Before the COVID-19 pandemic broke out, health experts considered the United States one of the best-positioned countries to deal with outbreaks of infectious diseases. Out of 195 countries ranked in the 2019 Global Health Security Index, the United States ranked first. But unfortunately, the United States was, in fact, ill-prepared for a real pandemic as we enter the third year of COVID-19.
Americans have suffered more COVID-19-related deaths than any other high-income country by 63 percent. There are 295 deaths per 100,000 people in the United States, compared to In Canada, there are 99 cases per 100,000, 152 in Germany, and 245 in the United Kingdom.
Many factors contributed to the U.S. response’s failure, and these will be discussed in detail over the coming years. The challenges range from an avalanche of misinformation stemming from communication challenges to a vaccine campaign that lags behind Australia, Canada, and most European nations. In addition, it is difficult for the fragmented health care system in the United States to cope with large-scale emergencies. In addition, the American health care system itself faces challenges. These problems existed long before COVID was introduced: access to care, health inequity, and underlying conditions.
Looking at how different countries have responded to COVID-19’s multiple waves over the past two years, one can find some practices that shine brighter than others. There has not been a perfect response from any country. For example, China’s zero-COVID policy has led to low morbidity and mortality rates in the first two years of the pandemic, but at a high cost. In addition to social isolation and a constant cycle of lockdowns. This strategy is unlikely to work with the highly contagious Omicron variant and its sublineages, such as the more infectious BA.2.variant. South Korea and Hong Kong, two regions that successfully mitigated the virus during its first two years, are now dealing with high cases and deaths. COVID responses worldwide offer a great deal of insight for the United States. Still, it should instead concentrate on a few steps it can take bothIt would be better if it focused on a few steps it can take legally and politically, including addressing misinformation and improving scientific communication, encouraging trust in government, and enhancing the public health data infrastructure in the United States.
Swabs and test shots
The United States failed to test enough in the early stages of the pandemic. Now that more rapid antigen tests are manufactured and distributed, U.S. officials can credibly claim that anyone can get a test. In November, however, the Omicron variant was soaring in popularity and demand in the United States. The number of tests currently available has grown due to reduced demand. However, most Europe offered ubiquitous testing much earlier, often free of charge or minimal cost. Rapid testing in public health was recognized much earlier in many European and Asian countries. As a result, international travelers were able to reduce quarantine periods by identifying infected people and cutting down on transmission chains. In Germany, Slovakia, and the United Kingdom, rapid antigen testing has become as routine as brushing one’s teeth due to this testing framework and removing barriers such as cost and availability. COVID-positive people could rapidly limit their exposure to others because of this culture of frequent testing. If U.S. regulatory approvals for new tests were faster and frequent antigen testing had been implemented earlier during the pandemic, some of the nearly 80 million confirmed cases of COVID-19 could have been prevented which, in turn, could have prevented some of the 969,000 U.S. deaths. COVID-related deaths. Today, the question isn’t whether the United States can maintain its testing capacity but whether it can continue funding levels under threat in Congress. In terms of vaccine supplies, the United States has been on top. Nevertheless, millions of eligible Americans remain unvaccinated despite three safe and effective COVID-19 vaccines. Around 18 percent of the population had not yet received a single dose as of March 21.
The vaccination campaign has faced several obstacles, including vaccine hesitancy, misinformation, disinformation, politics of public health, and widespread anti-science attitudes. The United States ranks 65th and 70th for vaccination rates, as 65 percent have been fully vaccinated and 29 percent have received a booster shot. United Arab Emirates: 98 percent vaccinated, and 50 percent boosted; Portugal: 92 percent and 61 percent; and Canada: 83 percent and 48 percent.
The vaccination campaign has faced several obstacles, including vaccine hesitancy, misinformation, disinformation, politics of public health, and widespread anti-science attitudes. As a result, the United States ranks 65th and 70th for vaccination rates, as 65 percent have been fully vaccinated and 29 percent have received a booster shot. United Arab Emirates: 98 percent vaccinated, 50 percent boosted; Portugal: 92 percent and 61 percent; and Canada: 83 percent and 48 percent.
No country has achieved a perfect pandemic response
In addition to access barriers, such as time off to get vaccinated and having to travel to get a dose, low trust in the government, and a lack of community cohesion are contributing factors to low vaccination rates in the United States. COVID-19 National Preparedness Collaborators conducted an exploratory analysis, which demonstrated the importance and consequences of trust in government and trust in communities, correlated with high vaccine coverage in middle and high-income countries.
