Coronavirus: 4 factors that explain the enormous impact of Covid-19 in the USA. USA, the country with the highest number of people infected and killed by the disease | Coronavirus

The United States has recorded more than 23,600 deaths and 582,500 cases as of Tuesday (14), according to data from Johns Hopkins University.

About 2,000 deaths have been reported daily in the past four days, most of them in and around New York City, although experts believe the actual number may be higher, as deaths in households have been excluded. of official statistics, according to the Reuters agency.

“We’re getting closer to the top now,” said the director of the Center for Disease Control and Prevention (CDC) last Monday on NBC’s Today show.

Here, we bring together four factors that, according to public health experts, epidemiologists, and analysts, brought the United States into this dire situation.

1- The slow response of the White House

If the experts agree on one thing, it is that the United States needed to have taken more serious and comprehensive measures before. The White House team in the front line of the fight against Covid-19 recognized these mistakes.

Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases and one of the top names in the country’s pandemic response team, admitted that “no one denies” that early mitigation measures could have saved lives.

The United States reported its first case on January 21. Ten days later, the government took the first important step, enacting a ban on foreigners who had visited China in the past 14 days from entering the country.

Even emphasizing the importance of this action, many analysts criticize the fact that it was not accompanied by other measures to prepare the country for the pandemic, such as recommending that citizens comply with the rules of social distance, which was only done in mid-March. . .

Furthermore, controversial and contradictory statements by President Donald Trump, who compared Covid-19 to a simple “flu” and said the epidemic would end the “heat” as “if it were a miracle,” suggested that the country had everything under control. .

Recently, when asked about his statements, Trump said he wanted to be optimistic and not alarm the population.

On April 11, the New York Times newspaper published an investigation into the warnings that Fauci and other officials brought to the White House, insisting that more aggressive measures be taken by February.

When asked about this, Fauci explained to CNN that “many times these recommendations are put into practice, sometimes not.” “But things are the way they are and we are where we are now,” said the doctor.

“What is taken into account when making these decisions is complex. There was a lot of pressure against isolation at the time.”

Defective tests, which had to be replaced, and limited access to tests delayed response to disease progression.

“Much of the blame for the current situation is due to delayed testing in the United States. We were watching the pandemic unfold, with no ability to test and identify cases. This resulted in the massive spread of Covid-19 in the United States, “said surgeon Thomas Tsai. , a health policy researcher at Harvard University, told the BBC earlier this month.

The problem started when the CDC decided it would be the only one to manufacture the tests, Krys Johnson, a professor of epidemiology at Temple University, said in an interview with the BBC in March.

“The result of this was that when the test kits started shipping to the United States, some flaws were detected, which had to be replaced. It was a process that took time and therefore many States were unable to start testing until recently, “he said.

For more than a month, each state had to send samples of possible contagions by mail to CDC headquarters in Atlanta, the capital of Georgia, the only center authorized for testing.

The complications did not end with the distribution of the kits, because this added to the difficult access to them, even if the person was considered a suspicious case.

Over time, the situation changed and, in mid-March, the number of tests conducted daily in the country grew exponentially, according to the Washington Post, which cites statistics from the Covid Monitoring Project.

On average, over the past seven days, the US USA It has performed about 147,000 new tests daily.

The health care system in the United States, based mainly on private health plans, complicates the situation when it is necessary to identify cases of Covid-19, according to epidemiologists.

Lack of health coverage is a persistent problem and, at this time, it becomes crucial: in 2018, 27.5 million people did not have a plan at any time of the year, according to Census data, which reflected an increase in this number in relation to the previous year.

This causes some of these people to avoid going to the doctor in case of infection: for those who do not have a plan, a consultation can cost hundreds of dollars.

“I haven’t been to the doctor since 2013,” wrote Carl Gibson, a 32-year-old American journalist, in an opinion column in the British newspaper “The Guardian” last month. “When you multiply my situation by 27.5 million, the image is terrifying.”

Undocumented immigrants, some 11 million people, often avoid seeking medical attention for fear of being deported.

“It is difficult for undocumented people to access medical care. Always remember the fact that the person’s name appears in the legal system when they go to a medical center and are at risk of deportation,” says Sebastián, who has lived in the country since then. 3 years old, when his parents brought him from Mexico.

But there are no problems just for those who are not covered by a plan. Basic coverage pays only a small fraction of the cost of consultation or treatment.

“During the flu season, we get very sick, but taking my children to see the pediatrician costs US $ 100 (R $ 520),” says Lisa Rubio, 28, who has one of these plans through the company. for which it works

These systemic failures were also exposed in other health crises, such as the HIV / AIDS epidemic in the 1980s, when the large number of people not diagnosed with HIV exacerbated the situation, according to Ravi Grvois-Shah, director of a clinic in mobile health. maintained by charitable donations. “There is nothing to indicate that it will be different with the coronavirus,” he tells the BBC.

Additionally, there is no requirement that employers in the United States offer paid sick leave to their employees.

4 – Lack of coordination between States

The difference in situations in each state of the country was a relevant aspect in the midst of the pandemic. Many analysts said the White House lacked leadership and that governors had to deal with the new coronavirus.

Although some imposed restrictions in advance and declared a state of emergency before the explosion of the cases, others chose not to do so, which, in the experts’ opinion, may have contributed to the escalation of infections.

California is one of the examples of success highlighted by public health experts, with only 641 deaths among the more than 22,000 cases registered until last Sunday, according to Johns Hopkins University.

Although the country has national agencies like the CDC, each state has its own public health infrastructure, and “part of the challenge is that there is no coordinated national strategy in the country, which makes each state describe its strategy individually,” he said. Tsai.

All states have already declared a state of emergency due to Covid-19. New York, among all of them, is the one facing the worst situation, with more than 189,000 cases.

Governor Andrew Cuomo, however, said Saturday that the death toll appeared to stabilize. After announcing 783 deaths in 24 hours, Cuomo emphasized that the numbers have been similar in recent days.

“It is not the highest number, and you can see that it is stabilizing, but it is happening at a horrible rate,” he said. “These are inconceivable numbers, representing extraordinary pain and loss.”