The U.S. Is Vaccinating the World but Can’t Cure Itself

How America’s lagging battle against COVID-19 is hurting its standing as a global leader.

The United States just passed the grim milestone of losing more than 700,000 Americans to COVID-19, a staggering number made all the more tragic because America leads the planet in medical research and vaccine technology. Medical experts and epidemiologists agree that many of those deaths were preventable if more people had followed public health safety guidelines and gotten vaccinated.

Most Americans—more than 55 percent—behaved responsibly and got the shot, but largely because of the Trump administration’s failure to stem the virus in its early days, and the millions of refuseniks who endanger the rest of us, the pandemic is now the deadliest in American history, worse even than the infamous 1918–19 influenza, and it continues to drag on.

That’s not the case everywhere in the world. In Europe, the Middle East, and Asia, many nations that lag behind the United States in quality of health care and vaccine availability have surpassed the U.S. in vaccination rates, keeping their people safer and beating back the pandemic far more successfully. The United Arab Emirates, Portugal, and Malta, for instance, have fully vaccinated more than 83 percent of their populations. Singapore, Qatar, Spain, Iceland, and Denmark have all vaccinated more than 75 percent of theirs. Some of those countries, like Denmark, are slowly returning to normal—or a post-pandemic new normal—and not turning back. Meanwhile, the U.S. still struggles with a pandemic of the unvaccinated.

Of course, the U.S. is helping address the international health crisis by sharing vaccines, expertise, and funding with other nations. But the sad truth is that America, while able to help countries abroad, has failed to get it right at home—even with all its incredible advantages.

Why? Unfortunately, responsible people of good will—be they public health officials in the Biden administration or those at the state level—have been thwarted by political division, widespread dissemination of misinformation, and growing levels of debilitating distrust of government, driven by a right-wing media echo chamber that purposefully amps all of these phenomena for its own advantage. As a consequence, more than 43 million Americans have been infected by SARS-CoV-2, the virus that causes COVID-19, since January 2020—nearly one in five of the world’s cases.

“Compared to almost every country in the world, we are the worst country in terms of COVID metrics: the number of cases, the number of deaths, the lowest vaccination rates, even though they are widely available,” says Dr. Robert Murphy, executive director of the Institute for Global Health and a professor of infectious diseases at Northwestern University’s Feinberg School of Medicine.

He blames this, largely, on the fact that the United States lacks a centralized public health system. “How do you put in a uniform, effective, public health policy during a pandemic when you have 50 states and more public health entities that all have a say in the matter—and so many people have managed to spread misinformation and anti-science?” Murphy told me. “It’s just crazy.”

Other countries with centralized systems, like Japan, imposed a state of emergency to fight COVID-19 and their people, in turn, got vaccinated. “Those systems work very well,” Murphy said, “and our system does not work. So we are the outliers. It is not so much what they are doing right—they are all doing it right—it’s what we are doing wrong.”

That damages America’s international standing at a crucial time when President Joe Biden hopes to lead a global effort to defeat the virus. Friends and allies (and enemies) don’t understand what ails the United States—and why it can’t do for itself what it’s asking the rest of the world to do.

Much of the American resistance to vaccines has come from Republican governors, right-wing talk show hosts, anti-vaxxers, conservative politicians, and trolls who spread disinformation on social media. They have put personal preferences disguised as personal freedoms, like not wearing a mask, ahead of collective freedoms and social responsibility to protect ourselves and others. They cynically continue to put their fellow citizens at risk.

When did Americans become so selfish, even reckless, about looking out for each other and the public good? This country and its allies literally saved the world from tyranny and fascism in the last century and rebuilt Europe. Today, we’re able to help other countries save themselves—with the Biden administration, at least—but we’re not able to save ourselves. And the longer the pandemic goes on globally, the more time there is for new mutations, like the Delta variant, to spring up and possibly thwart our recovery.

At the recent Global COVID-19 Summit, Biden committed the government to donating more than 1.1 billion COVID vaccines to countries around the globe, as Shannon Brownlee and Jeanne Lenzer advocated in the Washington Monthly in February. Already the United States has put more than $15 billion toward global COVID response. That means the U.S. is donating three doses to the world for every one shot it has administered at home. The U.S. has already shipped free vaccine doses to 100 countries—donating more globally than all other countries combined.

Still, we are struggling way worse than other world powers competing for global influence. What are other countries doing that Americans can’t seem to do? In China, authoritarian rule enforced strict lockdowns and other onerous measures to prevent the spread of the disease. Not pretty, but effective. Japan, Malaysia, and South Korea have even jumped ahead of the U.S. in the number of vaccine doses given per 100 people—with the South Koreans using the vaccines to keep most people out of the hospital and the death rate below .01 percent. Mandates work, it turns out, and they should be enforced here, as Biden is doing with increasing urgency for federal government workers and contractors. So, too, are private companies, such as United Airlines and Tyson Foods. If their employees need a push, so be it.

The basic protections against the virus have been mostly clear from the start of the pandemic: wearing masks, social distancing, contact tracing, frequent testing, and avoiding large gatherings—followed by getting as quickly as possible to a vaccination program. “That is the route that Australia, China, Hong Kong, Korea, New Zealand, and Taiwan have scrupulously followed,” Jeffrey Sachs, a professor and director of the Center for Sustainable Development at Columbia University, wrote in a recent piece for CNN. “Their death rates per million are a tiny fraction of the U.S. death rate,” he continued. “All those countries have suffered fewer than 50 deaths per million population, or less than one-40th of the U.S. death rate. If the U.S. had kept deaths to 50 per million rather than the actual 2,048 deaths per million, the U.S. would have saved 650,000 lives from COVID-19.”

So what now? Biden and public health officials need to double down on moving to more mandates. This is about life and death. People who want to beat up shopkeepers or flight attendants for asking them to mask up should be prosecuted to the max. More mandates should impact public transit and large gatherings. The majority has a right to be protected from a reckless minority.

It’s not just our lives that are at stake. It’s our standing in the world. “I think the credibility of the United States has suffered a lot in many ways,” Murphy said. “There used to be a special thing about the U.S., but people abroad are starting to see that we’re really not that special. And with this virus, they don’t understand—a lot of people around the world don’t get why we have no national health plan and why the United States can’t get their act together from a public health standpoint.”

Pretty soon, we may be in a position in which most of the rest of the world has moved on from COVID, but we’ll still be in trenches. What kind of global leader is that?

Support Nonprofit Journalism

If you enjoyed this article, consider making a donation to help us produce more like it. The Washington Monthly was founded in 1969 to tell the stories of how government really works —and how to make it work better. More than fifty years later, the need for incisive analysis and new, progressive policy ideas is clearer than ever. As a nonprofit, we rely on support from readers like you.

YES, I'LL MAKE A DONATION

Storer H. Rowley

Storer H. Rowley is a former national editor, editorial board member, and foreign correspondent for the Chicago Tribune. He teaches journalism and communication at Northwestern University.