Program Success Magazine Fall 2020 | Page 5

Program Success 5 Fall 2020 streams of patients confront dwindling I . C . U . capacity ; there are fewer bidding wars for ventilators and N95s . We ’ ve settled , instead , into a grinding battle , in which lives are lost incrementally but no less tragically . Six thousand dead in Georgia ; two thousand in Minnesota ; fifteen hundred in Nevada . It ’ s these small yet significant numbers , adding up month after month , that have gotten us to two hundred thousand .
The coronavirus has assailed America ’ s image of itself . How does one reconcile the deaths of two hundred thousand people - a fifth of all the COVID-19 deaths in the world - with the idea of an exceptional America , a compassionate America , a scientifically advanced America ? The most piercing question has come to be whether we live in a just America . Inequalities in income , housing , employment , and medical care have resulted in Black and brown Americans dying of COVID-19 at higher rates than whites .
The pandemic has especially hurt low-income Americans , many of whom are now out of work , but Congress remains locked in a stalemate over whether and how to deliver relief . Meanwhile , in some states , more than half of all COVID-19 deaths are linked to nursing homes , where many older Americans have died without being able to say goodbye to their loved ones . We tolerate these deaths because of a communal ageism . Our inability to protect the most vulnerable Americans has become both a publichealth failure and a moral stain .
The U . S . holds the unhappy distinction of suffering the most coronavirus deaths in the world . Still , adjusted for population , it ranks ninth among countries with significant numbers of cases , landing between the United Kingdom and Italy - bad , but not the worst . The case-fatality rate in America as a whole - three per cent - is also substantially lower than in many other developed countries : the C . F . R . is fifteen in the U . K ., and fourteen in Italy . C . F . R . is not a
perfect statistic : it ’ s calculated using the number of confirmed cases , not total infections , and so it fluctuates depending on how much testing is done among different populations .( If you test mostly older , hospitalized patients , as the U . S . did at the start of the pandemic , then the C . F . R . will appear higher , because a relatively high proportion of them will go on to die .) One way to understand America ’ s lower C . F . R ., therefore , is to look at its demography . Age remains the most important factor for predicting how deadly the coronavirus pandemic will be : Americans over the age of sixty-five account for nearly eighty per cent of the country ’ s COVID-19 deaths .
Across the world , a country ’ s case-fatality rate is highly correlated with the age of its population . In Uganda , where the median age is sixteen , the C . F . R . is one per cent . The median age is forty-six in Italy , and is forty in the U . K . We might conclude that the U . S . is lucky to be a relatively young nation , with a median age of thirty-eight . ( On the other hand , Japan — one of the world ’ s oldest countries , with a median age of forty-eight , has mounted an exemplary response to the pandemic and has a C . F . R . of only two per cent .)
The excess death toll is less likely to be skewed by confounding variables . It seems to be similar in the United States and Europe , once it ’ s been adjusted for size . There ’ s no question that the U . S . squandered valuable time early in the pandemic , and it ’ s clear that the country has since failed to develop the infrastructure necessary to effectively control the virus . But European countries , such as France and Spain , have also struggled , and are now seeing resurgent coronavirus cases and hospitalizations . The U . S . also isn ’ t the only country that ’ s been unable to protect its most vulnerable citizens . A high proportion of the COVID-19 deaths in Canada and Sweden have happened in nursing homes . In the U . K ., Black people also die of COVID-19 at much higher rates than whites , even though its nationalized
see PANDEMIC page 30