Global Health Blogs with Professor Swahn

     A number of countries had the COVID-19 outbreak before the United States giving us fair warning and plenty of time to prepare. Why have we failed so miserably? This is a conversation that’s been had several times at this point but it’s important in deciding how we move on at the occurrences of second waves of COVID-19. If we continue on like we are the deaths will continue to rise. COVID-19 is the pressing issue at hand but is really just exposing the faults that were already in the system like the disconnect between and public health and healthcare practices, poor decision making by political leader’s lack of compliance among the US and ideas like American exceptionalism.

It is no secret that the United States healthcare system is inefficient and full of inequities. Of the developed world we have the highest spending rates with equal or worst overall healthcare outcomes. The united states healthcare system charges more money for similar services and medications than other countries. We also generally recommend more services than needed to patients. Instead of making patients priority and acting from a patient centered view, money and politics are involved in the decisions made. The combination of many hospitals has reduced competition allowing prices to be raised. There are also a disproportionate amount of administrative cost of four times more than the average developed nation (excluding the US).

Oxford university create a scale to measure the response of different governments to the COVID 19 pandemic. This scale looks at how strict protocols were and what measures were taken. This includes quarantines, mask enforcement, contact tracing as well as things like stimulus checks to relieve financial pressures. The united states had a score 5.7 two weeks after their first confirmed case while South Korea had a score of 38. When comparing their deaths taking into account the population differences South Korea would have almost 2K deaths when the United States has 118K deaths. There was also a wide inconsistency in public policies. Different states issued stay at home mandates at various times and often didn’t implement them fir very long. Low testing rates led to a more rapid spread in the virus as unknown carriers continued to go out and live life to the fullest.

There is a loop of behavior happening. We underestimated it and spread the virus then got serious and hunkered down for quarantine then decided it wasn’t that bad again and spread it more. People are continuing to travel during the pandemic. I personally know plenty of people still taking trips. Looking at the bureau of transportation statistics travel dropped down 100 million people quick and sudden in from March to April but rose just as much by May. Travel has still decreased significantly from before the pandemic but looking at different times there is a pattern of panic and relief. When relief comes a heightened comfort level comes as well and travel begins again. Currently it looks like we might be on the rise.

There is a concept of American exceptionalism that is a cultural idea that the united states is better than everyone else in virtues like justice and freedom even among our constant failures and frankly embarrassing results across many domains. We are winning in mass incarceration, school shootings, most money spent on healthcare (With poor results) police brutality, debt and now COVID-19 cases. It’s really a perplexing argument to make with all this evidence against us. The dangers of this thinking blinds people to the idea that the United States can do wrong and deters them from being critical of policies and laws being implemented in our system. It’s a sort of blind trust that keeps those in office from taking responsibility for unjust decision making. Since the decision being made effect the lives of millions of Americans this is a dangerous concept to have. This hubris has allowed COVID-19 to run rampant in this country.

Another issue not spoken about enough is the debilitation and long-term effects of COVID-19. The focus has been on the worst-case scenario which can arguably be death. But there are worst results from contracting COVID-19. There have been many reports of lingering symptoms after contraction and recovery from COVID-19. The virus effects not only the lungs but the heart and brain as well. This sends patients home with many medications to treat these symptoms. Patients then have to take medical leave to continue recovery with thousands of dollars’ worth of medical bills. They then risk losing their job due to inability to work. Most Americans are provided insurance through their employers so this would be a tremendous blow on someone’s life especially if this insurance includes their children. Loss of employment can also lead to loss of housing. Our focus on death has shifted our perspective leaving those still alive to suffer dire consequences. That is why financial assistance is so important. Americans received one stimulus check since the pandemic started and our current president is threatening to withhold anymore unless he is reelected. Other than the fact that this is outrageous it is also very little compared to other countries. Canada for example gave 1400 for four consecutive months. In the Netherlands 90% of salaries were still paid out. The support given to the most vulnerable populations in America is beyond poor and must be addressed.

It is too late to reverse these deaths and those that have already contracted the virus. But, it is not too late for us as a community to comply with public health recommendations and come together to make the needed changes for a better and healthier future.