky. The amount of data was orders of magnitude less than it typically is.”
Dr. Olsen, the C.D.C. epidemiologist, pointed out that the vaccine choices are based on more than just existing strains. Scientists also consider other data, including forecasts of “the likelihood of any emerging groups of influenza viruses becoming more prevalent in coming months.”
And, she said, the uncertainty around the return of influenza makes getting vaccinated against the flu more important, not less.
There’s another hard-to-predict factor that could play a significant role when the flu comes back: whether society will carry on behaviors learned in the pandemic that benefit public health. Will mask-wearing become the norm? Will employers give their employees more physical space?
The last time Americans had a chance to make those behaviors part of the culture, Dr. Baker pointed out, they did not.
“The 1918 influenza pandemic should have been something that gave us some sort of societal learning,” said Dr. Baker, but behavior did not change. “So what is the journey you are about to go on from the Covid-19 pandemic, along that axis?” she added. “Will you wear your mask, even if no one else is?”
Something has gone horribly wrong in India. Today, the country has reported 346,786 new cases of COVID-19 for the previous 24 hours, with 2,624 deaths – the world’s highest daily toll since the pandemic began last year. Overall, nearly 190,000 people have died from COVID in the country, while more than 16.6 million have been infected.
The new outbreak in India is so severe that hospitals are running out of oxygen and beds, and many people who have been taken ill are being turned away. New Zealand, Hong Kong, the UK and the US have either banned direct flights to and from India, or have advised citizens against travelling altogether; and the list may well get longer.
The UK’s prime minister, Boris Johnson, who is keen to secure a post-Brexit trade deal with the country, has been forced to cancel a planned trip to India this coming week and, instead, plans to meet with President Narendra Modi virtually. For a country where COVID numbers appeared to be dropping dramatically just a few weeks ago, what has gone so wrong in India?
The Indian variant, known as B.1.617, appears to be wreaking havoc in the country. Since April 15, India has been reporting more than 200,000 cases of coronavirus every day and its capital, Delhi, recently announced a week-long lockdown after a rise in cases there overwhelmed the healthcare system.
“If we don’t impose a lockdown now, we might face a bigger calamity,” Delhi Chief Minister Arvind Kejriwal said as he addressed the city on Indian television on April 19. Worryingly, bed spaces and oxygen supplies in hospitals appear to be stretched, with reports of sick patients being turned away from hospitals and social media feeds filled with distraught family members whose loved ones cannot access the healthcare they need.
On Wednesday this week, as the COVID toll was rising, Delhi’s highest court took the unusual step of publicly criticising the central government and its approach to managing the country’s oxygen crisis. The court was hearing a petition filed by Max Hospitals seeking urgent help to tide over the oxygen shortage it was facing in six of its hospitals in the capital.
“Human lives are not that important for the State it means. We are shocked and dismayed that government doesn’t seem to be mindful to the extremely urgent need of medical oxygen,” the Bench stated. “We direct Centre to provide safe passage…so that such supplies are not obstructed for any reason whatsoever,” it said. “Hell will break loose [if oxygen is not supplied].” Damning words for the government in a time of crisis.
It is not entirely clear why this surge has happened in India, but it is likely to be because of crowded events organised in the run-up to elections – President Modi himself hit the campaign trail addressing election rallies in Kerala, Tamil Nadu and Puducherry on March 30 as the upturn of cases began. Large groups and social gatherings during religious festivals have also played a part, as well as the re-opening of public spaces and easing of lockdown measures which took place gradually throughout 2020 with the final “unlocking” of restrictions happening in December 2020.
There is also much concern about the emergence of new variants of the coronavirus in India. It is thought the dominant strain in the country now is the variant which was first identified in the UK, and which has shown to be up to 60 percent more transmissible between humans. On March 25, it was further announced that a new “double mutant” variant had been detected in India, now known as the “Indian variant”. This development is what has other countries spooked.
