Highly unequal US has highest Covid death toll in the world, it’s no coincidence | American News

The United States has suffered 900,000 deaths from Covid-19, the highest figure of any country. The death toll would equal the 15th most populous city in the country, more than San Francisco, Washington DC or Boston a ghost town whose population is growing every day.

It’s not just the total number. America also has the highest death rate of any wealthy country, with half of deaths occurring after vaccines became available.

The United States has never responded to the Covid pandemic in a sustained and proactive manner as a unified nation. Instead, much of the responsibility and blame lies with individuals. In a country characterized by vast income inequality, poor health and deep political divisions, the results have been grim.

All of these factors put people at higher risk of death from Covid, said Megan Ranney, an emergency physician and academic dean of public health at Brown University.

Vaccinations, in particular, have lagged behind, especially compared to other wealthy countries. The healthcare system was already precarious when it began to be battered by wave after wave of Covid.

Other countries with similarly high death tolls at the start of the pandemic saw fewer deaths from the Omicron variant, but in the United States, the death toll from Omicron exceeds the Delta wave of fall 2021 The past month has been one of the deadliest of the entire pandemic.

Meanwhile, US leaders are trying to emulate other countries’ return to normal, despite a starkly different picture with hospitalizations and deaths each day nearly matching the losses of the 9/11 terrorist attacks.

The first and most obvious [issue] is our vaccination and booster rate, Ranney said. Our vaccination rate, period, is lower than most other high-income countries, and our booster rate is also lower. And as abundant CDC data proves, vaccines and boosters are extremely effective in protecting against death, even with Omicron.

Less than two-thirds, about 64% of Americans are vaccinated, and only 48% of them are vaccinated, despite an adequate supply of vaccines.

For a country that has a vaccine-only strategy, was not very good at vaccinationWilliam Hanage, Associate Professor of Epidemiology

For a country that has a vaccine-only strategy, it’s not very good at vaccination, said William Hanage, associate professor of epidemiology at Harvard TH Chan School of Public Health and co-director of the Center on Communicable Disease Dynamics. . There are large parts of the country that are not vaccinated at higher levels and that is made worse by the fact that with Omicron, to get really good protection you also need to be boosted.

Problems of access to vaccines also persist. Wealthier people have had many opportunities to get vaccinated, but those in poorer households still struggle to get vaccinated and take time to recover from side effects. Some 15% to 20% of unvaccinated Americans say they are still interested in getting vaccinated, Hanage said they just haven’t been able to get it yet.

Meanwhile, poorer unvaccinated people also face a double whammy as they are also more likely to contract Covid, he said.

You have people who are more likely to be exposed to the virus, who are less likely to receive vaccines, who are less likely to be able to take steps to protect themselves even with vaccination, because they are afraid of missing a salary, they are afraid to take a day off, their employer will not let them.

The United States is the most economically unequal country in the G7 and offers no guaranteed sick leave.

The lack of paid sick leave is an absolute outrage, Hanage said. If you care about workers, give them sick leave. This sick leave will allow them to avoid infecting others, it will allow them to help protect workplaces, it’s just a no-brainer.

Another reason for the disparate results in the United States is the fractured healthcare system. People without health insurance tend to wait longer to be seen by doctors, making worse outcomes more likely. They are also more likely to have pre-existing health conditions that put them at greater risk for Covid.

There are many, many ways in which societal inequalities are reflected and amplified in our death rates, Ranney said. With Covid, there is no longer any way to hide all of these underlying issues, and the impact of these issues has been magnified as many of the social supports that allowed us to get by were no longer there.

The United States also has higher death rates from opioids and gun violence, and lower life expectancy rates than similar countries. Hospital overcrowding is also higher in the United States than in other countries, Ranney said.

Overcrowding correlates with poor outcomes for several types of illnesses and injuries, she said. And there has been preliminary data that people are more likely to die from Covid when there are more Covid patients in hospital or when intensive care units [intensive care units] are exceeded.

One predictor of Covid deaths by country is trust in government, according to a recent Lancet report: Countries with lower levels of trust in government had higher case and death rates.

If you don’t trust the government, you’re less likely to follow suggestions or mandates about lockdowns, early on, or masks. And then the lack of trust also hurts the ability of governments to do important things like masking or testing or good data acquisition, Ranney said.

Only 25 US states share reliable case data by age, making it difficult to know how many children are sick, for example. And then it hurts our ability to put data-driven public health measures in place, and people don’t follow public health measures because they don’t trust them. And it becomes this circular problem, Ranney said.

National leaders in the United States are unable to mandate precautions, such as masks or vaccines, for the entire country, with the responsibilities largely falling to state and local leaders.

Yet leaders have seen their ability to act in a health emergency even more limited during the pandemic, with more than half of US states introducing new limits on public health powers.

There’s a constituency in the United States that’s starting to look at this and see this opportunity, Hanage said. It largely boils down to: how much illness and death will people accept?

Those interested in limiting public health regulations look at this and think, whoa, a significant fraction of the population is fine with 900,000 deaths.

There is still time to change course and avoid future losses, Ranney said.

I think there is a chance to create a better future, she said, noting that leaders can use this moment to build the necessary infrastructure, so if and when there is another variant or another acute epidemic, we have the system in place to address it.

But the American reaction to the pandemic is also compounded by an American sense of exception.

It’s a very American idea to suggest that reality is what you want it to be. You can be whoever you want to be. Reality is a real thing, however. The virus doesn’t care who you are, Hanage said. He only cares that he can infect you.

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