In preparation for the upcoming 2024 US presidential election, The BMJ has initiated a forward-looking series that aims to shed light on the lessons learned from the country’s experience with COVID-19 and the necessary steps to avert the loss of millions of lives in future pandemics, while also improving the overall health of the population.
The series, authored by prominent clinicians and researchers across the United States, explores various topics including the contribution of systemic racism and economic inequality to the disparities observed during the COVID-19 pandemic. The articles also delve into the impact of mass incarceration and poor prison health on the spread of the virus, as well as the role of labor market inequalities and the diminishing presence of the public sector in the management of public health crises.
The authors advocate for a set of systemic reforms that they consider vital and should be central to the agendas of the 2024 US presidential candidates.
It is important to note that the objective of this series is not to assign blame, as there are multiple factors at play, but rather to focus on the future and outline the critical measures required to transform public health and preparedness in the United States, in addition to improving population health as a whole.
In an editorial introducing the series, guest editors Gavin Yamey from the Duke Global Health Institute, Duke University, and Ana V. Diez Roux from Drexel University Urban Health Collaborative, discuss how the United States experienced alarmingly high death rates compared to other countries during the devastating global COVID-19 pandemic.
They highlight the fact that 1.16 million Americans lost their lives to COVID-19, accounting for 16% of global deaths in a nation that makes up only 4% of the world’s population. Furthermore, an estimated 300,000 children were left orphaned or lost one or both parents, with a significant burden of long-term COVID-19 complications.
The series explores the complex and interconnected causes of the United States’ inadequate response to the pandemic, which can be traced back to two key contexts.
Firstly, the pre-existing structural and systemic features of the nation played a significant role in the disastrous outcomes of the pandemic. These include gaps in healthcare and public health systems, the absence of social safety nets and workplace protections, deep-rooted social inequality, and systemic racism.
These factors are the main reasons why the United States witnessed higher mortality rates compared to countries with more equitable healthcare systems. The authors highlight that pandemic deaths in the US were closely linked to social class and race.
Secondly, while the United States had access to numerous scientific resources, the government displayed a troubling inability to generate reliable information, communicate it in a timely and consistent manner, and translate it into effective policies.
Yamey and Diez Roux argue that these failures began at the highest level, with President Trump frequently disseminating false information about the pandemic. His suggestion of using bleach as a remedy for COVID-19 became a symbol of the chaotic communication from the White House during the initial year of the pandemic.
Inadequate communication of existing evidence also contributed to confusion and delayed actions. The authors point out that partisan differences played a role in the varying speed at which states implemented public health measures and the subsequent excess death rates, particularly after vaccines became available.
Furthermore, miscommunication of evidence led to inappropriate actions being taken.
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1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
