Are Americans Too Self-Absorbed to Contain CoVid-19?

The United States has a reputation for possessing the most sophisticated and robust levels of medical care in the world.  Many of the top scientists in the world are also in the U.S.  So with all this talent and access to all these resources, why is the U.S. struggling to contain CoVid-19?

Human behavior is partially to blame in that Americans hold their individual civil liberties above all.  This freedom results in many Americans (generalization that is not inclusive of all Americans) feeling that they cannot be forced to remain at home, practice social distancing or made to wear a mask.  The internet is bombarded with pictures and videos of individuals refusing to follow guidelines set forth by the Public Health experts.  This “bad” behavior of failing to follow guidelines has resulted in some States enacting emergency laws requiring compliance with local public health guidelines. The recent mass public protests (peaceful or otherwise) has united the country in many ways but also encouraged “bad” behavior in the context of the CoVid-19 CDC Guidelines for social distancing and wearing masks.  The more rural areas of the “Sun Belt” and the “Midwest” were once relatively less impacted by the novel virus– that is until the U.S. started opening up for business.  Now there are “hot spots” in many states that had so few cases that the recommendations for social distancing were far more relaxed than in those states inundated with patients with severe complications of CoVid-19.  In other countries around the world, which have successfully reduced stay at home restrictions and social distancing requirements, the containment of the CoVid-19 virus has been more statistically effective (based on hospitalizations and deaths and not testing).   The civic mindset of the people in the more successful countries has allowed voluntary compliance with laws/regulations requiring the wearing of masks in all socially dense venues outside of your home.  In those countries opening up more successfully, the people feel a civic duty to their fellow citizens to follow the guidelines of their public officials.   It is socially unacceptable to violate the guidelines in these venues.  See the latest data on the Johns Hopkins Coronavirus map https://coronavirus.jhu.edu

The public service announcements in those countries with a more positive opening experience are consistent, clear, concise and widely communicated on a national level.  While the internet is charged with conspiracy theorist who advocate behavior contrary to government guidelines, most citizens in the more successful countries trust their public officials and are voluntarily compliant (although their laws are more stringent/effective regarding consequences for failing to comply).   Compliance in those countries is garnered by trust, communication of a clear message, and a united command and control system of public health and government officials.  Modeling of the behavior you expect to see in others starts with the leadership demonstrating compliance.  If leadership does not believe they are at risk of contracting the CoVid-19 virus, and fail to follow their own guidelines, then many of the people will believe that they too will not contract the virus and that the guidelines are overreaching. http://<script src=”//z-na.amazon-adsystem.com/widgets/onejs?MarketPlace=US&adInstanceId=036d6777-1cc7-4391-83c4-3957e3501924″></script>

Initial reports of the virus’ effect on certain populations were based on the available at the time.  During the initial outbreak phase of this global pandemic, scientist and public health officials were reporting a trend that those with pre-existing illnesses and the elderly were more susceptible.  This may be due to the data being skewed by the prevalence of nursing homes/long-term health care facilities and hospitals where the people were generally contained in buildings/areas with CoVid-19 positive people (symptomatic or not).  Staff and patient alike in those contained spaces were infected and it spread like wildfire.  So there were high numbers in the collective data that probably had a lot to do with the initial assessment that certain groups were more susceptible.  This may have led to over confidence by young people (who are age appropriately already impulsive and feel invincible) to congregate and violate the social distancing guidelines and we are now seeing the numbers of affected patients are much younger than previously reported.

Visualization of coronavirus multiplying with a background of people at a train station concourse.

The U.S. has taken a state-oriented approach to a global problem.  In the National Incident Management System structure, the next higher level in the hierarchy is activated when the emergency exceeds the local capacity and resources and/or when the impact is potentially a national threat.  The Federal government did activate but it failed to develop a national plan-despite the fact that there were a plethora of pandemic response plans that could have facilitated the initial response.  Much public pressure was brought to bear on the leadership (at all levels) to lessen the economic impact particularly in those states where the numbers of infections did not warrant a shut down.  This pressure led to the Federal Government rolling out guidance but leaving the implementation to individual governors of states.  This deconstruction of national level command resulted in a lack of a Unified Command structure.  Travel and movement was initially restricted during the global quarantine and the numbers of patients dropped after a major spike (as predicted by the CoVid Task Force).  Once states began reopening, travelers flooded to the locations with fewer restrictions (graduation celebrations, vacations and large church gatherings) and bars, restaurants and clubs struggled or failed to maintain social distancing and with little to no enforcement, many just ignored the guidance/laws in hopes of trying to make up for staggering economic losses.  The result is another surge in the numbers in many of the states that opened before the federal guidelines were met and even some that were fully compliant.  The key is that many Americans believe that they are free to do as they please and they accept that if that get sick, it was a risk that they were willing to take. This cavalier, “Me First” attitude is contrary to those countries whose citizens are united in the compliance with their leaders’ guidance as they have a “we and us” attitude where the needs of the many outweigh the needs of the few. http://europa.eu

Mixed messages, a lack of a coherent national plan, inconsistent application of guidance provided by different governing entities has resulted in the American public feeling able to openly question local authority and disregard recommendations and guidelines as they are not enforceable whereas laws would be.  Inconsistencies in defining what safe behavior to include is:  No mass gatherings, No in-restaurant dining, no patient visiting has also been challenging. In some locales, it is perfectly legal to attend summer camp, play sports, protest in large groups or attend large/mega churches or large indoor funerals or political rallies.  American politics has divided the nation into believers that this is in fact a global pandemic with a deadly, virile virus and those who believe that this is a subterfuge to throw the election or cause America to decline in the global economic race.  Furthering this distrust is the constant sidelining of the “experts” to include the CDC and the CoVid-19 Task Force in favor of elected officials who are trying to learn on-the-fly all the complexities of a global public health emergency, and the failure of some leaders (not party specific) to publically embrace the Federal Guidelines and enact emergency laws that may infringe on civil liberties and the economy with the intent of protecting the public from the virus.  Wearing a mask whenever you are outside of your home where you might have trouble maintaining social distancing would save lives.  Is America too self-centered to save itself and even the world?  America is still the world leader…in people infected, people hospitalized and deaths.

Sharon K. Lobb, CEO/President Primed LLC!                                          June 27, 2020

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