America failed to test sufficiently throughout the pandemic even though rigorous tests have long been available. Antiviral drugs played a bit part because they typically provide incremental benefits over basic medical care, and can be overly expensive even when they work. And vaccines were already produced far faster than experts had estimated and were more effective than they had hoped; accelerating that process won’t help if people can’t or won’t get vaccinated, and especially if they equate faster development with nefarious corner-cutting, as many Americans did this year. Every adult in the U.S. has been eligible for vaccines since mid-April; in that time, more Americans have died of COVID-19 per capita than people in Germany, Canada, Rwanda, Vietnam, or more than 130 other countries did in the pre-vaccine era.
We’re so focused on these high-tech solutions because they appear to be what a high-income country would do, Alexandra Phelan, an expert on international law and global health policy at Georgetown University, told me. And indeed, the Biden administration has gone all in on vaccines, trading them off against other countermeasures, such as masks and testing, and blaming “the unvaccinated” for America’s ongoing pandemic predicament. The promise of biomedical panaceas is deeply ingrained in the U.S. psyche, but COVID should have shown that medical magic bullets lose their power when deployed in a profoundly unequal society. There are other ways of thinking about preparedness. And there are reasons those ways were lost.In 1849, after investigating a devastating outbreak of typhus in what is now Poland, the physician Rudolf Virchow wrote,
Ed YongThe answer to the question as to how to prevent outbreaks … is quite simple: education, together with its daughters, freedom and welfare.Virchow was one of many 19th-century thinkers who correctly understood that epidemics were tied to poverty, overcrowding, squalor, and hazardous working conditions—conditions that inattentive civil servants and aristocrats had done nothing to address. These social problems influenced which communities got sick and which stayed healthy. Diseases exploit society’s cracks, and somedicine is a social science, Virchow famously said. Similar insights dawned across the Atlantic, where American physicians and politicians tackled the problem of urban cholera by fixing poor sanitation and dilapidated housing. But as the 19th century gave way to the 20th, this social understanding of disease was ousted by a new paradigm.
While this article is ostensibly about the United States, some of the remarks apply equally well to my own country – especially the crucial role of education…
Unfortunately for the United States and many countries around the world, the social issues identified here are difficult to correct or alleviate: over-reliance on a single, technological ‘silver bullet’ to the point of dismissing complementary solutions; political divisions hindering health authorities and consistent measures; flawed journalistic practices resulting in conflicting and confusing messages or spreading unproven theories which are eroding public trust.
One significant difference between American and European economic policies during the pandemic was how they supported workers during lockdowns: while the US allowed workers to lose their jobs and expanded unemployment aid, European countries paid companies to keep people on their payroll by supporting their salaries. Some studies suggest that the European approach has worked better, causing less unemployment and disruption in the labor market.
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