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The Deadly Coronavirus Pandemic
Now , even though our efforts to contain the virus have stumbled , researchers stand a good chance of helping ourselves and the world .
health system generally does a better job than ours at reducing inequities in access to medical care . As bad as Trump has been on masks , citizens of other Western democracies resist wearing them , too .
As troubling as our pandemic response has been , the largest gap may not be between our performance and that of other countries but between our pre-pandemic understanding of America and what we now see revealed . The United States spends more on scientific research than any other nation and , as recently as 2019 , was ranked the world ’ s most prepared to handle a pandemic - and yet our response has been strictly mediocre , and unusually fractious , politicized , and confused . How much of America ’ s struggle is due to bungled leadership - Trump ’ s distraction and disinformation , governors who ’ ve been slow to embrace masks or restrict gatherings , and how much is the result of long-standing features of our political and public-health systems ?
Answering that question is more than an academic or partisan exercise , and it behooves us to answer it honestly ; what we find will have implications for identifying what ’ s broken and figuring out how to fix it . In the meantime , a recent survey of people in thirteen high-income countries found that confidence in America has plummeted during the pandemic : it ’ s now as low as it ’ s been at any point in recent history .
It ’ s not all bad . Our doctors , scientists , and pharmaceutical companies have been world-class . Many American hospitals rapidly and dramatically transformed to accommodate the deluge of critically ill COVID-19 patients ; many doctors found ways to provide Icare through telemedicine . Meanwhile , in less than a year , researchers have discovered an extraordinary amount about the biology , transmission , and treatment of a never-beforeseen virus . Vaccine development is proceeding at unprecedented speed , aided by cutting-edge advances in biotechnology ; enormous investments in clinical trials mean that dozens of drugs may soon be available to reduce the spread and deadliness of the virus . Much of this work builds on decades of biomedical research , a lot of which has been publicly funded . If the coronavirus had emerged just twenty or thirty years ago , we would have far less reason to be hopeful about better treatments or a cure .
Step by step , we have developed a nuanced picture of how the virus spreads . In the beginning of the pandemic , we worried a lot about contaminated surfaces ; now we know that they aren ’ t a major driver of transmission . ( Wash your hands and avoid touching your face ; but there ’ s probably no need to scrub your mail .) We understand that the virus travels primarily through respiratory droplets exhaled by infected people and through microscopic secretions known as aerosols . Droplets , which are relatively large , quickly fall to the floor , but aerosols can float in the air for minutes or hours , making poorly ventilated indoor spaces , such as movie theatres and campaign rallies , especially risky . It took time , and the collaborative efforts of scientists around the world , to come to grips with the aerosol threat .
The World Health Organization maintained that aerosol spread was worrisome mainly during medical procedures , until July , when two hundred and thirty-nine scientists signed an open letter urging it to revise its assessment . At that point , the W . H . O . released a statement acknowledging that aerosol-based transmission in restaurants , gyms , and other crowded spaces “ cannot be ruled out .” Many reopening plans were revised accordingly - favoring the outdoors over the indoors , and urging the opening of windows and the upgrading of ventilation systems when indoor activity was unavoidable .
Early in the pandemic , we didn ’ t fully grasp the challenges posed by asymptomatic transmission . We now know that people can start “ shedding ” the virus several days before they develop symptoms ; in fact , viral loads seem to peak just when symptoms are starting to appear . A recent study , not yet peer-reviewed , found that three-quarters of coronavirus transmissions occur in the two to three days before or after people develop symptoms . Because asymptomatic carriers , who may account for as many as forty per cent of infections , can also transmit the virus , it ’ s clear that curtailing the spread requires everyone ’ s participation - even the participation of those who don ’ t think they are sick .