Health and Healthcare Systems

How a US quirk became a strength for some areas fighting COVID-19

A member of Joint Task Force 2, composed of soldiers and airmen from the New York Army and Air National Guard, wears a face mask while carrying paper towels as he arrives to sanitize and disinfect the Young Israel of New Rochelle synagogue, as snow falls during the coronavirus disease (COVID-19) outbreak in New Rochelle, New York, U.S., March 23, 2020. REUTERS/Andrew Kelly - RC2RPF9XLLG9

A member of Joint Task Force 2, composed of soldiers and airmen from the New York Army and Air National Guard, wears a face mask while carrying paper towels as he arrives to sanitize and disinfect the Young Israel of New Rochelle synagogue, as snow falls during the coronavirus disease (COVID-19) outbreak in New York, US, 23 March 2020. Image: REUTERS/Andrew Kelly

John Letzing
Digital Editor, World Economic Forum
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  • A patchwork response to COVID-19 means some parts of the US have been able to independently make important containment progress.
  • That progress may provide hope for a country that is now the epicentre of the pandemic.

The US's historical aversion to big government did not necessarily serve it well when COVID-19 arrived.

The fragmented nature of US bureaucracy and healthcare delivery impacted everything from the availability of tests for the coronavirus, to obtaining ventilators, to the willingness of the infected to seek care. But it also meant some areas of the country were free to pursue relatively aggressive containment measures as they saw fit – in some cases demonstrating success and raising hopes for a nation that became the global epicentre of the pandemic as the month of March drew to a close.

Image: World Economic Forum

The number of reported COVID-19 fatalities varied widely among states as of 31 March – Hawaii had just registered its first case, there were 41 in Texas, 150 in California and a daunting 1,550 in New York.

Still, after an alarming outbreak, New Rochelle, a suburb north of hard-hit New York City, was able to implement drastic measures, including closing schools, religious buildings and other public buildings, and bringing in the National Guard to distribute supplies and clean. These measures rankled some people but contained the spread of the coronavirus.

Meanwhile, Seattle has seen some evidence that pursuing strategies like physical distancing at an early stage have slowed transmission, while data on fever levels published by a health technology company show that strict measures may be helping in a number of other locations. Still, confirmed cases continue to increase throughout the country at an alarming rate – as illustrated below.

Spread of COVID-19 in the US.
Spread of confirmed COVID-19 cases in the US. Image: World Economic Forum

Ultimately, America’s collective response effort has caused some to question whether there might be ways for it to better prepare for future health emergencies.

For more context, here are links to more reading courtesy of the World Economic Forum’s Strategic Intelligence platform:

  • Comparing US and South Korean responses to COVID-19 may not be fair, as the US government doesn’t have access to the same highly specific levers, this author argues. That’s by design and rooted in deep constitutional instincts about federalism. (Global Asia)
  • Why wasn’t the US prepared to quickly deploy COVID-19 tests? According to this analysis, the biggest obstacles to scaling testing capacity often boil down to shared behaviours, beliefs and values. (Harvard Business Review)
  • It’s also important to understand that testing isn’t a simple process. Here’s a behind-the-scenes look at all the steps involved. (Kaiser Health News)
  • The US's fail-safe mechanisms are being strained like never before, according to this analysis. (Harvard Kennedy School)
  • Among America’s shortcomings exposed by COVID-19: insufficient internet infrastructure, according to a former Federal Communications Commission official who writes that the country must build networks that can better respond to surges in demand. (Brookings)
  • While some public officials in the US have expressed concern that restrictive measures to curb COVID-19 would not be tolerated, survey research indicates that many Americans see the steps taken to date as reasonable. (Brookings)
  • Nearly two months ago, after senators tried unsuccessfully to allocate emergency funds for measures to prevent the domestic spread of COVID-19, the US government instead sent tons of donated medical supplies to China, this author explains. (Mother Jones)
  • Constraints on test kits make it hard to know exactly how many people in New York are really infected with COVID-19, these Harvard professors argue. They suggest an alternative approach: test a representative random sample of people from the state. (Vox)

On the Strategic Intelligence platform, you can find feeds of expert analysis related to COVID-19, Global Health and hundreds of additional topics. You’ll need to register to view.

Image: World Economic Forum
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