The Indian authorities do not think this new variant has yet become the dominant COVID strain in the country, but it is likely to be contributing to the increasing numbers. Genome sequencing of the new variant has shown that it has two important mutations:
1. The E484Q mutation: This is similar to the E484K mutation identified in the Brazil and South African variants, which have also been reported in recent months. The concern is that this mutation can change parts of the coronavirus spike protein. The spike protein forms part of the coronavirus outer layer and is what the virus uses to make contact with human cells.
Once contact has been made, the coronavirus then uses the spike protein to bind to the human cells, enter them and infect them. The immune response that the vaccines stimulate creates antibodies that target the spike protein of the virus specifically. Therefore, the worry is that if a mutation changes the shape of the spike protein significantly, then the antibodies may not be able to recognise and neutralise the virus effectively, even in those who have been vaccinated. Scientists are examining whether this may also be the case for the E484Q mutation.
2. The L452R mutation: This has also been found in a variant thought to be responsible for outbreaks in California. This variant is thought to increase the spike protein’s ability to bind to human host cells, thereby increasing its infectivity. A study of the mutation also suggests it may help the virus to evade the neutralising antibodies that both the vaccine and previous infection can produce, though this is still being examined.
This new wave in India has been devastating for the country. A coordinated response is needed between Indian states and central government to manage the supply of oxygen and essential drugs if the number of COVID-related deaths is to be brought under control. There is also a concern that we do not know the true number of deaths from COVID, as some people have died at home before they could get to hospital and many others in India, particularly in rural areas, have had difficulty accessing testing facilities.
Pressure urgently needs to be lifted off the healthcare system and the only way to do that is to ramp up the vaccination programme, strengthen social distancing procedures and re-introduce lockdown measures.
One of my passions as a doctor is being able to pass on my knowledge to the doctors of tomorrow. I have done it for years and am a senior lecturer at two UK universities.
A large part of the teaching I do involves getting my students to speak to and examine patients. This has been a challenge in the last 12 months as bringing patients into the surgery for them to see students has been too risky, and the patients that tended to have the illnesses the students needed to see were generally shielding to reduce the chances of them catching COVID-19.
Medical students have been lending a helping hand to COVID-ravaged hospitals all over the world, and their assistance has been welcomed by many. But we also need to prepare them for a world beyond COVID and, in the limited time we have with them, to ensure they are prepared for a wide range of medical conditions from the physical to the mental. But how can we do that if they were unable to see patients as normal?
Technology has been the answer. Our surgery, where I work as a family doctor in Bradford, northern England, is lucky enough to have a clinical skills lab that students can learn in. This is a room that has “model” body parts that the students can use for examination purposes.
Students can come into the surgery and, initially, hold telephone consultations with patients, speaking to real patients who ring in about their ailments. The students record a medical history by speaking to the patients and attempt to come up with a management plan which they then run past me or another doctor for approval.
Because the students cannot examine the patients physically, we then make a list of the examinations the students would have done and, once their clinic list is complete, move over to the clinical skills lab. I then ask them to practice the examination they would have done on the models. This might include a chest exam, a rectal or vaginal exam. The models can be adjusted so that each time the student uses them they will make a different examination finding, such as a new lump or abnormal breathing sounds. It really is quite clever.
Although it will never really replace the real thing, this method has allowed us to keep medical education going throughout the pandemic – something that has challenged medical schools the world over.
And now, some good news: Exercising can reduce the risks of COVID
A new study by Glasgow Caledonian University in Scotland has shown that regular exercise can reduce the risk of getting infections like COVID-19 by up to 37 percent. The researchers conducted a full-scale systematic review of 16,698 worldwide epidemiological studies published between January 1980 and April 2020, with world-renowned immunologists and epidemiologists from University College London (UCL) in the UK and Ghent University (UGent) in Belgium, as well as exercise and sports scientists from Cádiz University in Spain and a public health consultant from NHS Lanarkshire (NHSL) in the UK.
