The Failed Principles of American Healthcare, as Evidenced By Our Coronavirus Response
As you’re reading this article, I hope you’re sequestered in your home, separated from those around you. At this point, I hope you understand the dire necessity of social distancing.
I get it: social distancing is frustrating and quarantining is tense and suffocating. And for millions of Americans across the nation, it presents a catastrophic economic reality and a troubling degree of uncertainty.
There was a possible scenario, however, where our lives could have continued almost undisturbed. In this scenario, the virus would be contained to a steady, manageable linear growth, as opposed to the alarming exponential increase in cases currently seen in America.
Unfortunately, this possibility is no longer attainable. But it’s mere existence — it’s lingering, frustrating presence — sheds light on the backward principles of the American healthcare system and the utter failure that was the American government’s response to the advent of coronavirus.
The aforementioned scenario transpired in Singapore. Since late January, when its first case appeared, Singapore has maintained a linear growth in new cases. But at the same time, students are still attending school and workplaces have remained open. This might seem paradoxical: after all, how can the virus be contained when masses of people are interacting regularly? The answer lies in Singapore’s rapid response and proactive measures.
A graph depicting the growth of cases in Singapore versus other nations.
Firstly, Singapore imposed early travel restrictions. Starting in early January, travelers from Wuhan were screened, with all arriving travelers being screened by late January. Any suspected cases were transported directly to a hospital. Travelers arriving from at-risk areas such as northern Italy or Iran have become subject to a fourteen-day quarantine.
Secondly, much of Singapore’s success has come from early, widespread testing and screening and diligent contact tracing. Doctors were allowed to test any patients that they suspected cases in. Authorities interviewed infected patients at length to determine who they contacted, and they used CCTV footage and travel data to fill in gaps in their tracing. Testing was rapidly up-scaled to handle over 2,000 tests per day. In the community, workers have been asked to monitor their temperature and health regularly. Students and school staff are subjected to daily screenings. Throughout high-traffic areas, thermal temperature scanners are in place to allow for mass fever screening.
Finally, Singapore, a country that was heavily affected by SARS in 2003, has instituted prudent practices and established infrastructure to deal with a disease outbreak. This includes a 330-bed emergency center built for infectious disease management, regular exercises, and a national pandemic preparedness plan.
These measures have allowed for expeditious isolation of infected individuals and those who were exposed, thus minimizing the number of individuals a carrier can infect — effectively reducing the disease’s R0 (basic reproduction number). This is particularly important for a disease like COVID-19, whose danger lies in the fact that many of those who are infected will act as carriers, transporting the disease while being asymptomatic or showing only mild symptoms.
Contrarily, the US has been sluggish in its response. Criticism has been directed to the Trump administration’s repeated denial of the disease’s threat, budget cuts to medical research, and dismissal of the Obama-appointed pandemic response team. The greatest point of contention is the government’s inability to ramp up testing, starting when the outbreak was reported in Wuhan. Government officials failed to heed warnings of scientists and experts, leaving America severely compromised.
Dr. Fauci told Congress members that the lack of testing in the disease’s early stages in America was a “failing” on the government’s part. In reality, however, America’s response to the coronavirus corresponds with its longstanding healthcare policy: reactive medicine.
I’m currently in the process of finalizing a paper on health outcomes. My study analyzed the costs of COPD patients based on their risk factors. What I found was that the more risk factors a patient has, the higher their costs will be. The main takeaway, then, is that American healthcare should move to a more preventive system in order to reduce the staggering costs that are as debilitating as the health conditions that cause them. The promotion of healthier practices, regular screenings, and earlier diagnoses reduce the risk of disease onset, and they help to curb more drastic, expensive measures.
But American healthcare practice continues to follow a reactionary protocol. Along with the complications brought on by insurance policy, reactive medicine skyrockets medical costs.
Our government’s inadequate coronavirus response, therefore, is no surprise to me: it mirrors the principles that are currently dooming America’s healthcare system. I hope, however, that we can look to Singapore as a model of the benefits of preventive medicine — that our longing for normalcy, like the relative normalcy that is present in Singapore, can open our eyes to the disheartening state of our status quo. I hope that by seeing that your life could have been relatively undisturbed — that maybe you or your kids would still be in school, that perhaps millions of workers across the country would still have jobs — you realize not just that the American government failed us, but that the principles on which American healthcare are built must change.
