As COVID cases fall in Europe, calls to ban travel from America rise. What the EU got right about controlling coronavirus.
When the European Union reopens its borders on July 1 after months of coronavirus restrictions, travelers from China, Uganda, Cuba and Vietnam will be welcome to visit.
But probably not those from the United States.
A report Tuesday in the New York Times revealed that the EU is considering two potential lists of acceptable travelers based on how foreign nations are faring in their fight against COVID-19 — and neither list includes the U.S.
This slight — “a stinging blow to American prestige in the world and a repudiation of President Trump’s handling of the virus in the United States,” as the Times put it — not only underscores how much worse the U.S. outbreak has gotten in recent days. It also highlights how much better the EU is currently doing than the U.S.
And that raises the question of why.
“American exceptionalism was not supposed to mean this,” Tom Frieden, the former director of the Centers for Disease Control and Prevention, recently tweeted.
When it comes to COVID-19, comparing countries is a fraught and often misleading exercise. The United States is a very different entity than, say, Denmark or South Korea, with a much larger, more diverse population, very high levels of political polarization and an unwieldy federalist system of government. And those differences can explain a lot about various coronavirus disparities.
But the EU as a whole is a closer fit for the U.S. Its population is comparable: 328 million here, 446 million there. It’s at least as “diverse” as the United States, with deep fault lines of nationality and ethnicity. Politically, the EU is anything but uniform. And its system of government, a federation of self-governing member states, is similar. For the U.S., the EU may be the only COVID-19 comparison that makes sense.
But Americans aren’t measuring up — not even close.
The early stages of the EU and U.S. outbreaks were strikingly similar. At the beginning of March, neither place had recorded many cases. But soon Europe started to spike, logging about 1,800 cases on March 7, about 7,000 on March 14 and about 20,000 on March 21.
For a couple of days, America lagged behind. Then, around March 18, our curve started to rise at the exact same angle.
By the end of March, the EU had peaked at about 30,000 new COVID-19 cases per day. The U.S., however, was still heading upward. A few days later, on April 3, America finally passed Europe for the first time in the daily case count.
And that’s when the two curves stopped resembling each other.
For the rest of the month, the EU’s rolling seven-day average of new daily cases — a key metric that balances out daily fluctuations — fell every single day, from a high of more than 28,000 on April 1 to about 11,000 on April 30. It kept falling after that, too, slipping under 4,000 in early June. It’s remained there ever since.
America has been a very different story. In April, the U.S. curve seemed to plateau around 30,000, even as the EU was cutting its daily case average by roughly a third. Then, in May, America finally appeared to be making some progress, reducing its seven-day average to about 20,000 by the end of the month — an improvement, although still about five times the EU’s average at that point.
June is when the trouble started. With all 50 states reopened to one degree or another, and with residents easing up on social distancing as a result, America’s seven-day average of new daily cases started to tick up again — modestly at first, and then with increasing speed, rising more than 32 percent over the last week alone.
As of June 23, that seven-day average stands at 29,898 cases per day, America’s highest level since May 2. The angle of the U.S. curve is now the same as it was in late March, suggesting rapid exponential spread. If this keeps up, America will pass its previous peak in a matter of days.
So why are we seeing another surge in the U.S. and not the EU?
First things first: This isn’t a so-called “second wave.” For the most part, infections are way down in the U.S. states that were hit hardest this spring (New York, New Jersey, Massachusetts, Illinois, Connecticut, Maryland) and rising in states that never peaked the first time around (Arizona, Texas, Florida, South Carolina, Oregon). The virus isn’t making a comeback; it’s moving around. This is true even within states. Cases are climbing again in Louisiana, for instance, but New Orleans, once a national hot spot, is no longer the main driver of that spread. Same goes for Washington state, where rural Yakima County, in the south-central part of the state, is responsible for the latest surge in infections — not Seattle.
