On Wednesday the World Health Organization declared Covid-19 a pandemic. From that point onward every country ought to have focused on what epidemiologists call “flattening the curve” of infection rates – to prevent a surge of cases overwhelming hospitals as has happened in Italy and Iran. Instead only a handful of countries have met the crisis adequately and even fewer have prepared for worst case scenarios or risked preventative measures with steep economic costs.
China’s denial of the initial outbreak allowed the virus to spread but Xi Jinping’s subsequent clampdown, to a large extent, compensated for that error. There are now indications that its infection rates have plateaued. Since no other country has China’s draconian surveillance and enforcement capabilities, decisive leadership has meant the difference between managing the crisis or being overrun by it.
In South Korea, for instance, local authorities have tested hundreds of thousands of people and kept track of potential carriers with mobile phone and satellite technology. This has allowed them to remain in control of a sizeable outbreak and given them a good chance of managing the next few months in orderly fashion. Italy, by contrast, tested far fewer people and it has been forced to manage the subsequent surge with what is essentially a national lockdown. Both countries noticed their first cases around the same time, so the different outcomes which their responses have produced are instructive.
Politicking in these circumstances is obscenely inappropriate but it is impossible to make sense of the US response without taking its hyperpartisan political culture into account. The Trump administration’s ineptitude has been shameful. First downplaying the threat, then dismissing it as a hoax, senior Trump officials have dithered, blustered or lied repeatedly, to the point at which the president has become in the New York Times’ words a “bystander” to the crisis, if not an obstacle. Civil society has stepped in and state governors have taken the initiative in shutting down public schools and events to slow transmission of the virus even with negligible federal assistance. Close to the end of this week the entire US had tested less than 2000 people, less than one percent of what South Korea has managed in a comparable time frame. This means that the US likely will face a future closer to Italy’s than South Korea’s.
During the crisis Trump has become his own nemesis. None of his public statements can be taken seriously. His sunny predictions and with near total inaction have rattled markets and his pointless lying has alienated many within his own party. His fear that accurate statistics might undermine his re-election chances has forced senior officials not only to deliver North Korea style encomia to his leadership at public briefings, but forced them to ignore and suppress expert advice, with predictably disastrous consequences. As importantly, his mismanagement has erased three years of stock market gains and showcased his lack of statesmanship far better than any political rival could have managed to do with six months of attack ads.
The European Union has also struggled to coordinate its response, most notably by failing to alleviate Italy’s urgent need for medical supplies, but some of its leaders have faced the situation with unusual candour. German Chancellor Angela Merkel warned that experts estimate that up to “60 to 70 percent of the population will be infected” – a levelheaded reckoning that stands in stark contrast to Trump’s xenophobic blame-shifting. (To be fair, the GOP has a long history of denying science. In his study of the post-truth era, the philosopher Lee McIntyre has an entire chapter called “Science Denial as a Road Map for Understanding Post-Truth”).
With so many unknowns in play, it is hard to say what will happen next with the Covid-19 crisis, but as we watch governments formulate their responses, it is worth remembering the words of William Foege, a former director of the American CDC. In his 2017 book “Deadliest Enemy: Our War Against Deadly Germs” Foege’s friend and colleague, the epidemiologist Michael Osterholm recalls his advice that: “The purpose of public health is to promote social justice; Its philosophical base is social justice, and its scientific base is epidemiology.” Ultimately a leader’s willingness to embrace the first premise will determine his or her readiness to accept the latter.
