Much has been written about how China has responded to the onset of the COVID-19 epidemic. Even more has been written about how other jurisdictions have coped with what is now a global pandemic.
We still do not know the pivotal origin of this devastating virus. Wise voices from East and West have counseled that this is an exceedingly complex, scientific question. We do know, though, that the initial mass-circulation location for this virus was Wuhan. What I would like to consider now is where we might find ourselves today had a virus comparable to COVID-19 in terms of infectiousness and potential lethality first emerged, epidemically, in North America rather than in China.
This is not a fanciful exercise. In 2009, the world was very fortunate that the H1N1 virus, commonly known as swine flu, proved to have a low mortality rate (10 times less lethal than COVID-19, according to the World Health Organization). It was, however, highly infectious.
According to a New Scientist article in April 2009, this novel flu virus first appeared in North America. A Conde Nast report at about the same time explained that the swine flu looked to be a hybrid virus that combined pig flu strains from North American pigs and European pigs, likely brought to North America to interbreed with a view to enhancing pork production.
The swine flu seems to have first crossed, in contagious form, to humans in Mexico close to an American-owned factory hogfarm near the town of La Gloria in late 2008. There was speculation that this factory farm may have been the primary source of the new virus, according to Conde Nast. But this was never proved. It was detected in the US by March 2009 and spread widely across the globe from Mexico — and from the US.
Viruses are globally universal. Australian scientists identified a particular “cannibal virus” in Antarctica in 2011, and the BBC reminded us, in 2017, that viruses are even more widespread across the northern polar-regions. Potential pandemic viruses can and do arise in locations across the populated world, including in China and North America.
On the face of it, the US was far better prepared than anyone to cope with a novel pandemic virus in 2020. It is home to the renowned Centers for Disease Control (CDC) in Atlanta and dozens of other world-leading medical research institutions. The Global Health Security Index published by Johns Hopkins University in October ranked the US as the most prepared of the 195 countries surveyed. Moreover, recent reports say total US healthcare spending exceeds 17 percent of US GDP — double the OECD (Organization for Economic Cooperation and Development) average for spending on healthcare.
So how might the US have coped with such a challenge where it had to be the first responder following a pandemic outbreak of a novel, highly infectious, significantly lethal viral disease?
At the onset of the swine flu in 2009, the mortality rate was still being established. In the event, neither governments in the US nor lead scientific advisers considered that there was a need for major American quarantines, lockdowns or border closures. Within a year, according to the CDC, this new flu had infected 60 million in the US and killed 12,000. Worldwide, the CDC estimated that infections may have exceeded 1 billion and over 500,000 deaths may have resulted (figures not greatly different to those for annual seasonal flu).
According to the Washington Post, the US government and the CDC had been formally notified about the COVID-19 virus spreading in China by Jan 3. Human-to-human transmission was confirmed by China at a press conference in Guangzhou on Jan 21.
In the US, the CDC first insisted on creating its own (faulty) minimally available test kit rather than relying on WHO-based test protocols. According to the same Washington Post report, two leading US scientific advisers told a White House discussion in mid-February that they still did not have evidence (due to lack of confirming test data, presumably) of person-to-person COVID-19 infections. The US ultimately declared a COVID-19 national emergency on March 13 — some 70 days after the first formal notifications from China. By mid-April, COVID-19 infections and deaths in the US were over 600,000 and 26,000 respectively. The comparable figures, in mid-April, for South Korea were below 11,000 and 230, respectively. The US population is about 6.5 times that of South Korea. On a per-capita basis, the US has an infection rate that is almost nine times higher than South Korea and a death rate which is over 17 times higher. The recovery rate, at the same point, stands at almost 72 percent of confirmed cases in South Korea and around 8 percent in the US. With time, the recovery rate has been gradually lifting in the US.
The first COVID-19 case was confirmed on the same day, Jan 20, in the US and in South Korea. Both countries had the benefit of an over-two-week early warning from China.
As it happens, the US Department of Health and Human Services (HHS) staged a lengthy exercise in 2019 called “Crimson Contagion”, which firmly warned about a lack of national epidemic readiness. The New York Times reported that the US government did little to respond to the concerns expressed. HuffPost noted in March that the Trump administration eliminated a pandemic unit within the HHS in 2018 and took steps to cut the CDC budget in 2020.
According to The Guardian, Professor Stephen Walt of Harvard University recently concluded that what has happened in the US is “an epic policy failure”. Walt argued that “The Trump administration’s self-centered, haphazard and tone-deaf response (to COVID-19) will end up costing Americans trillions of dollars and thousands of otherwise preventable deaths.”
America, along with the rest of the world, has had to cope with the COVID-19 epidemic under immense pressure. Also, like the rest of the world outside of China, it has had the benefit of early warnings. Based on the clear evidence, both recent and from a decade ago, it is reasonable to assume that in 2020, if the US had been a first responder to a threat comparable to that posed by the COVID-19 epidemic, its performance in epidemic and pandemic management would have been, at the very least, “self-centered, haphazard and tone deaf” and possibly far worse. The consequences for the US and the world are terrifying to contemplate.
The author is a visiting professor in the Faculty of Law at the University of Hong Kong.
The views do not necessarily reflect those of China Daily.
