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11 March 2020updated 08 Apr 2020 8:55pm

Postcards from an infected world: Coronavirus highlights the deep flaws in the US healthcare system

Twenty-seven million Americans do not have health insurance and many more have insufficient insurance coverage; the US could be sleepwalking into a public health catastrophe.

By Sophie McBain

By 9 March over 570 people in the US had been diagnosed with Covid-19 and 26 had died, though this was not the most alarming statistic. In the absence of a national database, an investigation by the US magazine the Atlantic found that just under 4,400 people had been tested for the virus, which means the scope of the outbreak remains unknown and likely far exceeds the official figures. By the same point, the UK had tested 24,960 people and South Korea had tested well over 100,000 people. 

The US could be sleepwalking into a public health catastrophe. Yet Donald Trump, who is more focused on his re-election chances than on saving civilian lives, continues to downplay the crisis and to spread bogus science, drawing misleading comparisons between Covid-19, a new disease that the World Health Organisation has estimated could have a 3.4 per cent fatality rate, and the flu, which kills around 0.1 per cent of those infected. At a rally on 28 February, Trump described press coverage of the outbreak as “hysteria”. 

Covid-19 draws attention both to the failure of Trump’s leadership and the weaknesses in the US’s fragmented and unequal healthcare system. The prospect of large and unpredictable medical bills may make people reluctant to seek treatment or request a coronavirus test: the New York Times reported that one family placed under government-mandated quarantine was presented with a $2,600 hospital bill. Twenty-seven million Americans do not have health insurance and many more have insufficient insurance coverage.

New York State had confirmed 173 coronavirus cases by 10 March, the largest number in the US, but it’s hard to shake a city as big or as committed to hustle as NYC. On 6 March, soon after the city had confirmed its first six coronavirus cases, I squeezed into a crowded Manhattan wine bar. The following day, hours after New York declared a state of emergency and the number of cases in the city doubled, I watched the Bob Dylan musical Girl from the North Country in a packed-out theatre. The show goes on.

Step inside a Manhattan pharmacy, however, and you will catch the astringent whiff of hand sanitiser but you won’t be able to buy a bottle. On 9 March all five of my closest pharmacies had run out of hand sanitiser, disinfectant wipes and sprays, surgical masks, medical alcohol and aloe vera gel. Dazed shoppers congregated in the first-aid aisles, studying the labels of various lotions and gauzes. 

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In public bathrooms people wash their hands meticulously and contort themselves to avoid door handles. “Millie, if you lick the swing one more time, we’re going straight home,” one man told his toddler in Central Park, and the urgency in his voice suggested his anxiety ran deeper than the usual germaphobia displayed by many Manhattan parents. A stranger told my two-year-old to stop sucking her thumb because it’s “dangerous”. There’s a pervasive sense of unease; it’s becoming more common to see people wearing face masks. Everyone’s talking about the coronavirus, though often with a dark humour. My neighbour said she’d used the threat of Covid-19 to get her son to shower. She wasn’t sure it was her finest parenting moment, but it worked.

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Read the rest of “postcards from an infected world” series here

This article appears in the 11 Mar 2020 issue of the New Statesman, How the world is closing down