When the Spanish flu struck India in mid-1918 it found a nation ripe for devastation. Ruled by the haughty British and with a vast underclass of ‘lower caste’ Hindus living in squalor, Spanish flu wreaked havoc, killing around 13-million people, most of whom died in a period of just four months.
Globally, Spanish flu mortality was not equally distributed – when the pandemic struck Japan the island nation closed down shipping and transport by sea, and as a consequence Japanese mortality was estimated at 0.4%, a fraction of the world average of 3-5%.
The relative devastation of pandemic outcomes is guided by a myriad of factors. Italian culture sees families of multiple generations living together – in 2020 this led to many older Italians getting the Coronavirus from their children and grandchildren. Australia was blessed by its remote geography and able to see the pandemic develop elsewhere before locking down. Portugal and Spain live side by side, yet Portugal locked down when experiencing just 245 cases, and has become one of Europe’s coronavirus exceptions. Spain delayed, and has suffered five times as many deaths (per million).
So why has America, with 4% of the world’s population, endured a third of the globe’s coronavirus cases and over 27% of the deaths? America is a developed democracy with mature institutions, excellent medical facilities and a history of leading the world’s response to pandemics. Why has fate chosen America to suffer the worst death toll on earth?
Like India in 1918, it seems the coronavirus found – in America – a nation defenceless against viral catastrophe. A perfect storm of structural, societal and political weakness has sickened the nation as perhaps never before. 2020’s coronavirus pandemic found…
– A massive underclass of desperately poor people (with 14% of the nation living in poverty) with little or no social safety net. A dramatic collapse in the middle class has left 40% of Americans unable to find $400 in an emergency and now facing a choice – work, feed your family and risk your health, or stay home and try to survive.
– The absence of functioning public healthcare. Every other developed nation on earth offers its citizens free healthcare. America does not. As a result Americans, already suffering high rates of co-morbidities like obesity, diabetes and kidney disease, are often unable to access medical care until it’s too late. Coronavirus has allowed poverty and a lack of healthcare to combine in a vicious cycle, at the worst possible time – 9.2 million Americans have lost their health insurance because they’ve become unemployed.
– Distrust and disunity. A sharply divided country is impossible to unite when a crisis arises. As the virus has spread across the land, Republican voters and MAGA cap wearing protesters have defiantly gathered in dense crowds, arguing that ‘freedom’ justifies their distrust of government and refusal to conform. But inconvenience isn’t oppression. During a pandemic, rejecting expertise and demanding rights without the burden of responsibility isn’t freedom at all, it’s selfish nihilism. Social crises demand that individuals accept that they are part of a community, and many Americans seem hell-bent on thoughtless individualism, even if it means their life.
– Non-existent political leadership. Electing a reality TV host with no experience of government has proved a disastrous choice when a real crisis came along. Months into the pandemic, the federal government has yet to devise the most basic of co-ordinated responses, even as Trump continues to tout his success and give himself ten out of ten. The ineptitude and mishandling of the coronavirus by the Trump administration will be taught in history books a century from now, as will the reopening of America when the curve has demonstrably not flattened.
America’s bloated defense budget has bequeathed the nation unimaginable debt, yet again proved useless against an attack that bore no army fatigues. The coronavirus pandemic has shone a light on the grim reality of a divided nation and broken social contract. Decades of neo-liberalism have dismantled the state, removed barriers to contagion and weakened every flank in America’s armoury.
Politics and public health are inseparable during a crisis. It is political decisions that have caused or exacerbated the conditions that have left America without defence. Few of these are being addressed. Poor people still can’t get healthcare. Over 36-million are unemployed. The president continues to divide the nation each day. States are reopening at the same time as infections spike. There is little reason to believe that America’s ordeal is anything like over.
A degree of social conformity is good when times are bad, but while other countries have instigated track and trace apps and protocols, it’s impossible to imagine the level of public trust that would allow Americans to broadly accept such an imposition.
In 1918, when the first Spanish flu wave passed, many Americans had what Professor James Leloudis of UNC describes as ‘a sense of “that’s behind us and we can all move on”’. With President Trump so committed to reopening the economy and winning the election, cheered on by state TV and his fanatical supporters, America seems to have learned little from history.
Political pundits should take note. The appalling Spanish flu death toll in India was the harbinger of profound change. Just a few months after the peak of mortality, Mahatma Gandhi began his non-cooperation movement that heralded the beginning of the end of 150 years of British rule and, eventually, the collapse of the British empire itself. Pandemic catastrophes cause seismic social changes in ways that can change the course of a nation’s history. This may yet prove to be such a moment.