When the Covid pandemic erupted in America in early 2020 one might have predicted that the United States would weather it relatively well, better than most other western nations. We are a rich, well-educated people with a sophisticated medical system, advanced pharmaceutical research, and hospitals full of high-tech equipment, all regulated by watchful government agencies.
Yet, we did the worst.
The figure below displays one measure of Covid’s destruction: Cumulative excess deaths per million people, a measure that helps correct for missing diagnoses. (Simply counting deaths officially attributed to Covid reveals the same pattern.) Early on, the U.S. had about an average rate of excess deaths among several comparable western nations. (Adding more western nations yields the same pattern.) By February, 2021, the U.S. rates had risen to tie Italy at the top. By Thanksgiving, 2021, the U.S. stood on top alone, exceptional in excess deaths.
One reason is vaccination rates. We would have expected the U.S. to lead the world in Covid vaccination. In addition to the reasons listed above, the U.S. led vaccination development at “Warp Speed” and we bought up a lot of the early doses. For the first six months or so, as shown in the next figure, America did lead in vaccinations. A few months later, Americans fell behind, became, and then stayed exceptionally, tragically unvaccinated.
What is going on?
The Covid story displays the many ways that the U.S. is an exceptionally weird nation. (My earlier, 2020, take on this appears here.)
Exceptionalisms
I’ll get back to the “weird” label in a bit; before that, a note about the “exceptional” label As I have written before, social scientists who describe the U.S. as exceptional are not claiming it to be superior, gifted, or blessed (as some political rhetoric would suggest). We simply mean that it is very different in important ways from other nations–from even other rich, western democracies. It is, for better or for worse, very often an outlier. How so? Here are several ways.
Political Exceptionalism. The U.S. is unusual, perhaps unique, in (1) the fragmentation of its national power. We have three branches of government to check each other. One branch itself has two often-quarreling houses. Our judiciary, especially the Supreme Court, has exceptional power over policy. Therefore, many veto points block national action. This is what the Founding Fathers wanted, a government that would be neither the tool of a would-be monarch nor of populist street rabble, a government designed to not act. (2) Also unusual, American authority is highly decentralized: 50 states; over 3,000 counties or their equivalents; 18,000 police districts; 13,000 school districts; 3,500 local health departments–all this also by design and also further blocking, diffusing, and confusing action. And (3) unlike the great majority of comparable nations, we have a two-party system, which means that many decisions have zero-sum implications. A win for one party is a loss for the other. The fierce party polarization of the last generation (about which I will soon post) has exacerbated this dynamic. These three elements contribute to American policy delay and paralysis–all on display in the Covid experience.
Structural Exceptionalism. (1) The first example here is our mishmash of a health system: socialized medicine for the over-65, a confusing maze for the rest. We have both the most expensive health system per capita and the least successful one in the western world. Diseases and accidents cost Americans far more in lost years of life than they have cost residents of comparable countries and the disadvantage has been growing since the 1970s. (2) American economic inequality has come to exceed that of other western nations over recent decades. This topic has been well-covered. (3) Unusual racial divisions rooted in the history of slavery still persist in the U.S. and still shape people’s fates and the nation’s policies.[1] All three examples played out in the Covid story, too.
Cultural Exceptionalism. I refer to perspectives and preferences that Americans share– Americans of both the right and left. (1) One is a preference for the local, the assumption that the local is more virtuous, that power should be local, the ideology of “community control.” The Covid story was in tune, entailing resistance to national authorities and national media. (2) Also notably American is suspicion and dismissal of elites and experts, founded in the egalitarian assumption that Everyman is as wise and worthy as the high-and-mighty and the highly credentialed. This world-view has been seen as particularly American for centuries. In the Covid experience, we heard the call to “Do your own research.” (3) The most general exceptionalism is the centrality in American culture of personal choice. This is where we are the weirdest of the weird.
WEIRDest
Starting with a 2010 paper, and extended in books by Joseph Henrich, psychologists have argued that residents of Western, Educated, Industrial, Rich, and Developed (WEIRD) nations differ greatly in several ways–perception, values, reasoning, and more–from the greater part of humanity today and humanity in earlier eras. (And, therefore, Henrich and others argued, basing academic psychology on lab studies of western college students is a big mistake.) The core of the weirdness is the western presumption that the world is and ought to be the product of individual free will unencumbered by society. American culture contains the most extreme version of this view and is thus exceptional.
I have claimed (in Made in America and in blog posts–e.g., here and here) that what characterizes American culture most is voluntarism, the principle that people freely choose and ought to the choose their communities. A prime example is the conviction–foolish by world historical standards–that young people should freely choose their life partners based on “love.” Another example is the abortion debate, where the “choice” side appeals to individual autonomy and the “life” side appeals increasingly to the unborn child’s individual rights. (In Europe, the abortion debate is not couched in choice terms.) Then there is the example of the ACLU defending the rights of the psychotic to live on the streets if they so choose. It’s all about free choice.
And so revealed by Covid: The anti-vaxxers and anti-maskers have gladly adopted the slogan, “My body, my choice.” We argue about whose individual freedom is most impinged on, those who feel forced to wear a mask and vaccinate or those who feel forced to take risks in public settings. (To which the first group answers, It’s your choice to take the risk or not.)
Covid has brought much to America–fear, disruption, street fights, political gamesmanship, and much, much death. The experience has also put on display the ways that the United States, the most suffering nation in the West, is so exceptional.
Update, January 30, 2023: A newly-published study reveals that Republicans are less likely to say they would take a “personalized cancer vaccine” that was “both safe and effective at preventing cancer” than Democrats and especially so if the vaccine was the product of President Biden’s efforts.
Update, April 25, 2023: A blue-ribbon commission investigating the U.S.’s great Covid failure focused on governing. Among the blameworthy (besides a president who basically opted out), they note “that here is no U.S. national public health operational capability — practically all of it is in a patchwork quilt of states and localities, an anachronism from an earlier age.”
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Notes
[1] By this I mean the well-documented fact that many American policy decisions are driven by their racial implications–most often by whether a policy is viewed by many Whites as “for the Blacks.” See this recent paper, for example.
MADE IN AMERICA 