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The US set to hit 200,000 COVID-19 deaths, a symbol of national failure

Here in the US capital, the business district around the White House remains eerily deserted as most office workers stay at home. Public schools are closed, with all classes being conducted online – a decision that could have disastrous educational impacts for disadvantaged students. Meanwhile, you can eat indoors and visit the Smithsonian American Art Museum and go to the gym.

Life goes on – except when it doesn’t.

Two hundred thousand deaths means millions of grieving friends and relatives spread across the country. For Americans such as Rosie Davis – who lost her 75-year-old mother, Mary Castro, five days after she contracted COVID-19 – they are not just sorrowful but angry.

“Her preventable death is due to the most craven, callous failures of the federal and state government,” Davis wrote in a furious obituary published in her local newspaper, The Fort Worth Star-Telegram this month. “Her beautiful life should have never been collateral damage in their rush to reopen the economy.”

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In per capita terms, the US death toll remains behind other hard-hit countries such as Spain, Britain and Brazil. But it has been gaining ground on this metric. America’s per capita death rate now exceeds Italy, France and Sweden, which adopted a famously laissez-faire response to the virus. The US per capita death rate is more than twice as bad as neighbouring Canada, five times worse than Germany and 15 times worse than Australia.

The distinctive thing about America’s pandemic experience is how, at a national level, the virus has never truly been brought under control. Italy, France and Britain suffered devastating early waves but eventually brought their daily death counts down to single and double digits. In the US, the decline has been far less pronounced. Here the average daily death count peaked at 2200 in April, came down to 500 in July before bouncing back over 1000 deaths a day in August.

People have pre-existing conditions that make them especially vulnerable to the coronavirus and so do countries. The US had an array of co-morbidities that made the nation especially vulnerable to COVID-19. The virus has exposed, with fatal efficiency, the country’s underlying political, economic, medical and societal weaknesses.

First there was the country’s sprawling geography and decentralised political system. With 330 million people spread across 50 states, the nationally co-ordinated approach that many European countries used to drive down transmission rates was not possible in the US. The relatively steady national death toll obscures the way the outbreak shifted from states such as New York and New Jersey to Texas and Florida in the summer and now on to Alabama and Georgia following the reopening of college campuses there. There hasn’t been one national pandemic but a series of regional ones.

Each US state, and in many cases individual cities, has adopted its own rules on the reopening of businesses, wearing of face masks and post-travel quarantine.

Democratic presidential nominee Joe Biden has acknowledged he may not have the legal authority to implement a national mask mandate if he wins the November election: he would have to try to convince local mayors and governors to do so.

An estimated 45 per cent of Americans suffer from chronic diseases such as obesity, diabetes, heart disease and hypertension that put people in the high-risk category if they contract COVID-19.

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The country’s mostly for-profit health system is riven with wasteful spending and inequities; meanwhile spending for state and local public health departments has dropped by almost one-fifth since 2010.

Robert Redfield, the head of the Centres for Disease Control and Prevention, recently said the US had failed to appropriately invest in public health for more than five decades.

The Brookings Institution estimates that 44 per cent of all US workers are low wage, with median annual earnings of US$18,000 ($24,000). Many are restaurant workers, bus drivers and grocery store clerks – jobs that put them at high risk of contracting the virus.

If they lose their job, they lose access to their employer-funded health insurance. Emergency unemployment payments approved by Congress expired at the end of July, forcing people back to work if they want to be able to pay their rent and bills.

President Donald Trump has held packed indoor rallies, breaching local coronavirus rules.

President Donald Trump has held packed indoor rallies, breaching local coronavirus rules. Credit:Getty

Given America’s particular vulnerabilities, any US President is likely to have struggled to contain the outbreak. But the Trump administration has been notably inept.

First Trump downplayed the virus, saying it would “miraculously” go away; then he pressured state governors to rapidly reopen their economies, ignoring his administration’s own guidelines. He put too much faith in illusory miracle cures such as hydroxychloroquine while ridiculing effective prevention tools such as face masks. He recently held a packed indoor rally in Nevada where most attendees did not wear masks – a blatant breach of that state’s regulations.

A minor bright spot is that more recent surges in COVID-19 cases haven’t translated into the huge number of deaths seen early in the pandemic.

Doctors have developed better techniques for treating the virus and many of those catching the virus now are young and relatively healthy. A vaccine is hopefully on the way, even if it is likely to take longer to be widely available than Trump suggests.

In the meantime, winter is coming. The colder weather will send people back indoors where the virus can spread more easily.

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The University of Washington’s Institute for Health Metrics and Evaluation projects that 415,000 people will die from COVID-19 by the end of the year – a doubling of the national death toll in just three months. The figure seems hard to believe, but then so did the estimate of 200,000 deaths when Fauci first offered it.

As much as Americans may wish otherwise, their nation’s great coronavirus failure is nowhere near over.

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Our weekly newsletter will deliver expert analysis of the race to the White House from our US correspondent Matthew Knott. Coming soon. Sign up now for the Herald‘s newsletter hereThe Age‘s hereBrisbane Times‘ here and WAtoday‘s here

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