Last week the Joe Biden administration announced the US had crossed the inevitable milestone of one million Covid-related deaths. Although the actual toll is likely to be much higher, it is still the largest recorded number for a single country in the world, and one of the highest death rates per capita of any rich nation.
Public health officials are unlikely to contest the basic facts and figures, but they might take issue with the use of the word “inevitable”, a word defined by Merriam-Webster to mean: “incapable of being avoided or evaded.”
In February 2021 the Lancet published a report detailing how 40 per cent of Covid-related deaths in the US could have been avoided had the administration of the former US president, Donald Trump, not turned a public health crisis into an ideological battle pitting conspiracy theory-backed personal freedom against collective responsibility based on science. If the report’s figure is applied to the current death toll, that means a city roughly the size of Tulsa, Oklahoma could have been saved.
However, the word “inevitable” is an unfortunately apt way to describe an American exceptionalism that is historically proud of “going it alone”: the belief that anyone who falls behind in either health or wealth is personally responsible for not having strong enough bootstraps to pull themselves out of poverty or disability. The exceptionalism that many candidates will be asked to define in this year’s midterm elections pre-dated Covid and could be accurately summed up as lack of sick leave, high levels of child hunger, a slashing of public health expenditures and high maternal death rates.
Before the pandemic hit, the Center on Poverty and Social Policy at Columbia University helped calculate that 43 per cent of Americans and more than 50 per cent of American children lived in poverty or in low-income households. Many of these people had no access to affordable healthcare. It is therefore unsurprising that poorer Americans died from Covid in higher numbers – around five times higher than the wealthiest during the Delta variant wave, according to one study.
Marginalised ethnic groups also died in higher numbers than white people. The Centers for Disease Control and Prevention has reported that Native Americans were twice as likely to die from Covid as non-Hispanic whites, whereas black people and Hispanics were 1.7 and 1.8 times more likely to die compared with whites, respectively. The virus has also created a new demographic of up to 23 million Americans living with long Covid, which could push one million people out of the workforce.
Given the carnage caused by coronavirus, it seems obvious that the US would try to fix inequality so that another pandemic could not cause so much damage. This is not the case. If a political scientist was to wake up from a long coma and look at voting priorities, they would never guess the country had just sleepwalked out of a two-year pandemic.
Case in point: earlier this month one of the states with the highest Covid death tolls, West Virginia, held a Republican congressional primary. The winner, Alex Mooney, did not run on a platform to reduce poverty and increase health spending, which would have been great considering the state ranks poorly for its public health system, and was last in 2017 in median household income. Instead, electors chose a Trump-backed candidate who questions the legitimacy of the last presidential election.
This is the same state as Senator Joe Manchin who was responsible for holding up Biden’s Build Back Better Act. This legislation would have increased health spending and bolstered welfare programmes for the poor. Manchin’s excuse for not voting for the bill: a false concern that parents would use the child tax credit to buy drugs.
West Virginia is a microcosm of larger voter trends in the US. Before the recent spate of primaries, Trump-backed senatorial, congressional and gubernatorial candidates were elected with a success rate of 39 out of 40 Republican primaries. The well-known author JD Vance won the Republican nomination to contest a senate seat in Ohio with close to a 10 per cent margin thanks in part to Trump’s support. Cultural and financial issues appear to outrank concerns of health and poverty. One recent poll indicated that the likely voters for this year’s midterm election are mostly concerned with the economy and abortion.
The cynical side of me can’t help but think that America would never have gone past one million deaths had the victims of the virus been representative of its demographics. But poverty-related co-morbidities and injustices created a social and political landscape vulnerable to the silent sweep of a virus that snuffed out one million lives. Those deaths could have been prevented had the country embraced a genuine pro-life ideology that valued saving lives over the right to get a haircut.
Covid is a great example of US democracy. It exposed America’s fault lines of injustice and forced the population to take a good hard look at inequality, and ask what, if anything, it was willing to do about it. Two years and a million deaths later, the answer is simple – nothing. In this case, hindsight isn’t 20/20; it’s wilful blindness.