We have lost nearly three times as many Americans to COVID-19 as we lost in World War II.Approximate total number of certified deaths due to the new coronavirus 1.1 million Meanwhile, fewer than 420,000 Americans died in the war.
This is more deaths per capita than any other developed country.Only in Peru, Bulgaria and some countries in Eastern Europe I've done worse.
By my calculations, the United States has lost 540,000 more Americans during the pandemic than it would have if it had performed similarly to its peers such as Germany and Canada.
If this was a war, we would lose.
As I explore in “Epidemic Wisdom: Lessons from 25 Years of Pandemic Coverage,” to do better we need to create a Department of Defense for Disease.
The book, released last week, is based on lessons and observations he made while covering serious diseases as a science reporter for the New York Times.
In my nearly 30 years of reporting on pandemics and epidemics in more than 60 countries, one thing has become clear without a shadow of a doubt. That's our biggest flaw in the fight against the disease: no one is in charge. We don't have Ulysses S. Grant, we don't have Eisenhower, we don't have Westmoreland. The president has many advisers, from Tony Fauci to Jared Kushner, but the chain of command during a health crisis is chaotic.
The FDA approves drugs, the NIH makes grants, and the CDC provides advice. (It's actually the FBI, which is an investigative agency and has no guns or arrest warrants.)
When a vaccine was needed, an entirely new bureaucracy had to be conceived, playfully named Operation Warp Speed.
Many of the ideas in The Wisdom of Plagues will infuriate both the left and the right.
In it, I advocate policies that I would never have been allowed to defend at the Times.
I support mandatory vaccines during crises like COVID-19 and oppose religious vaccine exemptions. I highlight places like Taiwan where masks clearly worked during the 2003 SARS outbreak and defend Fidel Castro's imprisonment of Cuba's early AIDS victims (most of whom were soldiers, not gay men). do.
I generally support an iron-fisted response to epidemics. The reason is simple. That's because you have to choose the path that will save the most lives.
The dead lose everything — including the civil liberties that those lucky enough to be alive still bark at.
From Ebola to HIV, the greatest danger is not the virus itself, but the collective psychology of its response.
Too often it becomes mired in denialism, fatalism, bigotry, rumor-mongering, profiteering, and partisan politics.
Sure enough, all of these diseases hit America during the coronavirus crisis.
What is the root of this failure?
We became a nation in an era before germs were understood. The Founding Fathers knew about war and considered it a government problem.
George Washington's cabinet included a secretary of war.
However, in those days, epidemics traveled at the speed of horse-drawn carriages, and whether one lived or died was thought to be a matter of luck and prayer. In an age of jet travel and miracle cures, that's dangerously anachronistic.
Because the constitution is silent on health, the fight against disease has been left to local governments and ultimately to private industry.
We've seen the results for decades. When New York was in dire straits during the coronavirus pandemic, hospitals in cities with no new cases bought up ventilators. Countries fought over masks and monoclonal antibodies. During the 2016 Zika outbreak, mosquito control was left to the county. (We got lucky with Zika, but it could easily become a national disaster, as happened in Brazil, and as malaria and yellow fever epidemics once did.)
My chapter on the 2022 Monkeypox Outbreak describes an even more ridiculous weakness: Viruses reached us It wasn't until August that the White House finally made a decision in May. appointed a person in charge.
We were lucky again. The vaccine created decades ago because of a false rumor that Saddam Hussein had weaponized smallpox also happened to be effective against monkeypox.
But even the CDC didn't know how many doses there were.
It turned out that almost all of it had been frozen in bulk in Denmark. Implementation took several months.
Imagine such a war.
Any student of history can name great generals and their successes, from the Delaware River Crossing to D-Day.
From Little Bighorn to Pearl Harbor, they can name officers who have died or been ousted for blunders.
We know that victory requires peacetime preparation.
Rather, the situation we are experiencing is similar to the situation Lincoln faced when the Civil War broke out in 1861.
The standing army was very small, only 17,000 men, so they had to ask cities and wealthy citizens to raise regiments.
The result was confusion and defeat at the first battle of Bull Run/Manassas.
Congress then formed a true national army and appointed new commanders to replace the incompetent officer corps. By 1862, the North had 700,000 soldiers under arms.
We must take the same effective response that other countries can muster.
China used harsh methods to contain the coronavirus for three years.
By forcing people to take the drug, Vietnam reduced its extremely high rate of drug-resistant tuberculosis over 30 years.
The United States eliminated polio in 1979 and measles in 2000, but both could return if vaccination rates decline.
We need laws that work in times of crisis.
We must encourage private industry while tempering the tendency to prioritize profits over lives. (Warp Speed was a victory for the Trump administration, even if many of his supporters rejected the result.)
We have to manage our travel. In early 2020, evacuated residents of New York and Seattle spread the coronavirus across the country.
We need to reorganize our hospitals so that some hospitals treat victims of infectious diseases and others handle childbirth and surgery.
We have to be able to move resources to the front lines. No disease has hit all cities at the same time, as has been known since the Black Death.
We believe we should even have the power to conscript doctors. we did it During the Korean War.
Our dispersed health bureaucracy must work together just as military services do under the Joint Chiefs of Staff.
The CDC director should not be a political appointee.
You can never hire a White House operative again. Rewrite your agency research Or the desperate silence when President Trump falsely claimed that the pandemic would “just go away,” as he did with COVID-19.
We might even want to add weight to the mission by introducing ranks and uniforms, such as those worn by the Surgeon General.
Congress respects them, and the prospect of being awarded medals for success and stripping of epaulets for failure keeps leaders focused on achieving success.
And we must have a way to stop and even jail doctors who prescribe bogus treatments.
We will not tolerate spies who sell military secrets to our enemies.
We should not tolerate quacks who fatally betray their fellow citizens for money.
It also requires imagination and solutions that defy common sense.
As I witnessed during my career and detailed in my book, controversial measures to reduce and prevent the disease have long been used to protect porn actors in Los Angeles, sex workers in South Africa, and drug addicts in Canada from AIDS. It has existed for a long time.
Unconventional thinking includes enlisting traditional healers to detect Ebola outbreaks and recruiting imams to combat anti-vaccine rumors during polio vaccination campaigns. I am.
Given the polarization of our country, we despair of our ability to adopt new ways of thinking.
But thousands of American lives were needlessly thrown away. we have to do better.
Donald G. McNeil Jr., who led the New York Times' coverage of the coronavirus and global health, is the author of “Epidemic Wisdom: Lessons from 25 Years of Pandemic Coverage,” from which this excerpt was adapted.
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