Also worth noting: The increase in U.S. testing probably accounted for some of our nationwide “plateau” in April and May; today, it may also contribute to rising case counts in certain places, such as Ohio and California. But overall, the U.S. is still conducting fewer tests per positive case than the biggest, hardest-hit European countries, and our positivity rate (5.2 percent) is much higher than theirs (2.0 percent or less) and climbing. Hospitalizations are up here, too. Rt — an epidemiological statistic that represents transmissibility, or the number of people a sick person infects at a particular point in an epidemic — is now estimated to be above 1.0 in 29 states, up from six states two months ago. An Rt below 1.0 indicates that each person infects, on average, less than one other person; an Rt above 1.0 indicates that an outbreak is growing. Testing, in other words, does not explain why reported infections are rising in the U.S. and not in the EU.
Two other factors likely have a lot more to do with it. The first is how effective lockdown was. There’s no one-size-fits-all model for lockdown, as the vastly different measures implemented across the EU demonstrate. Finland, for example, never really locked down at all, with authorities advising against, but not banning, nonessential trips, while shops stayed open. Residents of Spain and Italy, however, were barely allowed to leave home for more than a month; the U.K. was locked down for 83 days. Yet there was a common thread: making sure the virus had been suppressed to a level low enough that containment was theoretically possible once business as usual resumed. This meant different things in, say, Germany and Denmark, but the goal was basically the same.
Some of the hardest-hit U.S. states followed this approach. But most did not. In fact, according to a BBC report from May 14, few states met the White House’s own guidelines for reopening — a “downward trajectory” of reported cases or a falling share of positive tests over a 14-day period — before ending lockdown. As a result, the virus was still too prevalent — still too widespread — to contain. As Dr. Anthony Fauci, the nation’s top infectious disease expert, put it at the time, if some areas “jump over those various checkpoints and prematurely open up without having the capability to be able to respond effectively and efficiently,” the country could “start to see little spikes that might turn into outbreaks.” Sadly, Fauci’s prediction is coming true.
The second contributing factor is how people behave once lockdown ends. Again, personal precautions are not consistent across Europe. In Denmark, for instance, almost no one wears a face covering; in Spain, Germany and Italy, masks are mostly mandatory. But these disparities, which reflect differing regional levels of risk, make sense when the virus has so far been suppressed to a manageable level and where governments are closely monitoring new case clusters and quickly reinstating localized lockdowns when infections spike.
That’s not the case, however, in places such as Florida, Texas and Arizona, where governors have resisted calls to make masks mandatory and have insisted that lockdown is over for good. According to a recent study reported in Health Affairs, mask mandates in 15 states may have prevented as many as 450,000 COVID-19 cases in the U.S., and new modeling from U.K.-based researchers suggests that effective public health efforts to track new infections and trace and isolate the contacts of those infected can also lower the risk of infection in a population by more than half.
Yet in the U.S., views about mask wearing and social distancing have become incredibly polarized. A new Gallup poll shows that only about 30 percent of Republicans would now advise others to stay home as much as possible (down from more than 80 percent in March), and fewer than half of Republicans say they’ve practiced social distancing in the last 24 hours (down from about 90 percent in March). Among Democrats, both numbers are still hovering around 90 percent. Given how little mitigation and containment some state governments are doing, and how lax certain segments of the population have become, especially young people, it’s no wonder that cases are rising. Few other countries have followed a similar curve, but the ones that have — such as Iran — also report widespread skepticism about science, distrust in government, premature rollbacks of lockdown and low levels of compliance with public-health guidelines.
The point here is not that lockdown should have continued forever. After all, it ended in Europe, and so far, cases haven’t spiked there. The point is that lockdown should have lasted as long as necessary to limit the amount of virus circulating in the population; reopening should have been tailored to conditions on the ground; and personal precautions should have been encouraged, not politicized.
If those things had happened, the U.S. might have looked more like the EU by now. And Americans might have been planning their trips to Paris or Barcelona.
