I believe there is a tag for infection control.

Basically curious if there is any type of reasonable guess as to why the U.S. has such a high rate of infection. I am not going to go through the numbers but they are so fantastic that I had to read multiple sources. The rate of infection in China as for example is just miniscule relative to the population. And this is where there were a million people during a Chinese New Year in the heart of the infection which then traveled throughout China and the world from what I read.

Yet other countries after some very horrific bad starts at infection control, as for example Italy, were able to get the infection under somewhat control. On the other hand the United States appears to be not only leading but leading by astronomical numbers of infections. Does anyone have a clue. I am mystified.

  • 3
    Might have something to do with the US president choosing to downplay things to "avoid panic", which included telling people it was no big deal and just going to go away. I think the answers to your questions are far more political than medical science-related. Sep 10 '20 at 1:57
  • Infection control is on topic here, but when the explanation for the failure of infection control in the US is entirely political, it may no longer be on topic. I'll leave this question open for now, but answers must be 100% based on medicine and science. It's okay if answers assess blame if they have the facts to back it up, but even a hint of political partisanship will likely get the answer deleted.
    – Carey Gregory
    Sep 10 '20 at 4:19
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    @Carey, Thank you ...I see what you mean. And you explained it very well.The intention I may want to say was to focus on what works and doesn't work in infection control in the light of this novel pandemic but as you say even the remotest hint that can be interpreted as political will get the answer deleted.
    – Sedumjoy
    Sep 11 '20 at 15:58

In simple infection-control terms, if you compare the US response to China's, the US measures pale in comparison. In China entire cities were locked down hard, with people not being allowed to leave their residences (mostly apartments), with only select few delivering food etc. Transport in and out of such cities was almost entirely shut down. Even asymptomatic people were forced into ad-hoc treatment/containment facilities.

(A bit of an aside, or a "natural experiment", Romania provides an example of what happens when people intially forced into treatment/quarantine are allowed to leave en masse; Romania's Constitutional Court overturned an initial government decision in that regard, likely being the cause of a large increase in cases. Their 2nd/August wave being substantially larger than their first/spring, although other Balkan countries have seen a similar pattern, so causality may not be that certain. Other sources attribute the rise (larger 2nd wave) in the Balkans to the [too] rapid relaxation of containment measures in general.)

Lockdowns do work at reducing infection at least in the short run. A more "apples to apples" comparison being Sweden vs its neighbors. By 23 June, Denmark, Norway or Finland had less than a third of Sweden's number of cases, per capita. (Now, in their defense, Swedish officials claim that in long run the total number of cases will "equal out", an assertion yet to be proven.) Besides such cross-country comparisons, there is a micro-level study from Italy on the effectiveness of lockdowns, using phone location data as a proxy measure for lockdown effectiveness at reducing travel/mobility.

Other countries have developed alternative strategies to lockdown, South Korea is one, focusing on testing and rapid tracing. The US pretty much failed to seriously implement any strategy that would have resulted in a substantial reduction in the spread of the infection, aside perhaps from banking on their pharma industry to rapidly produce a vaccine. (A "check" that has yet to be "cashed".) Also, unlike most European countries, the US also "reopened" while its infection rate had not gone down significantly, although in practice what this meant was that US states that were not hit hard in the initial wave failed to learn from the experience of those that were, reaching and surpassing their infection rates. (And speaking of history repeating itself, South Korea was not exactly immune to this either as a large August church rally was linked to hundreds of new cases, reminiscent of the early days of the pandemic in that country.)

One thing that you might have expected the current US administration to be good at was imposing travel restrictions, which would have bought the US more time. Alas, even in that department, a CDC study says that travel bans from Europe came too late.

Assigning political blame for these facts is beyond the scope of this post.

  • Nice job, thanks. +1
    – Carey Gregory
    Sep 11 '20 at 1:07
  • Question was not intended to be political. Thank you for bringing into focus these poinst. And I may add it certainly makes a little better sense of what I read on the infection rates in the light of what you have said.
    – Sedumjoy
    Sep 11 '20 at 14:25

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