IS THE U.S. A WORLDWIDE PARIAH?

The initial response to Covid-19 is an indicator of the success of each country to the pandemic. President Trump only took the virus seriously when the stock market dropped precipitously in mid-March.  Trump administration was the 24^th to stop flights from China and 38^th to stop flights from Europe.  Even after the ban, 400,000 travelers mostly U.S. citizens, arrived from overseas and 40,000 from China.  The timeline and the responses from the most successful countries fighting the virus- Singapore, Hong Kong, Taiwan, and South Korea- are in stark contrast to the response of President Trump.

Trump, not the governors, was briefed on the virus and its potential through January and therefore Trump is the only one that could have done any of the hard work to initially control the virus.  His decisions early on can be shown to be not only inadequate, but borderline negligent. 

In a New York Times article Dated March 19^th 2020 by Hannah Beach, included an analysis of the three successful countries and their responses to the virus at that time.  I will add South Korea and additions to the United States to her analysis. South Korea was added, they have been successful as well. 

Below I updated her statistics on cases and deaths after 3 months, however the results are interesting.  I used John Hopkins University data from June 20^th, for the updates of current values. It can be seen there that the obvious success is when the virus was taken seriously and not ignored, until it hurt Trump’s chances for re-election.  After Trump found out he had created a no-win mess, he offloaded the responsibility to the states for a 50-state solution to this century’s greatest medical challenge.  That’s leadership for you.

SINGAPORE

Knowledge of the Covid-19 virus was first reported in December, originating in Wuhan, China.  Hannah wrote “At the beginning of the outbreak in China, Singapore was at high risk for having an influx of travelers from mainland China because of the Lunar New Year. But Singapore’s response appears to have largely stemmed off the viruses spread—at least on the scale seen in other countries.”  The transparency and rapid action with government intervention was based on prior viruses such as MERS and SARS.  Once the information that a respiratory virus was spreading in Mainland China, Singapore immediately banned travelers from China in late January. At that point, the WHO had not recommended the action and advised against the move.

Singapore immediately implemented mandatory quarantine and imposed criminal charges. They also had the capacity to test 2,000 people/day, soon after the lockdown.  “Vernon Lee, director of the communicable diseases division at Singapore’s Ministry of Health, said, “We want to stay one or two steps ahead of the virus. If you chase the virus, you will always be behind the curve.”  Singapore is a very strict state that regulates everything including flushing the toilet and chewing gum with fines imposed.

“Lalitha Kurupatham, deputy director of the communicable diseases division in Singapore, said, “Maybe it’s because of our Asian context, but our community is sort of primed for this. We will keep fighting, because isolation and quarantine work” (Beech, New York Times, 3/17; Johns Hopkins tracker, accessed 3/19).”  Singapore is a city state with a highly dense population.

There are currently 41,833 confirmed cases and only 26 deaths in Singapore through 20 June, 2020 according to John Hopkins University of Medicine.

HONG KONG

“…. the population of Hong Kong seemed immediately ready to implement disease prevention measures, having learned its lessons from the large death toll it suffered after the 2003 SARS outbreak, in which almost 300 people died, Beech reports. Soon after people caught news of the new coronavirus, they were using hand sanitizer and malls and offices had set up Thermal scanners”  Hannah Beach reported, “Kwok Ka-ki, a lawmaker and doctor in Hong Kong, said, “The most important thing is that Hong Kong people have deep memories of the SARS outbreak. Every citizen did their part, including wearing masks and washing their hands and taking necessary precautions, such as avoiding crowded places and gatherings ”

“Eventually the government of Hong Kong implemented tighter border controls and ordered civil servants to telework, which led other companies to do the same, Beech reports. Hong also closed schools in January…”

As of June 20, 2020 according to John Hopkins University of Medicine, Hong Kong had 1,128 confirmed cases and 5 confirmed deaths.  This is excellent since the population density of Hong Kong is similar to that of New York where the east coast epicenter of the pandemic.

