Why U.S. pandemic management has failed: lack of attention to America’s epidemic engines

Few U.S. journalists, politicians, or public health officials expressed any extraordinary concern when reports of a novel respiratory virus began to emerge out of China in late 2019 and early 2020. After all, the U.S. had just ranked number one among 195 countries in the 2019 Global Health Security Index — the first major comparative assessment of national capacity to prevent, detect, and respond to infectious disease outbreaks. Experts believed the wealthiest large nation on earth to be well-prepared to weather whatever might come its way. Now, nearly two years since the first documented cases of Covid-19 appeared in Wuhan, more than 700,000 U.S. residents have been killed by a pandemic during which U.S. public health management has been among the world’s worst. Despite American wealth, monopolization of the global vaccine supply, and unparalleled spending on medical care, SARS-CoV-2 has decimated U.S. communities — especially those of color and lower incomes. Repeated policy failures have paved the way for the virus to rapidly replicate, mutate, and fuel deadly outbreaks not just inside this country but worldwide.