News Insight
Weakened defences
The way society functions in the US has made it more wlnerable
to pandemics. Could things be different, asks Chelsea Whyte
nm coronavirus outbreak is a
once-in-a~event-andit
seems the US has spent the past
too years unwittingly weakening
its defences.
ID fact, the US is probably the
developedeoonmeywiththe
wonttypeofbealthcaresyatem
totacklecovid-19.Manyeamomic
and healthcare policies it bas
enacted don't prioritise public
health, anditis finding out first-
hand how dangerous that can be.
The impact of this has been seen
in the put month or so in thelaclc
oftesting-asof23Man:h, the US
has done 238,632 t.ests compared
with 338,036 in South Korea, a far
smaller country. g
"Wedon'thaveenoush i
:resources to do the testing quickly ~
enough. andhave beenslowto ~
measuretheepidemicandreduce ~
its spread," says Ben Sommers, a ~
health economist and phJlldan n
at Harvard University.! L..::::3::::.:::lil
But the long-tenn issue la that
many people in the US simply
don't have adequate healthcare,
he says. "The biggest holes in
our system are the issues of
affordabiliqr and financing."
About 8 percent of people in
the country don't have health
insurance-and many morehave
plans that don't cover the full
cost ofhealtbcare. ID early .Man:h,
a man in P.IDrida said that even
thougbhebad.insurance,hewu
apectedtopayabout$l40otoget
a testfbrcovid-19.M businesses
close to enable social distancing,
some people will lose their jobs
and with ltthelremployer-
provided insurance.
The US Centers for Disease
ControlandPreventlonhasnow
lifted restr.id:ions on testing and
madeitfreetoall.ButSommers
points out that if someone needs
care fbr severe symptoms-fbr
example, a ventilator in an
intensive care unit (ICU) to help
mlRewlldalllllllllmdllmO
them breathe-that care won't be
covered bythetederalgovemment.
That isn't to say that universal
healthcare coverage is a panacea.
The US has one of the highest
numberofICUbeds pertoo,ooo
population, at 34-7 according to
the latest figures available. The UK,
with its National Health Service,$1400
.Amountonemanwasaslald to
pay far a mvld-19 wt m the UShas just 6.6, while Italy, witha
slmililr universal sentce, bas 12.s.
"Iundentand thet.emptation to
lookatthenewooronavirusand
sayweneed to get everyone
covered As we see in Italy. that
alone isn't going to fix this,"
says Sommers.
While universal healthcarecan't stop the vilUs spreading.
as seen in Italy, it may make it
easier to respond to the wider
economic crisis. Sommers says
it is one of many healthcare
policies that builds infrastructure
and creates patient-doctor
relatkmahips that can help
people stay healthy and working.
The US now seems to :realise
this. Emergency spending bills
bavealreadyincludedmoney
fbrex:pandingaccess to Medicalil,
aUSgovemmentpmgmmmeto
help people with low incomes
pay medical eo&ts. '1fwe spend
too bfllionmoM dollars ond!Ject
medical.c:are,tradethatoffwith
the losses from a significant
recession if we don't. This is one
casewbereitmabssemenot
to be stingy," says Sommen.
Healthcare isn't the only
worthwhile investment. Many
countries havewidespmad paid
sick leave, and it Is now becomingP9Gplewho .. 11om11m
.. someofth•most
wlnarabletomvld-19clear that this Is a public health
shield. not an employment perk
Japan. ca.uad.a and the US are three
majoreconomiesthatdon'thave
paid sick leave, while provision in
some places, including the UK, has
been undennined by the rise of
the gig economy. Self-employed
people don't nmmallyget sick pay
in the UK, butthegovemmenthas
said this wfll change.
"Predsel.ybecauseweneed
people to stay home when they're
sick, there is a cue to be made fbr
unlimitedprovisionofpaidleave
fbrthosewho do not have it,"' says
Vewniquede Rugy,aneconomist
at the MeICltus Center at GemBe
Mason University in Virginia.
But again, tbisisn'taslmple
solution.
"If you have no customers
comfng into your stores and on
top of that you have to provide
extrapaymenttoyouremployees
in the form of sick leave, it could
be a problem. It could create an
incentive to get rid of employees;
she says.
Thismightnotnormally be
an issue, as cather1ne Maclean
at Temple Ulliverslty in
Penmylvaniaand her colleagues
fbundwhen theyexaminedfive
US states that adopted paid sick
leave between 2009 and 2017.
"For those employers induced to
provide the covenge, employees
take about twomoredaysofpaid
sfckleaveperyear. Thecostper
employee houris about 21 cents,"
says Maclean.
With a :14-day quarantine
suggested by public health
officials, however, the cost in the
current outbreak is likely to be
much higher. ButMaclean says this
policy. along with better health
insurance and stronger food