USA TODAY US Edition

US death toll about to eclipse America’s total losses in WWII

- Jorge L. Ortiz

Besides being the first president to get impeached twice, Donald Trump will have a stain on his legacy with arguably longer-lasting consequenc­es: He’s about to become the only American leader in a century with more than 400,000 deaths from one event on his watch.

The USA is expected to cross that somber threshold in the coming days, perhaps as early as Sunday, yet another reminder of how poorly the nation with the world’s largest economy has fared during the coronaviru­s pandemic.

Not since Woodrow Wilson was in office during the 1918 flu pandemic – which killed about 675,000 in this country and 50 million worldwide – had a president overseen the loss of so many American lives.

The COVID-19 death toll will probably soon surpass the 405,000 U.S. fatalities from World War II – thousands of them recorded when Harry Truman was president after Franklin Delano Roosevelt died in April 1945 – to rank as the third-deadliest event in the history of the republic. About 618,000-750,000 were killed in the Civil War of 1861-1865.

“What’s so troubling about this loss of life is it was preventabl­e,” said Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonweal­th University. “This is an infectious disease we knew how to prevent, and as difficult as it is, far easier to solve than defeating Nazi Germany. And yet, we did not mount a response to wage war against this virus as we have in these other situations.”

Thomas Whalen, an associate professor at Boston University and an

expert on the American presidency, is even harsher in his assessment. Whalen cited reporting by journalist Bob Woodward, who taped Trump on Feb. 7 acknowledg­ing how dangerous the virus was even though he repeatedly downplayed its severity publicly.

“He has, you could say, blood on his hands,” Whalen said of Trump. “He knew this was a threat and really did not do what was necessary to respond to it in a thoughtful and resourcefu­l way.”

The USA, the undisputed global leader in coronaviru­s infections and fatalities, has averaged more than 230,000 new infections and 2,900 deaths in January, part of a powerful winter surge that has overwhelme­d hospitals in many regions and is likely to last through the rest of the month despite the arrival of vaccines.

The Institute for Health Metrics and Evaluation at the University of Washington projects 420,000 deaths by Wednesday’s Inaugurati­on Day – the one-year anniversar­y of the first reported COVID-19 case in the USA – and 567,000 by April 1.

The pace of new infections has accelerate­d at a stunning rate in the past 21⁄2 months, along with the number of fatalities. On Oct. 29, the IHME projected 399,000 deaths by Feb. 1. Around that time, the country averaged 87,000 new cases and 826 deaths a day. This past week, those figures shot up to 246,000 and 3,376.

Along with the vaccines, the biggest ray of hope public health specialist­s see comes from the incoming administra­tion of President-elect Joe Biden, which they expect to bring a science-based approach to containing the virus.

Except for the efforts to develop the vaccines in record time, the Trump administra­tion’s response to the pandemic has been assailed by the medical community. Even the vaccine achievemen­t has been tarnished by their slow rollout.

“By any metric, anybody who believes in data and science would acknowledg­e we’ve done terribly with this pandemic, arguably the worst in the world,” said John Swartzberg, a professor emeritus of infectious diseases at the University of California, Berkeley, citing failures with testing and protective equipment along with mixed messaging on masking. “What that tells us is how badly things can go if you have a bad administra­tion.

“Everybody, including me, is excited about the vaccines, excited about science and what it can do for us. It’s incredibly important. But I think we downplay the importance of what a good administra­tion can do in managing this pandemic. We will do a lot better when we have an administra­tion that

follows science and follows public health, that gives consistent messaging, that doesn’t politicize key institutio­ns like the CDC and the FDA.’’

Biden to take ‘more active role’

Biden has assembled a COVID-19 response team and vowed to have 100 million doses of vaccine administer­ed in his first 100 days in office. He said the $900 billion pandemic relief bill Congress passed in late December, which included more than $8 billion for vaccine distributi­on, was merely a “down payment” in the push to combat the virus.

Though Swartzberg considers the 100 million vaccinatio­ns goal “a stretch,” others said it’s realistic, including Jason Schwartz, assistant professor of public health at Yale University.

Schwartz said the Trump administra­tion set unrealisti­c expectatio­ns by saying 20 million Americans would be vaccinated by the end of December. As of Thursday, 30.6 million doses had been distribute­d, and 11.1 million vaccine shots had been applied, according to the Centers for Disease Control and Prevention.

The vaccine distributi­on has been hampered by a funding shortage – CDC Director Robert Redfield pleaded for more resources in September, but they weren’t approved until three weeks ago – and a lack of coordinati­on and direction from the federal government in the enormous task of making vaccines available to 330 million people in 50 states, Schwartz said.

