Why America Is Uniquely Unsuited to Dealing With the Coronavirus

For decades other countries were shaped by the traumas of disease outbreaks while the United States remained largely untouched. No longer.

People run through crowds on the East River during the Coronavirus outbreak in New York City.
People run through crowds on the East River during the Coronavirus outbreak in New York City. (Ashley Gilbertson / VII / Redu​x)

President Donald Trump has characterized the coronavirus crisis as “a time of shared national sacrifice,” but here’s the hard truth: The nation has never in living memory had to collectively sacrifice quite like this.

Geography has bestowed upon the United States the blessing of being surrounded, as a former NATO chief once put it to me, by friends and fish: Canada, Mexico, and two oceans. Even when the homeland has come under attack—at Pearl Harbor, on 9/11—we responded by fighting the enemy over there so we would not have to fight it back here. When it comes to national-security threats, here has long been a refuge, a fortress. Hence, perhaps, the impulse in the U.S., when the coronavirus began spreading, to prioritize keeping the threat there (via travel restrictions) over preparing for when it got here (by bolstering the health-care system to withstand a surge of cases).

Now, for the first time in generations, the homefront has become the battleground, in this case for the fight against an invisible foe undaunted by borders and oceans and America’s traditional defenses.

Suddenly America, now home to one of the world’s worst outbreaks of the virus, has discovered that it isn’t really wired for the all-of-society struggle that’s needed to fight the coronavirus. We do have many obvious strengths in this fight—we’re a wealthy nation, a hub for technological and scientific innovation, a democratic society with free-flowing information, and a leader in handling global-health crises. But the outbreak has also exposed weaknesses that put the country at a disadvantage from the start, particularly relative to other rich democracies that are confronting the same disease but have managed, if only partially so far, to flatten their curve. In the United States, the virus has struck a highly polarized, fragmented, and individualistic society, one not haunted and transformed by a previous epidemic the way other societies have been. These factors, along with the Trump administration’s failures to take the threat of the virus seriously when it first emerged, placed the United States squarely on the back foot in its battle against COVID-19.

One of the lessons from the various ways countries have responded to this pandemic is that swift, inventive, and aggressive testing and social-distancing measures are crucial to success. Another, however, is that—to channel Donald Rumsfeld’s infamous remark about the conflict in Iraq—you go to war against this virus with the country you have, not the country you might wish you had. The virus has landed in a diverse array of countries with remarkably similar force. What’s made the difference is the countervailing force that each nation has brought to bear.

While the United States has dealt with numerous disease outbreaks abroad in recent years, including SARS, Zika, and Ebola, this is the first time that many of its residents are experiencing such a traumatic, overwhelming public-health emergency. In contrast, several of the democracies that have made the most progress in combating the virus, including South Korea, Taiwan, and Hong Kong (along with authoritarian countries such as Singapore), bore scars from previous epidemics that spurred them to act quickly when a novel coronavirus was first reported in China in late 2019. The U.S. government prides itself on being prepared for 21st-century threats such as cyberwarfare and “great-power competition,” but it wasn’t nearly as prepared for the modern danger of pandemic disease. A new University of Oxford study of government responses to COVID-19 indicates that while the rate at which states have adopted stringent measures (school closings, travel restrictions, bans on public gatherings, and so on) has played “a critical role in stemming the infection,” the stringency of the U.S. response for weeks lagged behind its growth in new cases.

The United States and South Korea, for instance, each confirmed their first coronavirus case within a day of the other in late January. But South Korea raced far ahead of the U.S. in testing its population for COVID-19 and was able to contain the spread. This week, as infections in the United States soared, South Korea reported its lowest number of new coronavirus cases since a peak on February 29, emerging as the world leader in coronavirus diagnostics.

The South Korean government acted in part out of a desire to avoid repeating the previous administration’s bungled reaction to the spread of Middle East Respiratory Syndrome, or MERS, in 2015. The country’s outbreak of that disease, the largest outside the Middle East, featured a harrowing transmission chain through the nation’s hospitals and killed more than 30 people. It also motivated authorities to hone their systems for testing suspected cases and tracing and isolating infected patients and their contacts. Authorities even introduced new laws granting the government powers to collect anonymized personal data from people who test positive so their movements and contacts can be identified.

C. Jason Wang, a Stanford professor who has studied Taiwan’s COVID-19 response, similarly told me that the SARS outbreak was seared into “the psyche of the Taiwanese people.” Especially distressing were scenes such as the quarantining of an entire hospital for weeks in 2003. Seventy-three people died, which Wang said registers in a small country such as Taiwan. In its aftermath, the government created a National Health Command Center and, like South Korea, empowered authorities to track people and control the production of vital medical supplies during an epidemic.

