Almost two months ago, I published an article with a simple, incomplete, but very telling chart: a comparison of coronavirus cases in the US and Italy.
It seems like a lifetime ago. Coronavirus cases were peaking throughout much of Europe, Italy was the global epicenter of the pandemic, and the US had under 50,000 cases — yet I argued that an absolute disaster was brewing in the US.
Reactions were vitriolic, but it was not unsurprising — it’s not our first rodeo with negative comments, and, admittedly, it was a rudimentary comparison, aimed at highlighting a problem more than anything else
Unfortunately, it’s happening again. Coronavirus cases in the US are surging, and there are reasons to be very concerned.
Wearing masks and lockdown: it worked in Europe
Putting the US and Italy on the same chart wouldn’t even make much sense anymore, but we’ll do that anyway just to see how much things have changed in the past few months. In fact, let’s compare the US with the entire European Union.
If the US had problems with centralized action and left the states to fend for themselves, the EU isn’t even a confederation — it’s a union of independent states. The EU population (446 million) is larger than the US population (328 million), and that is depicted in the per capita chart above.
European countries, despite representing a political, cultural, and social mish-mash bearing striking individual differences, have generally had a remarkably unitary response. Masks have become a common occurrence in most places, and, even as some wavered in their initial response, no EU country ignored the virus. Meanwhile, the US federal response has been erratic, controversial, and contradictory at times. From President Trump’s tirades on hydroxychloroquine, his distasteful “joke” about injecting bleach, and his recent idea to slow down testing to report fewer cases, the US has suffered from a lack of coherent leadership. Instead, US leadership has politicized intervention measures so much that even wearing face masks, a simple epidemiological measure, can carry political significance.
In addition to the difference in wearing face coverings, lockdowns were very different in Europe than in most of the US. Excluding Sweden as a small but notable outlier, you’d struggle to find a European country that hasn’t had a lockdown lasting for around two months. This was not done without effort or sacrifice in Europe — nor has it always enjoyed full political support — but it has been done, and the results are visible.
No European country is out of the woods, but the curve has been flattened convincingly, and while some countries are seeing an increase in cases following relaxation, there isn’t a full-blown outbreak in Europe.
Meanwhile, the US has vehemently refused a widespread lockdown, even as it had seen what New York was going through.
It may be “worse politics”, but the “bad medicine” part aged like milk. If anything, what the US is doing now seems to be bad medicine, and a lot of it is owed to the politicization of the pandemic.
See, you’ll find countries all over the political spectrum in Europe. You’ll find the right and very non-liberal likes of Poland and Hungary, the left-wing social-democrats of Portugal and Spain, the centrist leaders of Germany and France, and all sorts of spotted alliances. Yet there was no major pattern in how political leaning affected how countries dealt with the pandemic.
Looking at the response in states such as Texas and Florida. ‘Clearly this is real’, Florida governor said of the coronavirus spread, after months of downplaying the risks. He then claimed it’s not a cause for concern and blamed it on immigrants. In Arizona, Governor Doug Ducey told citizens they need to learn to live with the coronavirus and refused to support wearing face masks. Meanwhile, Arizona has set records for the number of people hospitalized with coronavirus and hospitals are nearing capacity.
No doubt, you’ll find practical differences in how the rules were implemented, but the underlying principle was the same: a shelter in place to squash the first wave, and then a careful relaxing of the lockdown, especially when it comes to indoor places. Some deployed more efficient policies, some got better or worse results, some are seeing concerning new developments, but it’s nothing like what the US is reporting.
Today, the US is closer than ever to the nightmare scenario envisioned at the start of the pandemic: a nationwide crisis that seems to spread out of control and overwhelm the health system.
Initially, it was New York and New Jersey that fueled the pandemic, but now it’s almost everywhere. California, Texas, Florida, and most of the populous states are seeing increases in the number of cases. Nationwide, cases are up 30% compared to the beginning of this month, and hospitals are already struggling to cope. As Axios themselves put it, it is the “grimmest map” in weeks.
This is not owed to extra testing. The US positivity rate (the number of positive cases per test) is still higher than that those seen inser Europe (again, with the notable exception of Sweden), and the percentage has increased in the past weeks (original data here). Furthermore, hospitals in several states are reporting record numbers of hospitalizations. Make no mistake — this is not a side-effect of increased testing, the outbreak in the US is getting worse.
A perfect storm with few silver linings
Judging by what we’ve seen so far with this virus, the outbreaks have a lot of inertia. When the number of cases gets growing, it takes great time and effort to slow it down. We know that many people who are asymptomatic can still transmit the disease, and transmission chains are hard to detect.
To make matters even worse, the nationwide protests served as a potentially massive superspreader event, and there’s a good chance we will see the results of that soon as well.
The US is indeed far better prepared with testing than it was months ago, but whether it has sufficient testing capacity for all the country is a different matter. The one silver lining is that younger people seem to be making up a greater share of the cases, which means that the number of serious cases may not grow as much as in the past.
What’s next: Younger people are making up a greater share of all cases, and tend to be less susceptible to serious injury or death, so hopefully, this spike in new cases won’t be followed by an equivalent spike in deaths.
It’s a good time to remember the fact that the first wave of the Spanish Flu wasn’t nearly as devastating as the second one, which swept through the population mercilessly. The similarities are chilling, and one can only hope that the lessons of the past won’t come back to haunt us.
Although, this isn’t even the case here. The US isn’t in the second wave, it hasn’t even flattened its first one yet.