Glaring Systemic Failures: Shaken conceit of ‘US exceptionalism’

What if the real “invisible enemy” is the enemy from within — America’s very institutions? When the coronavirus pandemic came from distant lands to the US, it was met with cascading failures and incompetencies by a system that exists to prepare, protect, prevent and cut citizens a check in a national crisis. The molecular menace posed by the new coronavirus has shaken the conceit of “American exceptionalism” like nothing big enough to see with your own eyes. A nation with unmatched power, brazen ambition and aspirations through the arc of history to be humanity’s “shining city upon a hill” cannot come up with enough simple cotton swabs despite the wartime manufacturing and supply powers assumed by President Donald Trump.

The crisis turned doctors in the iconic American shining city, New York, into beggars with hands outstretched for ponchos because they couldn’t get proper medical gowns. “Rain ponchos!” laments tech entrepreneur Marc Andreessen. “In 2020! In America!” 

It’s turned a Massachusetts hospital executive into an under-the-radar road warrior, working up a deal through a friend of a friend of an employee who heard about a warehouse more than five hours away with masks. Two tractor-trailers disguised as grocery trucks picked them up, dodged interference from Homeland Security and took separate routes back in case one load got intercepted on highways through the northeast “pandemic alley.” “Did I foresee, as a health system leader working in a rich, highly developed country with state-of-the-art science and technology and incredible talent, that my organisation would ever be faced with such a set of circumstances?” asked Dr Andrew W Artenstein of Baystate Health, who was on hand at the warehouse to help score the booty. “Of course not.” But, he said, “the cavalry does not appear to be coming.”

At the time of greatest need, the country with the world’s most expensive healthcare system doesn’t want you using it if you’re sick but not sick enough or not sick the right way. The patchwork private-public healthcare system consumes 17% of the economy, unparalleled globally. But it wants you to stay home with your COVID-19 unless you are among the minority at risk of death from suffocation or complications. It wants you to heal from anything you can without a doctor’s touch and put off surgeries of all kinds if they can wait.

In the pandemic’s viral madhouse, the United States possesses jewels of medical exceptionalism that have long been the envy of the world, like the federal Centers for Disease Control and Prevention and the National Institutes of Health. But where are the results? For effective diagnostic testing, crucial in an infectious outbreak, look abroad. To the United Arab Emirates, or Germany, or New Zealand, which jumped to test the masses before many were known to be sick.

Or to South Korean exceptionalism, tapped by Maryland’s Republican governor, Larry Hogan, who accepted a planeload of 500,000 testing kits from Seoul to make up for the US shortfall. The aid was dubbed Operation Enduring Friendship and annoyed Trump, the “America First” president. Simple gloves. Complicated ventilators. Special lab chemicals. Tests. Swabs. Masks. Gowns. Face shields. Hospital beds. Emergency payouts from the government. Benefits for idled workers. Small business relief. Each has been subject to chronic shortages, spot shortages, calcified bureaucracy or some combination.

“This monumental failure of institutional effectiveness will reverberate for the rest of the decade,” Andreessen, a tech investor best known for the Netscape browser in the 1990s, said in his company newsletter. Yet Trump uses his daily White House briefings to claim success and talk about his poll numbers, TV ratings, favourite theories about science and the praise he gets from governors, who may be at risk of seeing their states intentionally short-changed by Washington if they don’t say something nice about him.

Connecticut Gov Ned Lamont, a Democrat, found something nice to say about the administration this past week: It’s relaxing some regulations. “They’ve now said you can come up with your own swab,” he said. “One good thing is, the federal government is getting out of the way.” That is one iteration of American exceptionalism now — a national government responding to a national crisis by getting out of the way. The cavalry isn’t coming. That’s what plunged Dr Artenstein into his great mask caper.

Public institutions are measured by their foresight as well as by their response. Why didn’t you see this coming? they get asked when things go wrong — when terrorists strike, hurricanes flood a city, a pandemic arrives. The US saw this coming 15 years ago and still wasn’t prepared. “If a pandemic strikes, our country must have a surge capacity in place that will allow us to bring a new vaccine online quickly and manufacture enough to immunise every American against the pandemic strain,” President George W. Bush said in a call for readiness in 2005.

The principal goal was “the capacity for every American to have a vaccine in the case of a pandemic, no matter what the virus is,” said Michael Leavitt, then the health and human services secretary. Bush announced billions of dollars for a wide-ranging plan for a pandemic like this one. It accelerated a new method of vaccine research, beefed up stockpiles and steered aid to states to build mobile hospitals and more.

Many of the needs of today were anticipated in a mix of federal and state plans. Children would be schooled remotely — TV was the medium of choice then. People would need ready access to advice about whether to leave home quarantine to seek care — in Texas, the plan was to have retired doctors staff phone banks for that purpose. If 911 dispatchers got sick, librarians would step in.

But for all the creativity and ambition, a year later almost half the states had not spent any of their own money for the preparedness subsidised by Washington, and in the years that followed — through the Great Recession, more war, more time passing — the federal effort languished, too. “Our country has been given fair warning of this danger,” Bush said at the launch, recalling the lethal 1918 pandemic and bird flu outbreak then spreading overseas. Americans have “time to prepare.” But foresight became a thing of the past. And to hear Trump, it’s as if it never existed.

“Unforeseen problem,” Trump says of the pandemic. “Came out of nowhere.” “This is something,” he said, “that you can never really think is going to happen.”