Why is the US making such a mess of it?


The highly dysfunctional manner in which the US is handling the Covid-19 can be quite perplexing especially as it is becoming increasingly clear that it is not confined to the POTUS (President of the United States) and his immediate team. Images from Michigan and other states where ordinary citizens are clamouring for their rights to gather in groups, celebrate mass services and not wear masks in public show that the anti-science sentiment is fairly widespread in sections of the American public.

The facts pertaining to the epidemiology of the Covid-19 are not difficult to comprehend. If the virus is allowed to spread without any attempt to practice physical distancing and isolate those who are infected, on the average each infected person will pass the infection to another 3 persons. In other words, the rate of transmission (ROT) is 3. Given that the average incubation period is 6 days, that would mean that 100 cases on Day 0 will lead to 300 cases on Day 6, 900 cases on Day 12, 2700 cases on Day 18, 8100 on Day 24 and 24300 cases on D30. If measures to disrupt the transmission are not implemented, one would get 218,700 cases by Day 42. However long before reaching this number, the hospitals will be swamped by the 15% of the cases who go into respiratory failure and require oxygen therapy. There will be a shortage of acute care beds, PPEs will run out and hospital staff will get infected in large numbers. Clinical services will collapse and the morgues will be full. These are not unfounded speculations. We all saw that happening in Wuhan, Spain, Italy, London and in New York. That’s the nature of this beast!

The US is nowhere near “herd immunity”. Studies done in New York reveal that about 24% of the population of New York City have the antibodies to Covid-19. New York City achieved that level of immunity after going through six harrowing weeks that saw more than 700 fatalities a day at its peak. But that level of immunity will still not protect them from another wave of infection if they relax their lockdown too quickly. The ROT for New York City will be 2.28 if they do not take active steps to reduce transmission. (3 x 0.76 = 2.28) An ROT of below 1.0 would mean that the number of new cases will decrease over time. ROTs of more than 1.0 will witness a rising number of new cases on a compounded rate. It would take an antibody prevalence level of 70% to confer herd immunity to a community. (ROT: 3 x 0.3 = 0.9) Some of the upstate districts of New York have antibody prevalence rates of 5% or so. This lower rate is probably reflective of the situation in most other States in the US.

The rash decisions being taken in many states in the US to open up the economy before the epidemic is brought under proper control is going to cause a huge spike in cases and tremendous amount of human suffering. The US already has 1,691,229 diagnosed cases (30.54% of the world total) and 99,398 deaths (28.6% of the world total) despite comprising only 4.3% of the world population. They are going to find out in a painful fashion that you cannot control an infectious epidemic through bluster, fake news, blaming others and exhorting the population to return to normal activities. All the states now opening up in a gung-ho fashion will have to declare lockdowns eventually as that is the only proven way of disrupting transmission and bringing down the ROT to below 1.0. All the other solutions being touted – summer sunshine and hydroxychloroquine are highly speculative, and there is no evidence that they can bring the ROT down.

The willful rejection of scientific advice on such a large scale in the American public cannot be attributed solely to rugged American individualism. It is a sociological phenomenon that has a societal cause. My take is that the American middle and working classes have become very mistrustful of their political elite which has, over the past 30 years, put the US on a path that has seen well paying, secure jobs relocating in large numbers to overseas destinations, closure of factories all over the country, casualization of labour, stagnant incomes for the bottom 70% of the population despite huge increases in wealth in the top 15%, increasing debt levels for households and students and growing financial insecurity. These trends have continued under both Republican and Democratic governments, and on the whole, the policies causing these trends – eg free trade agreements such as NAFTA, progressive lowering of corporate taxes, liberalization of the financial markets – have been supported by the academics and experts (who appear in various talk shows on TV) as the best way to preserve the American way of life.

As it is said “you can’t fool all the people all the time”. Significant sections of the American public have come to the conclusion that the elite – political, economic and the Ivy School educated intelligentsia – are lying to them and ripping them off in the process. Their quality of life is deteriorating, and their daily life increasingly precarious, but the elite are living in luxury. This I think is the emotive force behind the anti-science, “post-truth” stance shown by so many. It is a form of rebellion against the status quo (somewhat like the “apa salah boss ku” phenomenon we see in Malaysia). Trump isn’t the engineer of this sentiment but he is riding it. Criticisms of Trump by mainstream media and academicians actually enhance the support he is getting from this section of the public who feel deeply that the system has failed them and that the elites – political, academic – are a bunch of self-serving crooks.

It is interesting that this anti-science sentiment is not as pronounced in certain states. The population of New York for example, seems quite willing to go along with the lockdown imposed there. That might be partly because of the high rate of Covid-19 infection and they could see that their lives were at risk and that something had to be done. But I think the manner in which the New York Governor, Andrew Cuomo is taking efforts to painstakingly explain various aspects of the responses taken by the state authorities, and the reasons these were being taken, played a big role in winning skeptics over and ensuring a broad-based support for a scientific approach to handling the Covid crisis in the State. New York has inflected the curve downwards and they are now talking about a phased re-opening of the economy.

Should the rest of the world be concerned that America is lurching towards a monumental health disaster? Yes, I think so. The world is so inter-connected today that no part of the world can be safe if the epidemic is not brought under control everywhere. The second wave that is incubating in the US can re-seed the infection back to countries that have managed to flatten the curve, if these countries are silly enough to lift travel restrictions too rapidly. Secondly, the US accounts for about 24% of global GDP. The huge negative impact of a poorly controlled epidemic on the US economy will depress global aggregate demand for the rest of 2020 and prolong and deepen the recession that is unfolding.

Thirdly, a wounded tiger is most dangerous, especially when it happens to have the largest military force on the planet. The POTUS and his team are trying to deflect blame onto China, and large sections of the American public seem to be falling for this ploy. The US is also taking a more belligerent stance towards Iran, Venezuela and nuclear arms control. There is a serious danger of military interventions by the US in the next one year.

The US’s descent into “post truth” should serve as a warning for those among us who believe that rationality and science should be the basis for plans to develop our country. If we, the intelligentsia in Malaysia, fail to connect with the ordinary people and use science and rationality to address the real problems that they are facing, but instead sell our intellectual and professional services to the corporate elite and promote economic activities that widen the income gap, reduce social support networks, and make the lives of ordinary Malaysians more precarious, our “post truth” moment cannot be too far away.

Dr.Jeyakumar Devaraj
PSM Chairperson
27th May 2020

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