After announcing their first known death from Covid-19 on February 29, 2020, in the Seattle region, the United States crossed the symbolic barrier of 500,000 deaths on Monday.
Why does the world’s largest power hold the sad record for the number of known deaths from the disease? What first lessons are American specialists drawing from this pandemic year? Why has the United States been hit so hard?
An element of surprise
For Doctor Joseph Masci, who has fought all epidemics since AIDS, today one of the managers of Elmhurst Hospital in Queens – at the heart of the epidemic in New York – the Covid-19 pandemic presented a element of surprise.
Before the pandemic, the United States was watching coronaviruses ” from afar “, he said. There had been very few cases of SARS (Severe Acute Respiratory Syndrome, a coronavirus detected in 2002) in Canada. “ And there, suddenly, the United States found itself at the epicenter of the problem ”.
The reaction ” messy From the Trump administration did not help. “In a country like ours, with 50 states, an immense surface area, a network of largely private hospitals, it was going to be difficult to bring everyone together around the same strategies. “
Competition between hospitals
“The fact that hospitals were competing for protective equipment made no sense. It would have been necessary to centralize that very quickly, and they did not do it ”, he said.
For him as for Dr. Michele Halpern, specialist in infectious diseases in a hospital in the New York suburbs where the epidemic arrived in force in February 2020, one of the mistakes was to let the wearing of the mask become “A political question”.
With its reversals, its skepticism displayed on the virus and the barrier gestures, Donald Trump’s management of the health crisis has been strongly criticized.
“It’s not difficult to wear a mask, you get used to it. But we have to make people understand that it is important ”, said Dr Halpern.
What are the first lessons to learn from the crisis?
For Joseph Masci, the first lesson was to learn how to reconfigure hospitals to be able to cope with a sudden influx of patients.
« We participate in disaster preparedness exercises […], we did a lot of exercises but never did any to simulate it – suddenly going from 12 intensive care beds to 150, with the necessary staff and equipment. “
Over the months, the group of public hospitals that Elmhurst is a part of have come up with strategies to spread the burden among New York’s 11 public hospitals.
More generally, says Michele Halpern, “We must realize that hospitals need resources […] You have to invest in research, but also in hospitals and retirement homes, you have to have enough staff and they have to have the equipment they need ”.
Inequalities in health
The epidemic has also exposed in the United States the inequalities in health, especially in terms of housing, which mainly affect black or Hispanic minorities, underlines Dr. Masci. The promiscuity caused by housing that is too small makes it difficult to respect barrier gestures and it is necessary to consider ways of adapting housing to future epidemics “Because there will be others”, he said.
Despite the acceleration of the vaccination campaign, uncertainties surrounding the British and South African variants are pushing experts to remain cautious.
Without these and with more than 70% of the vaccinated population, there would be “Good chances that we no longer wear masks” end of 2021, says Joseph Masci. If they settle down, it becomes “Much more difficult to say that we will be out of the woods” in December.
“I hope that the vaccines will be effective, but it is difficult to be sure that they will be so in the long term or on the new variants”, said Dr Halpern. “You have to be prepared for it to last a while longer. “
For the long term, says Dr. Masci, “ we must not fall into the trap of forgetting “ by not thinking about the epidemic once over.
“It is disturbing to think that all of this happened without warning. […] We really need to have a global pathogen detection system, because we live in a time when we can no longer say – there is something happening in Asia that will not affect America ”.
Coronavirus. The reasons the United States remains the hardest-hit countryOuest-France.fr
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