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Dying in a Leadership Vacuum

Kovid-19 has caused worldwide crisis. This crisis has tested leadership. With no good options for combating a novel pathogen, countries are forced to make difficult choices about how to respond. Here in the United States, our leaders have failed that test. They have taken a crisis and turned it into a tragedy.

The magnitude of this failure is surprising. According to the Johns Hopkins Center for Systems Science and Engineering,1 The United States leads the world in Kovid-19 cases and in deaths due to the disease, exceeding the numbers in large countries such as China. The death rate in this country is more than double that of Canada, higher than Japan, a country with a weak and elderly population, by a factor of about 50, and even lower rates in low-middle income countries Dwarf does, such as Vietnam by a factor of about 2000. Kovid-19 is a massive challenge, and many factors contribute to its severity. But what we can control is how we behave. And in the United States, we have consistently behaved poorly.

We know that we could have done better. China faced the first outbreak, choosing strict quarantine and isolation after initial delays. These measures were severe but effective, essentially ending transmission at the point where the outbreak began and reducing the death toll to 3 million per million compared to more than 500 per million in the United States. Countries that had more exchanges with China, such as Singapore and South Korea, began intensive testing, along with aggressive contact tracing and proper isolation and had relatively fewer outbreaks. And New Zealand has used the same measures, with these geographical measures, to come closer to eradicating the disease, something that would limit the time that the country was shut down and give society at a pre-standard level Allows to reopen. In general, not only have many democracies worked better than the United States, but they have outperformed us by orders of magnitude.

Why has America handled this epidemic so badly? We have failed at almost every step. We had enough warning, but when the disease first came, we were unable to test effectively and could not even provide the most basic personal protective equipment for healthcare workers and the general public. And we remain behind the curve in testing. While the absolute number of tests has increased significantly, the more useful metric is the number of tests performed by an infected person, a rate that puts us down the international list, such as below Kazakhstan, Zimbabwe and Ethiopia, countries that do not claim The biomedical infrastructure or manufacturing capacity that we have.2 Furthermore, the emphasis on developmental competence means that US test results are often delayed for a long time, rendering the results useless for disease control.

Although we focus on technology, most interventions that have major effects are not complex. The United States late and inconsistently instituted quarantine and isolation measures, often after implementing them without much effort, the disease had spread to a large extent in many communities. In many places the lack of our rules on social deformity has been at best, with the loosening of restrictions until adequate disease control was achieved. And in most parts of the country, people do not wear masks only, largely because our leaders have explicitly stated that masks are political tools rather than effective infection control measures. The government has invested reasonably heavily in vaccine development, but its rhetoric has politicized the development process and is leading to increased mistrust.

The United States came into this crisis with huge gains. With tremendous manufacturing capacity, we have a biomedical research system that is the envy of the world. We have enormous expertise in public health, health policy, and basic biology and are able to continuously transform that expertise into new treatments and preventive measures. And much of that national expertise resides in government institutions. Yet our leaders have chosen to ignore and even discredit the experts.

The response of our nation’s leaders has been consistently insufficient. The federal government has largely left disease control to the states. There is diversity in the reactions of governors, not by the party so competently. But whatever their capacity, governors do not have the equipment that Washington controls. Instead of using those devices, the federal government underestimated them. The Centers for Disease Control and Prevention, which was the world’s premier disease response organization, has been expelled and faced dramatic tests and policy failures. The National Institutes of Health has played an important role in vaccine development but is excluded from the government’s critical decision making. And the Food and Drug Administration has been shamefully politicized,3 Responding to pressure of administration rather than scientific evidence. Our current leaders have little faith in science and government,4 The loss that will surely outperform them. Rather than relying on expertise, the administration has turned to “opinion leaders” and character-less people who obscure the truth and facilitate outright lies.

Let us be clear about the cost of not taking simple steps. An outbreak that has inconsistently affected communities of color has increased tensions associated with inequality. Many of our children are missing at critical times in their social and intellectual development. The hard work of health care professionals, who have put their lives on the line, has not been used wisely. Our current leadership is proud of the economy, but while most parts of the world have opened up to some extent, the United States still suffers from a rate of illness that has prevented many businesses from reopening, resulting in hundreds of billions of dollars more Millions have been lost. Of jobs. And more than 200,000 Americans have died. Some deaths from Kovid-19 were inevitable. But, although it is impossible to project the exact number of additional American lives lost due to weak and unfair government policies, it is in an epidemic of at least tens of thousands more than any conflict already experienced since World War II Has killed more Americans.

Someone else carelessly wasted life and money in a way that would have legal consequences. Our leaders have largely claimed immunity for their actions. But this election gives us the power to decide. Reasonable people will certainly disagree about the many political positions taken by the candidates. But the truth is neither liberal nor conservative. When it comes to the response to the biggest public health crisis of our time, our current political leaders have demonstrated that they are dangerously incompetent. We should not stop them and allow them to keep their jobs to enable the deaths of thousands of Americans.

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