How the U.S. saw 200,000 people die from COVID-19 in 8 months

The U.S. death toll from the coronavirus topped 200,000 Tuesday, a figure unimaginable eight months ago when the scourge first reached the world's richest nation with its sparkling laboratories, top-flight scientists and stockpiles of medicines and emergency supplies.

"It is completely unfathomable that we've reached this point," said Jennifer Nuzzo, a Johns Hopkins University public health researcher.

The bleak milestone, by far the highest confirmed death toll from the virus in the world, was reported by Johns Hopkins, based on figures supplied by state health authorities. But the real toll is thought to be much higher, in part because many COVID-19 deaths were probably ascribed to other causes, especially early on, before widespread testing.

The toll is still climbing at a considerable rate. Deaths are running at close to 770 a day on average, and a widely cited model from the University of Washington predicts the overall U.S. toll will double to 400,000 by the end of the year as schools and colleges reopen and cold weather sets in.

Reaction from the Democratic leader in the Senate:

"The idea of 200,000 deaths is really very sobering, in some respects stunning," Dr. Anthony Fauci, the government's top infectious-disease expert, said on CNN Tuesday.

Despite the toll, U.S. President Donald Trump told supporters at a rally Monday night that the coronavirus "affects virtually nobody."

In an interview Tuesday with a Detroit TV station, Trump boasted of doing an "amazing" and "incredible" job, adding: "The only thing we've done a bad job in is public relations because we haven't been able to convince people — which is basically the fake news — what a great job we've done."

'We failed miserably'

The figure reflects America's unenviable spot, which it has held for five months, as the world's leader by far in sheer numbers of confirmed infections and deaths. The U.S. has less than 5 per cent of the globe's population, but more than 20 per cent of the official deaths, though reporting in many developing or autocratic nations is not always robust.

Only five countries — Peru, Bolivia, Chile, Spain and Brazil — rank higher in COVID-19 deaths per capita.

"All the world's leaders took the same test, and some have succeeded and some have failed," said Dr. Cedric Dark, an emergency physician at Baylor College of Medicine in Houston who has seen death firsthand. "In the case of our country, we failed miserably."

Blacks, Hispanics and American Indians have accounted for a disproportionate share of the deaths, underscoring the economic and health-care disparities in the U.S.

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For the U.S., it wasn't supposed to go this way.

When the year began, the U.S. had recently garnered recognition for its readiness for a pandemic. Health officials seemed confident as they converged on Seattle in January to deal with the country's first known case of coronavirus, in a 35-year-old Washington state resident who had returned from visiting his family in Wuhan, China.

On Feb. 26, Trump held up pages from the Global Health Security Index, a measure of readiness for health crises, and declared: "The United States is rated No. 1 most prepared."

That was true. The U.S. outranked the 194 other countries in the index.

Besides its labs, experts and strategic stockpiles, the U.S. could boast of its disease trackers and plans for rapidly communicating lifesaving information during a crisis.

The leadership of the U.S. Centers for Disease Control and Prevention was respected for sending help to fight infectious diseases around the globe.

But the stealthy coronavirus slipped into the U.S. and spread undetected. Monitoring at airports was loose. Travel bans likely came too late to be overly effective. Only later did health officials realize the virus could spread before symptoms show up, rendering screening imperfect.

Coronavirus exploited inequalities in U.S.

The virus swept into nursing homes, which suffered from poor infection control, where it began claiming lives, now numbering more than 78,000.

It also exploited inequalities in the United States: Nearly 30 million people in the country are uninsured, and there are stark health differences among racial and ethnic groups.

At the same time, gaps in federal leadership led to shortages of testing supplies. Internal warnings to ramp up production of masks were ignored, leaving states to compete for protective gear. Governors led their states in different directions, adding to public confusion.

Trump downplayed the threat early on, advanced unfounded notions about the behaviour of the virus, promoted unproven or dangerous treatments, complained that too much testing was making the U.S. look bad, and disdained masks, turning face coverings into a political issue.

Democrats have criticized the administration for muzzling or distorting information from health experts.

On April 10, the president predicted the U.S. wouldn't see 100,000 deaths. That milestone was reached by May 27.

At others times he has said if it weren't for his administration, the country could have seen two million deaths, an improbable figure that could have only resulted without prescribing any mitigation efforts.

'Anti-science' currents revealed

Nowhere was the lack of leadership seen as more crucial than in testing, a key to breaking the chain of contagion.

"We have from the very beginning lacked a national testing strategy," Nuzzo said. "For reasons I can't truly fathom we've refused to develop one."

Such co-ordination "should be led out of the White House," not by each state independently, she said. "We aren't going to restore our economy until every state has this virus under control."

The real number of dead from the crisis could be significantly higher: As many as 215,000 more people than usual died in the U.S. from all causes during the first seven months of 2020, according to CDC figures. 

Researchers suspect some coronavirus deaths were overlooked, while others may have been caused indirectly by the crisis, which created such turmoil that people with chronic conditions such as diabetes or heart disease may have been unable or unwilling to get treatment.

Despite the health costs, some Americans have protested stay-at-home orders as being an unfair intrusion on their civil liberties.

Dark, the emergency physician at Baylor, said that before the crisis, "people used to look to the United States with a degree of reverence. For democracy. For our moral leadership in the world. Supporting science and using technology to travel to the moon."

"Instead," he said, "what's really been exposed is how anti-science we've become."