The US reports more than 82,400 COVID-19 cases, overtaking Italy and China in the total number of confirmed cases. The US is now the epicenter of the outbreak, as New York braces for weeks of crisis.

Scientists and media alike warned that the US was prone to a devastating COVID-19 outbreak. With its lack of universal health care, fumbled initial testing, mixed messages from Donald Trump, and no coherent plan, a storm was brewing.

Rising fast

It seems surreal, but just weeks ago, Donald Trump was issuing conferences saying that cases will “likely go down”, and New York City mayor Bill de Blasio was expressing confidence in his city’s ability to handle the crisis. Now, cases are expected to rise for approximately three weeks, and hospitals are already overflowing. De Blasio recently announced that he expects half of New Yorkers to get the virus.

As it is so often the case, the US has maybe more resources than anyone. The country had every opportunity to be prepared for this. Yet, as authorities ignored and then downplayed the risk of the virus, even as it spread from China to other countries, decisive action was taken when the virus had already established a foothold in the country. A series of missteps, including a failure to deploy mass testing in the initial phases of the outbreak left the US in a precarious, vulnerable situation.

The US is the richest country in the world, but many of its inhabitants don’t really feel that — because of a large economic inequality, 46.2 million Americans (or 15% of the country’s population) are considered impoverished.

The country is now forced to face its inequality in a novel way: while it undoubtedly has some of the best specialists and treatment facilities in the world, it also has a surprising amount of shortages: basics such as masks and protective gear for doctors and nurses on the front lines, as well as ventilators to keep the critically ill alive. The public health system, handicapped by years of underfunding, limped as it found itself unable to contain the outbreak. In 2017, public health represented just 2.5% of all health spending in the country.

Countries are increasingly starting to treat the pandemic as a war. If this is indeed the case, the Pentagon wasn’t ready. The President wasn’t ready. In truth, few were.

New York is one of the cities with the best hospitals in the world. The crown jewel of the US, a megacity that has inspired generations. If the mammoth New York is kneeling under the pressure, what does this mean for other areas in the country? If the disease continues to spread as it has so far, there is little good news. As many states are still hesitating to impose severe containment measures, there are concerns that New York is merely a sign of what is to come elsewhere.

You don’t make the timeline — the virus makes the timeline

Hopefully, lockdown and social isolation can prevent the virus from spreading. Donald Trump wants things to “reopen” the country by Easter, but that is simply unrealistic — or irresponsible.

For now, suppression is the top priority. The disease must be contained, as we’ve seen that is possible in China and other Asian countries. These countries are also concerned now about a potential second wave, but that’s a concern that the US can’t afford to prioritize right now.

When hospital admissions have started to drop, when the number of cases has stabilized and is decreasing, and when front-line workers have a moment to pause, then the long term strategy can be revised.

‘You don’t make the timeline, the virus makes the timeline’, Anthony Fauci emphatically and very correctly pointed out. This is a changing situation to which we must adapt and respond accordingly.

The US has misunderstood the situation and missed the start. But the race is far from over.

It may be months before US doctors start giving reassurances. It may extend into the summertime, or well beyond it. By that time, we can hope that the researchers working on the case (many of them inside the US) have made significant progress on treatments and vaccines. As always, the US has the resources to overcome this crisis. But it cannot afford any more missteps. The race is on.