They found that doing 30 minutes of exercise which gets you out of breath and a bit sweaty five times a week strengthens your immune response to infectious diseases. It is thought that regular exercise increases the number of immune cells in the body acting on the first line of defence – the mucosal layer of antibodies. These cells are responsible for identifying foreign agents or “germs” in the body without depressing the rest of the immune system, so it’s perfectly safe and protects you against infectious disease.
We have known for some time about the benefits exercise can have for a person’s overall physical and mental health. Now, in the time of COVID, it has been shown to help boost your immune system too. So the message is clear; get outdoors and exercise if you can or to the gym if it is in keeping with your local COVID guidelines. If neither is possible, your kitchen or living room is a perfectly good place to do 30 minutes of dancing, jumping or whatever floats your boat!
Reader’s question: Is it safe to go to my hospital appointment during a pandemic?
Over the past 12 months, people have repeatedly been told that the safest place for them is home and that hospitals are busy dealing with COVID-19 patients. While that is true, it is also important to remember that other illnesses have not gone away.
I have found that many of my patients are not attending their appointments for other conditions because they are worried about catching COVID or think their illness is not as important as coronavirus. Hospitals and GP surgeries all over the world have gone out of their way to make large parts of their buildings COVID-free. This means that they can be used for non-COVID-related services and staff working there will not be crossing over to cover COVID wards or clinics. So, if you receive an appointment to attend a clinic or hospital service, it is really important that you do go.
Countries across Europe are imposing new restrictions as the second wave of coronavirus infections that’s swept across the region since summer-time has recently taken a turn for the worse—seeping into older, more vulnerable populations and driving a surge in hospitalizations.
All but three European countries—Cyprus, Finland and Norway—have reached the European Centre for Disease Prevention and Control’s (ECDC) coronavirus alarm threshold, which designates countries reporting above 20 cases per 100,000 residents on a seven-day average at high risk.
The ECDC’s most recent report, published last Thursday, also noted the rising death rate in Europe and identified sustained case increases in 27 countries, many of which are reporting more new infections than in the spring (though better detection methods play a factor).
Among the countries faring the worst, the Czech Republic, reporting 22,179 cases and 158 deaths in the past week, enacted a second state of emergency Monday, while Madrid has entered a partial lockdown, barring non-essential travel to and from the city, as Spain reports nearly 10,000 new cases per day.
France’s capital, which moved into a state of “maximum alert” on Monday as 30% of emergency beds in hospitals filled, leading to the closure of Paris bars and cafés, may be on the verge of tougher restrictions as the number of Covid-19 patients in emergency beds jumped to 40% on Tuesday.
Brussels, which has overtaken Paris and trails only Madrid in terms of infections per capita among Europe’s major cities, also announced it is shutting down bars and cafés in the city for a month on Wednesday.
Meanwhile, a slew of other countries, including Ireland and Scotland, are mulling tough new restrictions.
While France, Spain, the Czech Republic and the U.K. are reporting higher numbers of new cases on average than they were during the peak of their spring outbreaks, the crisis isn’t as severe as it was through March and April. However, European authorities are concerned that rising infections, which have begun to spill into older populations, could soon bring hospitals back to the brink.
“The enemy hasn’t been defeated yet,” said Italian Prime Minister Giuseppe Conte last weekend, calling on Italians to be careful as to avoid a return to stricter pandemic measures. Italy, once the centre of the coronavirus pandemic, was the first country in the world to activate a nationwide lockdown in March.
There are mounting concerns the pandemic will cause a global recession. It has been another torrid day on the markets. Stocks plunged around the world, despite a coordinated effort by central banks to protect growth and jobs. Al Jazeera’s Neave Barker begins our coverage with a look at the situation around Europe. –
The COVID-19 global health crisis poses a multitude of challenges for every entrepreneur. Experts in some economies predict that in the coming recession, up to 40 percent of all businesses could cease to exist. Virtually every business owner is affected by the crisis this way or another and many feel a deep need for orientation in this difficult time.
