The novel coronavirus shows no signs of slowing down as it rips through the United States – the worst hit country in the world.
And with schools returning, and winter approaching, there are grave warnings of “third waves” and a deadly new surge in cases.
The US has recorded more than 5.58 million known cases of COVID-19 and more than 174,000 deaths. But despite the grim record, the spread is far from contained in much of the country.
“We had a lack of response at the beginning, and we’ve being playing catch-up ever since,” says Dr Melissa Hawkins, an epidemiologist and Director of the Public Health at the American University in Washington DC.
“We’ve been playing catch up getting information, and on what that information means and who do we trust.”
The virus did not hit the country evenly. New York was devastated early in the pandemic but the state has now managed to get the virus largely under control – a rare story in the country of 330 million.
As it spread across the US, lockdown measures were introduced. However as many states were starting to catch-up to the virus spread, the stringency of the measures was reduced and case numbers surged upwards.
As a result, the US is staring down the barrel of a long and deadly winter.
21 states still have ‘uncontrolled spread’
A group of public health and crisis experts have launched a project tracking the country’s pandemic response. Those involved have experience working at the White House, the US Department of Health and Human Services, and on the Ebola epidemic in West Africa.
It shows the worrying baseline of cases that America is dealing with as 21 states still have “uncontrolled spread” in what has become a disturbing “new normal” for the nation.
“We are going into the cold weather season in this country ... when the virus is more likely to spread as people stay indoors,” Dr Hawkins told Yahoo News Australia.
“COVID fatigue, or quarantine fatigue – whatever you want to call it – that is also happening at the same time ... when this could be a potentially significant problem going into the winter months.”
The project also maps the case trend in each state tracking the percentage change in new cases over the past 14-day period.
It shows a handful of states continuing to head in the wrong direction, such as California (+19%), Delaware (+40%), Hawaii (+84%), Illinois (+15%), Kansas (+17%), Michigan (+11%), Wyoming (+26%), South Dakota (+29%) and North Dakota (+14%).
Mistrust of science fuelling America’s ‘broken system’
The deep divisions in the country – both political and economic – have been laid bare during this pandemic as those in poorer areas have been more affected by inefficient testing regimes and greater community transmission.
“In public health we say your zip code predicts your health better than your genetic code,” Dr Hawkins lamented.
The politicisation of the pandemic has also seen one side of politics, egged on by the president, become resistant to messages from public health experts.
“I think that has been a fundamental breakdown in our response and in our ability as a public to do our part,” she said.
“Because science needs to do its part, our leaders need to do their part, we as individuals need to do our part as well, but that is contingent on trust.”
“Trusting the science, trusting the people who are communicating the science to you and this is where we’ve gotten into serious challenges and barriers in our country,” she said.
Coupled with a dysfunctional healthcare system, in which health insurance for many people was tied to their job that disappeared when the pandemic hit, the wounds of the country have been painfully exposed.
The lack of trust in information “has really interfered in an already broken system, that has become clear – a broken medical system in many ways and a fragmented public health system,” Dr Hawkins said.
Despite the second uptick in cases since June, she said America’s failure to get the initial wave under control means the country is still very much in the first wave of the pandemic. With a Victorian-style lockdown largely out of the question for much of the country, all hopes are pinned on a vaccine.
On Thursday (local time), the director of the US Centers for Disease Control and Prevention (CDC) said he was tentatively optimistic that cases in southern states were seeing a progressive drop.
“Hopefully, by this week and next week we will see the death rate really start to drop (across the country),” CDC Director Robert Redfield said in an interview to the Journal of the American Medical Association.
However he warned that data from the 21 trouble states continued to show there was no drop in coronavirus cases, including a number of states in the midwest such as Nebraska and Oklahoma.
“We don’t need to have a third wave in the heartlands, we need to prevent that,” he warned.
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