Why did the US manage the pandemic so badly? The world’s largest economy, with a powerful communication network and cutting-edge biomedical technology, research and structure, is still a leader in infections, with mortality rates higher than in many low-income countries. If the crisis was a test of leadership, the leaders of the nation that so often led the world “failed”, the New England Journal of Medicine (NEJM) said in an editorial. “They took on a crisis and turned it into a tragedy.”
The editorial itself is symptomatic. In the 208 years of the most prestigious medical publication in the world, this was the 4th editorial signed by all editors (34), parading for the first time criticisms of the government in the middle of the electoral period.
Even with an unparalleled biomedical and industrial infrastructure, the US has been unable to adequately provide protective equipment for healthcare professionals and the population and to promote mass testing, as South Korea or Singapore have done. China, after the initial hesitation at an unprecedented pathogen, adopted strict quarantine rules, suppressing the outbreak at the root: while its mortality rate is 3 people for every million, in the USA it is 500. The performance of democracies in general has also outperformed that of the USA.
Particularly disturbing for Brazil is the fact that, apart from references to technological and financial resources, the editorial – significantly titled Dying in a Leadership Void – could be transliterated, exchanging “USA” for “Brazil” without any detriment to accuracy diagnosis. Especially because a substantial part of effective interventions depends little on technology or money.
There, as here, isolation measures were often late and inconsistent, poorly supervised and prematurely relaxed. Most people do not wear masks, largely because many leaders boast that they are tools of political control rather than effective means of reducing contagion.
“The federal government has largely abandoned control of the disease to states. Governors varied in their responses, not so much because of their parties, but because of their competence. But whatever their competence, governors do not have the tools that Washington controls. Instead of using these tools, the federal government undermined them, ”says NEJM. Regarding wasted tools, Minister Eduardo Pazuello candidly confessed that until he was recruited to plug a hole in the Ministry of Health “he didn’t even know what the Unified Health System (SUS) was.”
There, as here, public institutions – such as the National Institute of Health or the Food and Drug Administration – were excluded from crucial and “shamefully politicized” decisions, responding to government pressure rather than scientific evidence. “Our leaders have destroyed confidence in science and government, causing damage that will last. Instead of relying on experts, the administration turned to uninformed ‘opinion leaders’ and charlatans who obscure the truth and facilitate the promulgation of blatant lies. ”
The shocking similarity with Brazil is not only in the diagnosis, but in the prognosis. “Anyone who irresponsibly wasted lives and money in this way should suffer legal consequences. Our leaders demanded broad immunity. But the elections give us the power to deliver the verdict. ” There, as here, “in response to the greatest public health crisis of our time, our political leaders have proven that they are dangerously incompetent.” There, as here, “we should not encourage them and make thousands more deaths possible by allowing them to keep their jobs”.
Americans have a chance to start a renovation that Brazil will only be able to do in two years. But municipal elections are already an opportunity to show that the lesson of the pandemic has been learned. If not, the electorate will not only be dishonoring the memory of thousands of dead, but preparing the harvest that will take many others.