In every walk of life, you always should learn from the best people in your area. Being an entrepreneur myself, I spent the last seven years travelling the world and interviewing some of the best entrepreneurs on the planet. I met over three dozen self-made billionaires on a mission to find out what in their personalities made them so extremely successful in business, to learn their thinking patterns and business strategies.
I published the results of my research in the book “The Billion Dollar Secret” and founded with half a dozen billionaires the 10 Digit Impact Group, a global platform for 10 digit individuals to exchange thoughts, experiences, and co-ordinate their international philanthropic activities to have a positive impact on the lives of billions of people.
Here is how billionaires approach the COVID-19 crisis and the three steps they take to thrive nevertheless:
1. Stabilize your business.
The first rule in business is: Don’t go broke! Also, in the crisis, the first and most important goal is to stay in business.
The COVID-19 crisis shows up in its first phase as a liquidity crisis. For business owners, it’s critical to keep liquidity. You don’t want to be in a situation where you are forced to sell your assets. To achieve that, you need to be flexible and quickly adapt to changing conditions. Innovation and the use of new technologies can help you achieve that.
In hard times, it is wise to reduce your dependency on financial institutions. Many billionaires have no debt in their companies or they want to reach zero debt soon.
No business can exist without customers. In a deep recession like this one, it’s not enough to think only about the financial condition of your company. You also have to think about the financial condition of your customers. You want them to survive so your company can survive. Sometimes you need to give them better business terms, give them more time to pay the obligations, temporarily waive the interest or even forgo part of the debt. It may be painful in the short term but it may save your company in the long term.
2. Prepare for opportunities.
Cash is king! It sounds like a slogan but there is no other time when these words are more true than now. Every crisis is an opportunity and there are many opportunities to come in this crisis. There will be assets in different areas to be had cheaply, be it real estate or companies. To take advantage of these opportunities, you need cash.
Billionaires have prepared for it by selling some of their non-essential, non-strategic assets and currently keep unusually large amounts of cash so they can invest with a discount at a later point in time.
3. Invest during max panic.
When everybody thinks in one direction, don’t be surprised when the situation develops in the opposite direction. When everybody runs for the hills, that’s when you should take a contrarian view and go against the crowd. You will always find opportunities there where somebody loses liquidity and has to sell.
Billionaires expect real estate and the stock market to go down in price even further in the coming months and years. When the panic in the market caused by the fears about the second wave and potential second lockdown reaches its maximum, that’s when the opportunities will outweigh the risk.
That’s when you should look for potential acquisition targets in your industry or expand your activities to new markets using your cash stash.
Forty-five days before the announcement of the first suspected case of what would become known as COVID-19, the Global Health Security Index was published. The project—led by the Nuclear Threat Initiative and the Johns Hopkins Center for Health Security—assessed 195 countries on their perceived ability to handle a major disease outbreak. The U.S. ranked first.
It’s clear the report was wildly overconfident in the U.S., failing to account for social ills that had accumulated in the country over the past few years, rendering it unprepared for what was about to hit. At some point in mid-September—perhaps by the time you are reading this—the number of confirmed coronavirus-related deaths in the U.S. will have passed 200,000, more than in any other country by far.
If, early in the spring, the U.S. had mobilized its ample resources and expertise in a coherent national effort to prepare for the virus, things might have turned out differently. If, in midsummer, the country had doubled down on the measures (masks, social-distancing rules, restricted indoor activities and public gatherings) that seemed to be working, instead of prematurely declaring victory, things might have turned out differently. The tragedy is that if science and common sense solutions were united in a national, coordinated response, the U.S. could have avoided many thousands of more deaths this summer.