TAIWAN

The Times article continues; “Taiwan also acted quickly, utilizing its national health command center that was set up after the SARS outbreak, to begin screening passengers flying in from Wuhan, before the Chinese government had admitted the virus spread between humans. Joseph Wu, Taiwan’s foreign minister said, “Having learned our lesson before from SARS, as soon as the outbreak began, we adopted a whole-of-government approach.”

“By January’s end, the country suspended all flights from China and began integrating its health insurance database with information from immigration and customs to begin tracking potential cases of COVID-19, according to Jason Wang, director of the Center for Policy Outcomes and Prevention at Stanford University.”

There are 446 confirmed cases of the virus and 7 confirmed deaths in Taiwan according to John Hopkins University of Medicine as of June 20, 2020.

SOUTH KOREA

Again, their experience with swine flu, SARS, MERS and other viruses that emit from China on a regular basis prepared them for Covid-19 pandemic.  When the World Health Organization offered 250,000 test kits to the United States and we said we were fine with our faulty kits, South Korea obtained the kits and immediately used them to isolate and trace and locked down.  This is an example of how immediate response limits the impact.  Our first confirmed case was at the same time as South Korea’s, yet look at the difference.

There are 12,373 confirmed cases of the virus and 280 confirmed deaths in South Korea according to John Hopkins University of Medicine as of June 20, 2020.

UNITED STATES

Since we were so late in the initialresponse to the virus, the only tool left in the arsenal is testing, contact tracing and isolation.  The one thing that is known to slow the numbers of infections are masks. At his Tulsa rally on the 20^th The President said he “slow the testing down please” so the to keep the numbers down, maybe we shouldn’t test.  Denial is the world’s longest river.  With Trump, it’s the optics not the substance. If it can’t be seen it doesn’t exist like a preschooler.   It’s only, “don’t make me look bad I’m trying to be re-elected!”.  When you deny science you also deny the truth.

Why are we at 119,112 confirmed deaths and over 2,220,961 confirmed cases?  With 4.5% of the worlds population and 26% of the worlds deaths., what could explain the inequity?  The Times article suggested two potential explanations, which ignores the Trump delays when the article was published on the 19^th of March 2020.  The two below are only excuses for lack of preparation and response time.

The first is monitoring, contact tracing, with the experience with SARS being prepared.  The second point was made by Hannah Beech as reported; “There’s also the question of scale—how to implement a model used by smaller Asian centers into larger Western countries. Citizens of Western countries may also balk at the idea of the government using closed-circuit television cameras or immigration records to monitor coronavirus cases.”

Facemasks and hand washing rituals are instilled in the Asian communities and has helped to control the outbreak.  Optional does not work in a pandemic.  Masks should be made mandatory, with fines for non-compliance and the proceeds used to supply masks for the medical community.

The EU has approximately the same population as the United States and is just as diverse.  The EU is on the downturn in cases and is opening without the spikes in the numbers of cases and currently appear to have conquered the virus.  When you look at the data, we have flattened the curve and not reduced the numbers of cases since its peak.  I guess that flattening the curve in some ways is a success until the fall spike?

Trump was late in taking the virus seriously and has continued to think that testing is no big deal when testing, isolation and contact tracing is the only way we can return to normal without a vaccine or other prophylactics.  Masks and social distancing will slow the transmission and should be mandatory not optional.  Trump has downplayed and poo pooed masks and flaunts social distancing.  Testing and contact tracing, according to the medical experts, was and is totally inadequate.

Just look at the actions of the successful countries, using strong leadership and tried and true methods. These countries managed not to totally disrupt their economies by using their methods.  When you must be in quarantine for 3 weeks if you are traveling abroad, are you a pariah? With our infection rates- yes- we are becoming a worldwide pariah.

There are 2,220,961 confirmed cases of the virus and 119,112 confirmed deaths in the United States, according to John Hopkins University of Medicine as of June 20, 2020.  Our response can be considered pathetic.