Why the U.S. has the Highest Covid-19 Cases and Deaths?

by Fernando Perfas, Ph.D.

| Photo by Mat Napo on Unsplash

As of this writing, there have been 98.3 million cases and 1.09 million Covid-19 deaths in the U.S. since the beginning of the pandemic in early spring of 2020. A staggering number for an advanced and wealthy country, not to mention a leader in rapid Covid-19 vaccine development. Although the U.S. leads in Covid-19 cases and deaths, it is joined by most developed countries as having the most Covid casualties compared with low-income countries in the rest of the world.

It is ironic that the first country to produce and deploy mass Covid-19 vaccinations, the U.S. still has the most unvaccinated population compared with other wealthy countries. The factors at play in explaining what has gone wrong or why the U.S. has lagged in mitigating the onslaught of the Covid-19 pandemic are complex.

Early in the pandemic, it was established that advanced age is the greatest risk factor for Covid-19. What the U.S. has in common with the rest of the world’s developed economies is the larger number of aging populations, those 65 and above, compared with less developed countries. Seniors are at risk because they tend to have several comorbidities or health issues that make them vulnerable to Covid, such as diabetes, obesity, cardiovascular, chronic pulmonary, and other chronic diseases that are more prevalent in developed countries, even among the relatively young.

Some experts argue that wealthier countries have a higher number of cases because they have better testing resources and higher levels of transparency in reporting Covid cases and deaths compared with lower-income countries.

Air travel is another reason why wealthier countries have more cases than low-income countries. Air traffic volume is higher in affluent countries than in poorer countries, facilitating rapid local and global spread and virus transmissions.

What sets the U.S. apart from its peers in North America, Asia, and Europe is the politicization of the U.S. Covid-19 response and the proliferation of misinformation and conspiracy theories about the virus and the vaccines. The lack of a unified approach and division along political lines to Covid mitigations have sharpened public distrust of government policies and guidelines. In addition, some in the government advocated for herd immunity as a Covid-19 control policy, blunting effective mitigation strategies and encouraging some people to forego vaccination.

“The poor often get immunity naturally through a hard and painful way, getting sick. All things equal, populations of richer countries are more vulnerable to Covid-19, and it’s folly to refuse to get vaccinated.”

Politics and conspiracy theories aside, the expectations that poorer countries would be the most vulnerable and devastated by Covid-19 did not materialize. Ironically, the consequences of poverty might have favored their populations. Consider how poor people in these countries deal with diseases. Many don’t see doctors when they get sick from seasonal illnesses such as the flu and other common infections. Instead, they rely on natural remedies and let the illness run its course. Consequently, they have a robust immune system that lacks the kind of drug tolerance we often see in more affluent people. Results of a recent study provide some support for this observation.

A recent comparative study of 65 and older adults contrasting influenza vaccinated against non-vaccinated showed the protective effects of influenza vaccines against Covid-19. The results showed significant protection among those vaccinated. Covid-19 is a novel, virulent, and deadly variant of coronaviruses that requires a specific vaccine that prompts the immune system to mount an adequate and appropriate response against it. A different variant of coronaviruses causes influenza. Although the flu vaccine does not protect against Covid-19, it prompts the immune system to mount some response against it.

Our body develops immunity against viruses through natural exposure, which often makes us sick, or through vaccination, which is a proactive means of protection. In general, people repeatedly exposed to bacteria and viruses due to a less ideal environment and lifestyle often develop robust immune systems compared with people who are less exposed to a variety of illness-inducing germs.

What is the lesson learned? People from affluent countries who are less exposed to diseases or have the wherewithal to fend off severe illnesses through medications can acquire protection against serious diseases like Covid-19 or pneumonia through vaccination. The poor often get immunity naturally through a hard and painful way, getting sick. All things equal, populations of richer countries are more vulnerable to Covid-19, and it’s folly to refuse to get vaccinated.

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