Indeed, many other countries in similar situations were able to face this challenge where the U.S. apparently could not. Italy, for example, had a similar per capita case rate as the U.S. in April. By emerging slowly from lockdowns, limiting domestic and foreign travel, and allowing its government response to be largely guided by scientists, Italy has kept COVID-19 almost entirely at bay. In that same time period, U.S. daily cases doubled, before they started to fall in late summer.
Among the world’s wealthy nations, only the U.S. has an outbreak that continues to spin out of control. Of the 10 worst-hit countries, the U.S. has the seventh-highest number of deaths per 100,000 population; the other nine countries in the top 10 have an average per capita GDP of $10,195, compared to $65,281 for the U.S. Some countries, like New Zealand, have even come close to eradicating COVID-19 entirely. Vietnam, where officials implemented particularly intense lockdown measures, didn’t record a single virus-related death until July 31.
There is nothing auspicious about watching the summer turn to autumn; all the new season brings are more hard choices. At every level—from elected officials responsible for the lives of millions to parents responsible for the lives of one or two children—Americans will continue to have to make nearly impossible decisions, despite the fact that after months of watching their country fail, many are now profoundly distrustful, uneasy and confused.
At this point, we can start to see why the U.S. foundered: a failure of leadership at many levels and across parties; a distrust of scientists, the media and expertise in general; and deeply ingrained cultural attitudes about individuality and how we value human lives have all combined to result in a horrifically inadequate pandemic response. COVID-19 has weakened the U.S. and exposed the systemic fractures in the country, and the gulf between what this nation promises its citizens and what it actually delivers.
Although America’s problems were widespread, they start at the top. A complete catalog of President Donald Trump’s failures to address the pandemic will be fodder for history books. There were weeks wasted early on stubbornly clinging to a fantastical belief that the virus would simply “disappear”; testing and contact tracing programs were inadequate; states were encouraged to reopen ahead of his own Administration’s guidelines; and statistics were repeatedly cherry-picked to make the U.S. situation look far better than it was, while undermining scientists who said otherwise. “I wanted to always play it down,” Trump told the journalist Bob Woodward on March 19 in a newly revealed conversation. “I still like playing it down, because I don’t want to create a panic.”
Common-sense solutions like face masks were undercut or ignored. Research shows that wearing a facial covering significantly reduces the spread of COVID-19, and a pre-existing culture of mask wearing in East Asia is often cited as one reason countries in that region were able to control their outbreaks. In the U.S., Trump did not wear a mask in public until July 11, more than three months after the CDC recommended facial coverings, transforming what ought to have been a scientific issue into a partisan one. A Pew Research Center survey published on June 25 found that 63% of Democrats and Democratic-leaning independents said masks should always be worn in public, compared with 29% of Republicans and Republican-leaning independents.
By far the government’s most glaring failure was a lack of adequate testing infrastructure from the beginning. Testing is key to a pandemic response—the more data officials have about an outbreak, the better equipped they are to respond. Rather than call for more testing, Trump has instead suggested that maybe the U.S. should be testing less. He has repeatedly, and incorrectly, blamed increases in new cases on more testing. “If we didn’t do testing, we’d have no cases,” the President said in June, later suggesting he was being sarcastic. But less testing only means fewer cases are detected, not that they don’t exist. In the U.S. the percentage of tests coming back positive increased from about 4.5% in mid-June to about 5.7% as of early September, evidence the virus was spreading regardless of whether we tested for it. (By comparison, Germany’s overall daily positivity rate is under 3% and in Italy it’s about 2%.)
Testing in the U.S. peaked in July, at about 820,000 new tests administered per day, according to the COVID Tracking Project, but as of this writing has fallen under 700,000. Some Americans now say they are waiting more than two weeks for their test results, a delay that makes the outcome all but worthless, as people can be infected in the window between when they get tested and when they receive their results.
