Is this the moment the US goes belly-up?

While I’ve been jumping on park benches, watching videos of people fighting in supermarkets and trying to train the cat to be vacuum-cleaned, my brother has been keeping an eye on geopolitics for us. The below is a summary of what he tells me.

At the time of writing, 31 March, the US is the most infected country in the world by far, with 17,000 new confirmed cases today. (See updated figures on the Worldometer tracker.) The American healthcare system is highly imbalanced, with excellent healthcare available to the rich but not to the rest. However, in the event of this pandemic, the wealthy don’t benefit from this advantage. In order to control a pandemic effectively, you have to make healthcare affordable and available to everyone. Even if 95% of the population can access and afford it, the 5% who can’t will continue to spread the virus to everyone else. 

(Part of this issue, of course, is the job market: even if you make free testing and healthcare available to everyone, people in precarious jobs who can’t afford to take time off work to quarantine themselves will keep spreading it. As I heard it so succinctly explained: No matter how well off you are, during this pandemic you are only as well protected as the least protected member of your society.) 

China, South Korea and Taiwan, who got their ducks in a row after the SARS epidemic while much of the rest of the world thought no more about the matter, have controlled the spread of the virus not only through testing extensively and for free but also by imposing authoritarian measures: tracking people’s movements through their phones, so that if someone tests positive the authorities can see where they have been and track down anyone they have come into contact with, and forcing people into quarantine. The approach has worked; in fact, in many places it has even made lockdowns unnecessary, because when you can track who has the virus and who they may have passed it to, you can quarantine just those people, rather than throwing a blanket quarantine over the entire population. These countries now report having almost eliminated domestic transmission and are able to start focusing on getting back to business. (Interesting articles on South Korea’s and Taiwan’s strategies.)

European countries, meanwhile, may lack the efficiency in testing and contact-tracing, and may be more squeamish about surveilling their citizens so closely and strong-arming them into quarantine, but they at least run on (mostly) socialist systems, which means they generally have national healthcare systems, so each government can coordinate a nationwide response that makes healthcare available to everyone. So European countries are likely to bring the disease under control sooner or later.  

Italy and Spain are, at the time of writing, the two European countries hardest hit. Italy had its first confirmed case on 30 January. There was then a lag before the first deaths occurred, during which time infections spread, first gradually then explosively. The deaths similarly started in a trickle before becoming a flood, and now, at the end of March, the number of new infections appears to have peaked and be back on the way down. Spain is tracking Italy closely.  

The UK appears to be on the same track, about two weeks behind, with numbers of confirmed cases growing explosively, to be followed in the next week or two by the accompanying deaths. Then, hopefully, a couple of weeks from now the numbers will start falling again.  

The US, meanwhile, is at the stage of exponentially spreading infection and is seeing the first few deaths, with an explosion of them due soon. However, it will have a much harder time getting the spread of infection back under control because of its fragmented and frequently prohibitively expensive healthcare system.  

There are sometimes historical junctures where it is possible to pinpoint the moment when historical narrative turns a corner and everything from that point on is framed differently. The Suez Crisis in 1956, for instance, when Britain was elbowed out of Egypt by the Egyptians and the Americans, was the moment beyond which Britain could no longer plausibly claim to sit at the head of an empire. Might this be such a juncture?

A few weeks from now, the US may well be in meltdown.

Where will it be able to turn for help?  

After decades during which the US has continually stepped up and taken charge of sorting out (or attempting to sort out, or pretending to sort out) every major international crisis – the financial crash, the Twin Towers attacks, the war in Syria, etc. –this could be the first time it is unable to do so.

Europe may be recovering by the time the American meltdown hits, but it will be preoccupied with trying to get back on its feet and will have little energy left to help the US.  

African countries will probably be fighting their own battles against the disease by then – as well as dealing with all their usual economic and political challenges – and will be in no position to help. (See this article, dated 24 March, for an overview of the challenges that coronavirus poses for Africa and how the various countries might deal with it.)

China, regaining its strength, may well use the opportunity to step into the breach. China is already sending teams of doctors to Italy and medical supplies to Switzerland. (Just read that sentence again: China is sending doctors to Italy and medical supplies to Switzerland.) Might we end up seeing the world’s current superpower collapse and be superseded by what was just two decades ago an impoverished communist state?  

But there is another possibility.  

This may be Cuba’s moment to shine.  

In Cuba – another communist state and a sworn enemy of the US – most jobs tend to be low-paying but education is free and available to everyone, so many Cubans stay in education for a long time, which means the country has a highly educated population.

In particular, it churns out doctors (it currently has over 95,000 of them – which is more than the whole of Africa does – for a population of less than 12m) which it exports all over the world in exchange for raw materials, crops and diplomatic favours. (Venezuela’s national health system, for instance, is run by Cuba, in exchange for subsidised oil.) It also has a booming pharmaceutical industry.

Many of Cuba’s expat doctors work in Africa, where they have plenty of freedom to experiment with new treatments. Notably, it looks as if some of the HIV drugs that Cuba is developing in Africa may turn out to be useful in treating coronavirus.  

So a few months from now, the US may find itself at the mercy of a communist country that it has spent 60 years trampling all over but that holds the key to fighting the disease that is decimating the American population, while Cuba grows rich and powerful selling its treatment.  

4 thoughts on “Is this the moment the US goes belly-up?

  1. Hmm, that’s a good question. It sounds like the health care issue is something they are trying to resolve, at least temporarily, by making all coronavirus cases covered, but it’s hard to know what that means exactly, and the virus will definitely wreak havoc on all aspects of society, as it already is doing. But I tend to think, living here in Italy, that even countries where the health care system offers universal coverage, that there will be other problems that crop up, like not enough space in the hospitals or insufficient / poor planning, or a lack of supplies. There are positive things about the American system that it’s hard to find here in Italy, and vice versa. Whatever happens, it’s time for the states to overhaul their health care in favor of something that offers coverage for everyone, no matter what, and I think this pandemic is really opening our eyes to that. It’s going to be brutal in America, I feel. It’s very scary.

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