The United States has failed on COVID-19. Canada shows a better way

646,970 lives.

That’s the number of Americans who would be alive today if the United States had the same per capita death rate from COVID-19 as our northern neighbor, Canada.

Consider for a moment the magnitude of the lives lost. 646,970 is more than the entire population of Detroit. And that’s more than the total number of American lives lost in World War I, World War II, and Vietnam combined.

No country is more like the United States than Canada, whose economy and culture are closely tied to ours. Yet, in the face of a potentially deadly pandemic of historic proportions, Canada has been far more successful in protecting the lives of its people than the United States. How are we to understand the superior performance of Canada and the disastrous performance of our own country, which has the mortality rate (3023 per million, compared to 1071 in Canada) of any wealthy democratic country?

In comparing the two countries, the starting point must be the different response at the highest levels of government. In Canada, Prime Minister Justin Trudeau said in March 2020: “I will ensure that we continue to follow all recommendations from public health officials, particularly regarding staying home whenever possible, self-isolation and social distancing”. This message was reinforced by Dr. Teresa Tam, Canada’s Chief Public Health Officer, who delivered a message in March calling for solidarity, saying: “We must act now and act together.

In the United States, President Trump, in stark contrast, said he would not wear a mask, saying “I don’t think I will… I just don’t see it.” And instead of reinforcing messages from Dr. Anthony Fauci and other top public health officials, Trump actively undermined them, saying in reference to stay-at-home orders in some states, “I think elements of what ‘they did are just too difficult.’ Not content with undermining his top public health advisers, President Trump further undermined public confidence in science by suggesting “cures” for COVID-19, including at one point ingesting bleach and taking hydroxychloroquine, a drug that research has confirmed has no effectiveness as a COVD-19 treatment.

These divergent responses at the national level were to shape the responses at the state and provincial levels of the United States and Canada, respectively, as well as the public response. By early July 2020, the impact of these divergent responses was already visible, with Canada’s death rate only 60% of the US rate. While Canada’s tougher public health measures – which included larger and stricter stay-at-home orders, the closure of restaurants, gyms and other businesses, curfews and limits on public gatherings – entered into force, the gap between the two countries widened further. . By October 2020, the per capita death rate in Canada had fallen to just 40% of the rate in the United States.

It’s tempting to blame Trump for America’s disastrous response to COVID-19, and there’s no doubt he missed the situation. But the pandemic exposed deep flaws in American institutions and culture that would have made effective responses difficult no matter who was in the White House. If Barack Obama, for example, had been in power when COVID-19 arrived, he too would have faced the country without a national health care system, with deep distrust of government, exceptionally high levels of poverty and inequality, strong racial divisions, a polarized political system and a culture with a strong undercurrent of libertarianism at odds with the individual sacrifices necessary for the collective good.

The differences between the United States and Canada have become even more stark on the issue of vaccines. The United States, which had purchased a massive amount of vaccines in advance, was initially far ahead, with 21% of Americans and only 2% of Canadians vaccinated as of April 1, 2021. The United States was still in the lead in July , but on October 1, 74% of Canadians were fully vaccinated, compared to just 58% of Americans. Part of the difference is undoubtedly the superior access provided by Canada’s publicly funded universal health care system. But equally, if not more important, is the much greater trust Canadians have in their national government: 73% compared to 50% in the United States. Coupled with greater vaccine resistance in the United States, the net result is a vast gap in the proportion of the population. who is not fully vaccinated: 32% in the United States, but 13% in Canada.

The simple fact that Americans are less healthy than Canadians is also implicated in the much higher COVID-19 death rate in the United States. Lacking a universal health care system and plagued by unusually high levels of class and racial inequality, Americans are more likely to have pre-existing medical conditions associated with death from COVID. Americans have an obesity rate of 42% compared to 27% for Canadians and a diabetes rate of 9.4% compared to 7.3% for Canadians. Overall, Canadians are healthier and live longer, with an average life expectancy of 82.2 years compared to 78.3 years in the United States.

The profound cultural differences between the two countries exacerbate these health differences. More than three decades ago, sociologist Seymour Martin Lipset noted in the continental divide that the ideologies of anti-statism and individualism had much more resonance in the United States than in Canada. For many Americans influenced by the powerful libertarian stream of American culture and its elaborate right-wing media apparatus, masks were a violation of freedom and vaccines a form of tyranny. Canada, which produced a convoy of truckers that shut down the nation’s capital, is not immune to such sentiments. But they were much more prevalent in the United States and led to a degree of non-compliance with government and public health officials that had no equivalent in Canada; to take just one example, the percentage of Canadians wearing masks in January 2022, when the Omicron variant was at its peak, was 80%, compared to just 50% in the United States.

Following a national disaster of this magnitude, there must be a serious investigation into what happened and how it could be avoided or mitigated in the future. That’s what the nation did after the 9/11 attacks, forming a commission that issued a major report within two years of its formation. A pandemic that has claimed the lives of more than a million Americans certainly deserves a report of at least equal severity. But in today’s atmosphere of intense political partisanship, it might be better for such an investigation to be conducted by a non-governmental entity made up of distinguished citizens and experts, or by a non-partisan body such as the National Academy of science. But whatever form such a commission might take, it must answer a pressing question: why so many countries, including Canada, have proven so much more effective in responding to the COVID-19 pandemic. We could – and should – learn from their experiences, so that the United States does better when the next pandemic arrives.

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James C. Tibbs