Most experts believe that early on, we did not understand the full scale of the spread of the virus because we were testing only those who got sick. But now we know 30% to 45% of infected people who contract the virus show no symptoms whatsoever and can pass it on. When there’s a robust and accessible testing system, even asymptomatic cases can be discovered and isolated. But as soon as testing becomes inaccessible again, we’re back to where we were before: probably missing many cases.
Seven months after the coronavirus was found on American soil, we’re still suffering hundreds, sometimes more than a thousand, deaths every day. An American Nurses Association survey from late July and early August found that of 21,000 U.S. nurses polled, 42% reported either widespread or intermittent shortages in personal protective equipment (PPE) like masks, gloves and medical gowns. Schools and colleges are attempting to open for in-person learning only to suffer major outbreaks and send students home; some of them will likely spread the virus in their communities. More than 13 million Americans remain unemployed as of August, according to Bureau of Labor Statistics data published Sept. 4.
U.S. leaders have largely eschewed short- and medium-term unflashy solutions in favor of perceived silver bullets, like a vaccine—hence the Administration’s “Operation Warp Speed,” an effort to accelerate vaccine development. The logic of focusing so heavily on magic-wand solutions fails to account for the many people who will suffer and die in the meantime even while effective strategies to fight COVID-19 already exist.
We’re also struggling because of the U.S. health care system. The country spends nearly 17% of annual GDP on health care—far more than any other nation in the Organisation for Economic Co-operation and Development. Yet it has one of the lowest life expectancies, at 78.6 years, comparable to those in countries like Estonia and Turkey, which spend only 6.4% and 4.2% of their GDP on health care, respectively. Even the government’s decision to cover coronavirus-related treatment costs has ended up in confusion and fear among lower income patients thanks to our dysfunctional medical billing system.
The coronavirus has laid bare the inequalities of American public health. Black Americans are nearly three times as likely as white Americans to get COVID-19, nearly five times as likely to be hospitalized and twice as likely to die. As the Centers for Disease Control and Prevention (CDC) notes, being Black in the U.S. is a marker of risk for underlying conditions that make COVID-19 more dangerous, “including socioeconomic status, access to health care and increased exposure to the virus due to occupation (e.g., frontline, essential and critical infrastructure workers).” In other words, COVID-19 is more dangerous for Black Americans because of generations of systemic racism and discrimination. The same is true to a lesser extent for Native American and Latino communities, according to CDC data.
COVID-19, like any virus, is mindless; it doesn’t discriminate based on the color of a person’s skin or the figure in their checking account. But precisely because it attacks blindly, the virus has given further evidence for the truth that was made clear this summer in response to another of the country’s epidemics, racially motivated police violence: the U.S. has not adequately addressed its legacy of racism. The line for a drive-through food pantry in Grand Rapids, Mich. Neil Blake—The Grand Rapids Press/AP
Americans today tend to value the individual over the collective. A 2011 Pew survey found that 58% of Americans said “freedom to pursue life’s goals without interference from the state” is more important than the state guaranteeing “nobody is in need.” It’s easy to view that trait as a root cause of the country’s struggles with COVID-19; a pandemic requires people to make temporary sacrifices for the benefit of the group, whether it’s wearing a mask or skipping a visit to their local bar.
Americans have banded together in times of crisis before, but we need to be led there. “We take our cues from leaders,” says Dr. David Rosner, a professor at Columbia University. Trump and other leaders on the right, including Gov. Ron DeSantis of Florida and Gov. Tate Reeves of Mississippi, respectively, have disparaged public-health officials, criticizing their calls for shutting down businesses and other drastic but necessary measures. Many public-health experts, meanwhile, are concerned that the White House is pressuring agencies like the Food and Drug Administration to approve treatments such as convalescent plasma despite a lack of supportive data. Governors, left largely on their own, have been a mixed bag, and even those who’ve been praised, like New York’s Andrew Cuomo, could likely have taken more aggressive action to protect public health.
