David Wallace-Wells says we did — but he doesn’t mean “we” as in “the United States,” or “the United States under President Trump,” as so many people who make similar statements do; he means (and says) “the West.” But the evidence his own article presents undercuts even that conclusion.
Francois Balloux, an infectious-disease epidemiologist and computational geneticist at the University College of London, goes further. “It’s not obvious that different measures taken in different places have clearly led to different outcomes,” he says. “There’s a lot of idiosyncrasy, and I think it’s simplistic to say that the countries that have controlled or eliminated the virus did things extremely differently. If you just list, for instance, the interventions that places like New Zealand or Australia have implemented, they’re not drastically different — in stringency nor duration — than in some other places. The country that had the strictest lockdown for longest in the world is Peru, and they were absolutely devastated. I think the slightly depressing message,” Balloux says with a sigh, “is that there is not just a set of policies that will bring success and can just be applied to any place in the world.” . . .
This is not to say that policy and behavior don’t matter — only that containing a novel disease we understand incompletely is not as simple as hitting the “Science” button. The mitigation measures on which the country has focused the most — masking, social distancing, school closures, restaurant restrictions — are curve-benders, not firewalls. And many of the factors playing a much larger role in shaping the spread of the pandemic fit much less comfortably in a technocrat’s shoulder bag or a liberal’s scolding moralism.
A partial list: There is stochasticity, better known as chance, driven in part by superspreader dynamics, whereby the vast majority of new cases are produced by a thin slice of existing infections and most disease chains simply die out. There is demography, with the skew of lethality so dramatic that many of the world’s younger countries have almost no death toll. There is distribution of comorbidities throughout the population. There is geography, with islands enjoying obvious advantages, and with communities at higher latitudes apparently more at risk, perhaps due to the salubrious effects of sunlight. There is a country’s relationship to its own borders, and who its neighbors are, and its position in the networks of travel and commerce. There is climate, with temperature and especially humidity appearing to shape national outcomes much as they’ve shaped some seasonal rhythms of the disease within countries. There is air conditioning — whether you have it, and what kind. There is what Crotty described to me as a version of the “hygiene hypothesis” — the possibility that regular exposure to pathogens generally might train your immune system like it does your gut biome. There is the catchall of “cultural forces,” covering everything from multigenerational living and employment structures to cheek-kissing and handshakes.
I could go on: residential density, blood type, vitamin D, ICU capacity, proximity to bats. . . .
The whole thing is worth reading, but to my mind the passages in that vein overwhelm the ones suggesting that the West’s response to COVID was a failure. If we can’t really say why some countries got hit worse than others, then we also can’t say how much better they would have done with different responses.