The most challenging part of the pandemic response involves informing the public, inspiring trust in government, and empowering them to take needed precautions to protect themselves and their families from an emerging infectious disease. Almost every country has struggled with this, though some started with a stronger trust in government. But some countries just used their previous experience with viral outbreaks. Knowing that COVID posed a threat led them to take swift action. Communication between trusted messengers and the public has been essential in maintaining trust. New Zealand and Germany have been particularly successful in providing reliable, science-based information to their people. The message was received well because the messenger and the message were communicated openly and honestly. While the importance of crisis communication cannot be overstated, there is still a lack of training in the field, especially in how to counter misinformation. The importance of communication must be put first in all countries, and it should be incorporated into advanced medical, scientific, and public health training programs.
Information wars
A vital shortcoming of the U.S. response to the pandemic has been its reliance on other countries’ clinical and epidemiological data, such as who should receive a booster dose. In the United States, Israel has been leading the way to boost demand for vaccinations. In the United States, one of the gravest pandemic deficiencies is the lack of standardized data collection and real-time reporting and interpretation. This has been known for decades. “Our country has neglected its public health data infrastructure, which is often aging, outdated, and insufficient to meet our needs … Progress was limited due to lack of funds and legal authority.” former directors of the Center for Disease Control and Prevention wrote; earlier this month..” Public health agencies collect and store data in different ways.
In contrast, health care is privatized, posing challenges for integrating clinical and epidemiological data. In addition, health care and public health systems do not communicate with each other, and there is little interoperability for sharing critical data. In contrast, the United Kingdom has benefited from its standardized medical procedures and its ability to perform large-scale clinical trials. Danish, Israeli, and South Korean surveillance systems are also among the most sophisticated globally. U.S. researchers are exploring ways to address this challenge, including incentivizing data sharing and creating new strategies for large-scale clinical trials.
The United States has a tough time keeping up with the virus as it evolves. World Health Organization executive director Mike Ryan said it best: “Speed trumps perfection.” When it comes to emergency response, “perfection is the enemy of effectiveness.” The United States has been slow to implement policy measures, including non-pharmaceutical interventions such as mask mandates. In February 2021, shortly after the Biden administration took office, the federal mask mandate for public transportation was introduced a full year after the pandemic began. In addition, regulatory agencies have been slow to approve critical pandemic products; for example, the Food and Drug Administration took a long time to approve rapid at-home tests and acknowledge their value as a public health tool. The United States has also rolled back other measures, such as lifting mask ordinances in some states or reducing surveillance testing. Despite the federal government’s efforts, the bottom-up approach in the United States has resulted in an uncoordinated, uncollaborative response. Instead, each state of the United States has a different epidemic.
Countries that implemented rapid responses to COVID-19, such as Taiwan, Singapore, and Hong Kong, have previously dealt with pandemic threats, such as SARS 20 years ago and the ongoing threat of avian influenza. As a result of their prior outbreak experience, these countries were equipped to deal with a pandemic with a high level of trust from the population. As with COVID-19, one can only hope that the next time the United States is faced with an infectious disease threat, it will have better instincts.
A next chapter
In the United States, COVID-19 has now entered its third year, resulting in a mass casualty event every single day. While many consider this current period a lull, more than 1,000 deaths are still reported each day. The time has come to prepare for future outbreaks and stay one step ahead of this virus. COVID-19 preparedness plan by the Biden administration has four main goals: prevent and treat COVID-19, prepare for variants, prevent economic and educational shutdowns, and continue vaccinations. Even though the U.S. government’s spending package removed funding for this plan, it is not certain that a standalone, supplemental bill will pass. Congressional inaction could have severe consequences for the American people.
The United States still has a lot of work to do, including revolutionizing and investing in public health infrastructure, bridging data integration between disparate health care systems, and changing the reactive mindset of the country. There is a lot to be accomplished. There will need to be a reestablishment of a sense of community and a restoration of trust in the government. In addition, it will require recommitting to public health and the health care workforce, which is still reeling from two years of nonstop emergency response with morale at an all-time low. The government will have to provide leadership and resources for these efforts. U.S. policy on bubble gum and Band-Aids must end with this pandemic.