Absent adequate leadership, it’s been up to everyday Americans to band together in the fight against COVID-19. To some extent, that’s been happening—doctors, nurses, bus drivers and other essential workers have been rightfully celebrated as heroes, and many have paid a price for their bravery. But at least some Americans still refuse to take such a simple step as wearing a mask.
Why? Because we’re also in the midst of an epistemic crisis. Republicans and Democrats today don’t just disagree on issues; they disagree on the basic truths that structure their respective realities. Half the country gets its news from places that parrot whatever the Administration says, true or not; half does not. This politicization manifests in myriad ways, but the most vital is this: in early June (at which point more than 100,000 Americans had already died of COVID-19), fewer than half of Republican voters polled said the outbreak was a major threat to the health of the U.S. population as a whole. Throughout July and August, the White House’s Coronavirus Task Force was sending private messages to states about the severity of the outbreak, while President Trump and Vice President Mike Pence publicly stated that everything was under control.
Truly worrying are the numbers of Americans who already say they are hesitant to receive an eventual COVID-19 vaccination. Mass vaccination will work only with enough buy-in from the public; the damage the President and others are doing to Americans’ trust in science could have significant consequences for the country’s ability to get past this pandemic. Cardboard cutout “fans” at an L.A. Angels baseball game Jae C. Hong—AP
There’s another disturbing undercurrent to Americans’ attitude toward the pandemic thus far: a seeming willingness to accept mass death. As a nation we may have become dull to horrors that come our way as news, from gun violence to the seemingly never-ending incidents of police brutality to the water crises in Flint, Mich., and elsewhere. Americans seem to have already been inured to the idea that other Americans will die regularly, when they do not need to.
It is difficult to quantify apathy. But what else could explain that nearly half a year in, we still haven’t figured out how to equip the frontline workers who, in trying to save the lives of others, are putting their own lives at risk? What else could explain why 66% of Americans—roughly 217.5 million people—still aren’t always wearing masks in public?
Despite all that, it seems the U.S. is finally beginning to make some progress again: daily cases have fallen from a high of 20.5 per capita in July to around 12 in early September. But we’re still well above the springtime numbers—the curve may be flattening, but it’s leveling out at a point that’s pretty frightening. Furthermore, experts worry that yet another wave could come this winter, exacerbated by the annual flu season.
There are reasons for optimism. Efforts to create a vaccine continue at breakneck speed; it’s possible at least one will be available by the end of the year. Doctors are getting better at treating severe cases, in part because of new research on treatments like steroids (although some patients are suffering far longer than expected, a phenomenon known as “long-haul COVID”). As the virus rages, perhaps more Americans will follow public-health measures.
But there is plenty of room for improvement. At the very least, every American should have access to adequate PPE—especially those in health care, education, food service and other high-risk fields. We need a major investment in testing and tracing, as other countries have done. Our leaders need to listen to experts and let policy be driven by science. And for the time being, all of us need to accept that there are certain things we cannot, or should not, do, like go to the movies or host an indoor wedding.
“Americans [may] start to say, ‘If everyone’s not wearing masks, if everyone’s not social distancing, if people are having family parties inside with lots of people together, if we’re flouting the public-health recommendations, we’re going to keep seeing transmission,’” says Ann Keller, an associate professor at the UC Berkeley School of Public Health.
The U.S. is no longer the epicenter of the global pandemic; that unfortunate torch has been passed to countries like India, Argentina and Brazil. And in the coming months there might yet be a vaccine, or more likely a cadre of vaccines, that finally halts the march of COVID-19 through the country. But even so, some 200,000 Americans have already died, and many more may do so before a vaccine emerges unless America starts to implement and invest in the science-based solutions already available to us. Each one of those lives lost represents an entire world, not only of those individuals but also of their family, friends, colleagues and loved ones. This is humbling—and it should be. The only path forward is one of humility, of recognition that if America is exceptional with regard to COVID-19, it’s in a way most people would not celebrate.