Wang noted that the command center, which he described as essentially 100 people in a bunker continuously coordinating information from central and local governments, was activated on January 20 of this year, even before the first coronavirus case in Taiwan was confirmed. Well before that, at the end of December, when the World Health Organization was still looking into a mysterious pneumonia in Wuhan, China, Taiwanese authorities were boarding planes and checking passengers on direct flights from the city for pneumonia symptoms. Within weeks officials had cut off travel from Wuhan and were tracking cellphones to make sure those who had been quarantined were staying at home.

The Trump administration acted far less expeditiously. When China began confining many millions of people to their homes in January, the U.S. government should have gotten the message that this was serious, the Yale sociologist and physician Nicholas Christakis told me. “We lost six weeks” in the United States to prepare—“to build ventilators, get protective equipment, organize our ICUs, get tests ready, prepare the public for what was going to happen so that our economy didn’t tank as badly. None of this was done adequately by our leaders.”

Taiwan, which also confirmed its first coronavirus case within a day of America’s, currently has more than 200 confirmed cases, compared with more than 50,000 in the U.S. This is all the more remarkable given, as Wang and his co-authors note in their article, that “Taiwan is 81 miles off the coast of mainland China and was expected to have the second highest number of cases of [COVID-19] due to its proximity to and number of flights between China.”

Taiwan, a territory that neighboring China claims as its own, and South Korea, which is threatened by North Korea, are also far more accustomed than the United States to existential danger lurking nearby. “Given that Taiwan has faced everything from its giant neighbor—the spreading of fake news, military threats, the withholding of vital medical information during the SARS outbreak in 2003—the country knows it must be on its fullest guard whenever any major problem emerges in China,” the Taiwan-based journalist Hilton Yip recently wrote in Foreign Policy.

Taipei metro staff in the MRT station monitor the temperatures of passengers with a thermal scanner on March 19, 2020 in Taipei, Taiwan. Taiwan, Singapore and Hong Kong have had more successful approaches in battling the pandemic given their experience with SARS in 2003. (Paula Bronstein / Getty)

Wang, for example, pointed out that Taiwan has a vice premier who doubles as the country’s chief information-security officer because of the constant threat of Chinese cyberattacks. When coronavirus descended on the country, this official was able to integrate the state’s immigration and customs database with its national health-insurance database and use big-data analytics in real time so that, “when somebody got off the airplane from Wuhan and went to see a doctor, the doctor would get an alert saying ‘this person just came from Wuhan.’”

The U.S. response, by contrast, has been hobbled in part by low levels of trust in government and high levels of partisanship, reflected in how even the concept of social distancing has become politicized. “While anxiety about the disease is rising on both sides of the partisan divide, Democrats consistently express much more concern about it than Republicans do, and they are much more likely to say they have changed their personal behavior as a result,” my colleague Ronald Brownstein wrote recently. (South Korea too is intensely politically polarized, but more than a fifth of those who support the opposition party approve of the government’s response to the virus.)

When people are operating on different sets of facts, national solidarity is elusive, Eric Klinenberg, a sociologist at New York University, told me. Efforts to impose “physical distancing and isolation only works if people respect the order and take heed of the scientific facts … You can’t promote public health without social solidarity. Here is a case where it’s clear that our fate is linked to the fate of our neighbors.”

In the United States, moreover, “we have not just cultural fragmentation but political fragmentation” in terms of how power is divided among government agencies and between the federal government and states and localities, he added. This has been a major factor in why the rollout of COVID-19 testing and the overall response has been so sluggish and haphazard in the U.S. relative to more centralized governments such as South Korea’s. And it helps explain why the United States, with its individualistic creed and decentralized power structure, hasn’t yet imposed a nationwide lockdown despite suffering more coronavirus deaths than a country such as France had when it announced its lockdown.

“When the state is seen as smart and generous and honest and competent, when state programs are seen as normal and good, not stigmatized, I think that elevates levels of solidarity and trust,” Klinenberg said. “When you have a market-based, hyper-individualistic system organized around distrust and fragmentation, as we have here, the cultural response … is to do everything possible to protect yourself: You buy up all the toilet paper. You stockpile cold medications. You use your celebrity status to get yourself a COVID-19 test.”

Klinenberg noted that while the U.S. government is scrambling to make all sorts of emergency policy changes, from ensuring paid sick leave to buttressing the public-health system, the measures are too little, too late. What they signal, however, is that this emergency will reshape the nation. “I think that the America that we make in the aftermath of this disaster looks very different than the America we live in today,” he said. For decades other countries were shaped by the traumas of disease outbreaks while the United States remained largely untouched. No longer.