Why the U.S. and U.K. Failed Their Coronavirus Responses

Why the U.S. and U.K. Failed Their Coronavirus Responses

On Oct. 24, 2019—45 days before the world’s first suspected case of COVID-19 was announced—a new “scorecard” was published called the Global Health Security Index. The scorecard ranked countries on how prepared they were to tackle a serious outbreak, based on a range of measures, including how quickly a country was likely to respond and how well its health care system would “treat the sick and protect health workers.”

The U.S. was ranked first out of 195 nations, and the U.K. was ranked second.

You read that correctly. The two countries that on paper were the best prepared to deal with a pandemic turned out by June 2020 to be two of the world’s biggest failures in tackling COVID-19.

With 122,300 excess deaths—the number of deaths over and above what would be expected in non-crisis conditions—the U.S. ranks number 1 on this metric. In second place, with 65,700 excess deaths, is the U.K.

There’s a reason the scorecard got it so wrong: It did not account for the political context in which a national policy response to a pandemic is formulated and implemented.

There is an eerie similarity in the appalling political decisions made by President Donald Trump and Prime Minister Boris Johnson—two right wing “illiberal populist” leaders who believed their nations were invulnerable, generally rejected science, and turned inwards and away from multilateralism.

Their parallel decisions consigned many of their citizens to the grave.

Even before COVID-19 hit, Trump and Johnson had devalued the importance of public health investment and degraded their national pandemic preparedness capabilities.

One week before Trump’s inauguration, the outgoing Obama administration urged its replacement team to get ready for a pandemic that could be the worst since influenza in 1918, warning of possible ventilator shortages and stressing the importance of a coordinated federal response.

The Trump team reportedly dismissed the advice. Instead, in May 2018, Trump shut down a White House office devoted to pandemic preparedness that President Obama set up after the 2014-2016 Ebola epidemic.

And while the Trump Administration’s requests for deep cuts overall to the CDC were repeatedly rejected by Congress, the White House did succeed in gutting the CDC’s Public Health Science and Surveillance program, which plays a key role in outbreak preparedness.

Across the Atlantic, a decade of austerity politics that had weakened public health was compounded by Brexit. In 2016, Britain ran a simulation exercise codenamed “Cygnus,” which revealed that the country would face a massive shortage of ventilators and personal protective equipment (PPE) for health workers if a pandemic struck.

Yet an investigation by the Times of London found that addressing these shortcomings was “put on hold for two years while contingency planning was diverted to deal with a possible no-deal Brexit.”

On January 23, 2020, the World Health Organization told all countries that they were at risk of a COVID-19 epidemic, telling them to get prepared “for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread.”

It is a tragedy that both the U.S. and U.K. failed to recognize the risk to their nations, believing that their own exceptionalism would pull them through and that outbreaks were something that happened elsewhere in the world. A deep faith in their national greatness had been the very basis of their epidemic preparedness programs prior to COVID-19.

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