On January 15th, COVID-19 showed up in the United States. On February 27, at a time when there were just over a dozen cases, Trump said “When you have 15 people, and the 15 within a couple of days is going to be down to close to zero, that’s a pretty good job we’ve done”.
Today, we have over 1000 cases, and we haven’t started taking any meaningful action in attempting to contain this outbreak. (As I write this, I’m learning of Trump’s travel ban on people coming from Europe. While this is certainly an action, it will be of limited effect now that the outbreak is already here.)
“It doesn’t even do anything to impact the epidemic…The idea [the travel ban] would reduce transmission here is not based on evidence.” — Lawrence Gostin, Global Health Law Professor, Georgetown University
This is, unquestionably, going to get worse before its gets better. The question is how much worse, and for how long. If Europe is any indication, especially when contrasting the social infrastructures of afflicted nations compared to the United States, the U.S. is going to have a much harder time than just about anywhere else.
Why COVID-19 Is Likely To Infect Most Americans
That may seem like a bold statement, even entering the realm of fear mongering, but it’s worth examining just how likely this outcome is. Germany’s Chancellor Andrea Merkel said recently that “Given a virus for which there is no immunity and no immunization, we have to understand that many people will be infected. The consensus among experts is that 60 to 70 percent of the population will be infected.”
That “apocalyptic” scenario assumes that little action is taken to prevent the spread. But that lack of response is exactly what we are seeing in the United States. With a public health system that lacks far behind many other major nations, it’s worth considering that “worst case” is also “likely case”.
With a public health system that is already failing working Americans, and an administration that has done nothing to stop the spread of this virus in the United States, the worst case seems nearly certain.
One of the biggest challenges the United States is likely to face is compelling the working class into self quarantine. They are, to put it lightly, not in a position to handle an interruption to their incomes. A recent study showed that 40% of Americans lack the ability to cover a $400 emergency from their cash savings. Most working Americans — especially those in retail and hospitality , those with the most contact to others — also don’t have any form of paid sick leave. It’s not hard to see that even symptomatic individuals will be financially unable to abide by self quarantine orders. This represents a seemingly unavoidable powderkeg of viral spread.
When you have a workforce that can’t afford to miss a shift, and no safety nets through paid sick leave to protect them, the likelihood of slowing the spread of a virus drops to exactly zero.
If self-quarantine measures are sure to fail us in spectacular fashion, that means we have to look to other places for containment — public health systems, and government implemented measures.
Public health care is not going to fare well. That same struggling working class often lacks health care coverage — because the symptoms of this virus aren’t severe, many simply won’t seek treatment until they absolutely have to. Without doctors visit to get a proper diagnosis, quarantine isn’t even on the table — you can’t contain what isn’t being presented to you.
Public health measures will do all they can to save as many lives as possible — containment is something that will be well beyond their abilities this late in the outbreak game.
That leaves government intervention. Republicans have cried that the response and event at large have been unfairly politicized. While I disagree, siding with the idea that President Trump’s downplaying and contradictions are tantamount to throwing gas on a lit fire, let’s also admit this: even the most competent and proactive administration would have likely failed to respond fast enough to this quickly moving threat.
If we can admit that, the perceived ineptitude of the current administration matters less: instead of the outbreak infecting 200M people, a complete and instant response could have cut that number in half. But it seems unlikely that once we refused to lock down communities at the first few cases, we stood any chance at containing this virus from spreading to most major cities in America, and then out from there.
Government measures won’t be effective in containing this outbreak.
For those reasons, the estimates that this could infect 50–70% of Americans seem far less than outlandish. Based upon a 2% fatality rate, experts estimating a range between 1% and 3%, that puts us at as many as 230M infected, and over 4M fatalities.
Without paid sick leave and access to health care, the vast majority of Americans simply cannot stand to self quarantine. With a public health system that is already failing working Americans, and an administration that has done nothing to stop the spread of this virus in the United States, the worst case seems nearly certain.
European countries with these measures already in place are struggling bad to find containment. Without these measures, I wonder if we stand any hope at all.
I was wrong about COVID-19 once already — I said that it would hardly match the fatalities we see every year from the common influenza. It appears that it could kill many, many multiples more than the flu.
I now think COVID-19 will take several million American lives. I desperately hope to be wrong again.
Follow Michael Francis for more on politics, culture, and the human experience.