“The design so far of this vaccinatio­n rollout was so decentrali­zed that it was basically, ship vaccines to each state, you tell us where to ship them, give us the mailing addresses and you take it from there,” Schwartz said. “One thing

we’ve seen already from the incoming Biden administra­tion is they intend to have a far more active and engaged role in supporting this vaccinatio­n effort, coordinati­ng it, leading it.”

The early stages of the vaccinatio­n program are the easy part, Schwartz said, because those first in line – health care workers, plus residents and staff of long-term care facilities – are readily accessible.

Expanding the effort to rural communitie­s and people without regular access to health care will be harder.

Schwartz said it’s important to keep promoting mitigation measures such as mask use, social distancing and frequent hand washing.

Neither the vaccines nor the strategies implemente­d by the new administra­tion are likely to make a major dent on the pandemic for at least a couple of months. Researcher­s don’t know whether vaccines prevent transmissi­on in addition to symptoms.

Swartzberg predicted a “horrific” rest of January followed by several ups and downs in cases, deaths and hospitaliz­ations throughout February before a gradual leveling off by mid-March and continued improvemen­t after that. He doesn’t envision a return to some semblance of normalcy before late summer, a less optimistic outlook than presented by some members of the Trump administra­tion, such as former Operation Warp Speed head Moncef Slaoui.

Any forecasts could be nullified by the emergence of more contagious variants of the virus – although they don’t appear resistant to vaccines – or in the best of cases, by the developmen­t of therapeuti­cs that might ameliorate the disease’s worst effects.

Setting those factors aside, Biden’s team will be charged with clearing a monumental wreckage.

Woolf pointed out COVID-19 was the country’s leading cause of death in the spring of 2020 and late in the year, surpassing cancer and heart disease.

That’s not even taking into considerat­ion the likely undercount of coronaviru­s fatalities or other excess deaths caused by the pandemic – often because of people skipping or being unable to access medical care – which Woolf estimates at one for every two COVID-19 deaths.

WWII deaths took 4 years

The virus is likely to kill more than 400,000 Americans in less than a year – the first such death is believed to have occurred Feb. 6 – whereas it took almost four years for that many U.S. service members to perish in World War II.

Woolf said an infectious disease had not been America’s leading killer since the flu pandemic a century ago, and he highlighte­d three reasons why COVID-19 turned into such a scourge here:

• U.S. life expectancy has been falling compared with other wealthy nations since the 1980s, putting Americans at a disadvanta­ge.

• A fragmented system divides public health response across 50 states, while other countries mounted a national response.

• The United States lacked national leadership, particular­ly from the president but also from the rest of his administra­tion and Congress. Other countries’ leaders promoted policies that reduced spread of the virus and inspired the public to respond.

“This shouldn’t have happened, and it didn’t happen in other countries that are modern and industrial­ized,” Woolf said. “This is a uniquely American phenomenon.”

Whalen said the calamitous handling of the pandemic brings into question the notion, widely held in these shores, that the USA is the world’s greatest country.

He drew a parallel between Trump and Wilson, who presided over the U.S. participat­ion in World War I from April 1917 to the conflict’s end in November 1918.

Not only did both leaders contract the disease that engendered a pandemic, Whalen said, both were less than forthcomin­g with the public about the danger it presented and showed little regard for human life, in Wilson’s case sending infectious soldiers into battle on crowded vessels.

Wilson was contending with two catastroph­es, whereas Trump was enjoying the fruits of a thriving economy and domestic peace when the coronaviru­s emerged as a threat.

“The fact we were fighting a real ugly world war (in 1918), that kind of pushed everything to the background,” Whalen said. “But we don’t have that excuse right now. Trump has no excuse.”

 ?? GREG LOVETT/USA TODAY NETWORK ?? Richard Herman, 82, receives the Moderna vaccine from nurse Sherry Phillips on Dec. 30 in Delray Beach, Fla.
GREG LOVETT/USA TODAY NETWORK Richard Herman, 82, receives the Moderna vaccine from nurse Sherry Phillips on Dec. 30 in Delray Beach, Fla.
 ?? CHRIS PEDOTA/USA TODAY NETWORK ?? Rabbi Shmuel Plafker follows a casket to be buried at the Mount Richmond Cemetery on April 30, 2020, in Staten Island, N.Y. The Hebrew Free Burial Associatio­n provides for indigent members of the Jewish community. COVID-19 deaths increased the need for burial space.
CHRIS PEDOTA/USA TODAY NETWORK Rabbi Shmuel Plafker follows a casket to be buried at the Mount Richmond Cemetery on April 30, 2020, in Staten Island, N.Y. The Hebrew Free Burial Associatio­n provides for indigent members of the Jewish community. COVID-19 deaths increased the need for burial space.

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