Unproven therapies

From March 1 to April 30, 2020, Trump tweeted 11 times about unproven therapies, and mentioned them 65 times in White House briefings, according to the National Library of Medicine, which is operated by the federal government and is the world's largest medical library.

In television interviews about her recently published book, Silent Invasion, Deborah Birx, coordinator of the White House coronavirus task force under Trump, said she felt "paralyzed" when the president suggested injecting disinfectants as a COVID-19 treatment during a White House news conference in April 2020.

Public health officials say another mistake early on was the lack of testing available to the public. The CDC developed its own test for the virus rather than adopting a German-made test used by the WHO. The CDC test turned out to be faulty, which allowed the virus to spread further. More people died from COVID-19 by the winter of 2020 than at any other time during the pandemic.

The Food and Drug Administration also was slow in approving testing kits made by private companies, compounding delays. By the time testing kits were widely available, COVID-19 had swept through New York City－killing 800 people each day at one point－into rural communities, and was spreading fast.

The virus devastated nursing homes, where elderly people, often with preexisting health conditions and weak immune systems, live in close proximity. More than 200,000 residents and staff members at care facilities had died as of February 2022, according to the CDC.

"A failure to protect our nursing home populations early in the pandemic was also responsible for many of our deaths before vaccines," said Gandhi.

Amid the pandemic, several issues became politicized, especially mask-wearing.

While wearing masks was commonplace in Asian countries like China and Japan as far back as the SARS epidemic of 2002 and 2003, it was an uncommon sight in the US.

Trump mocked anyone who wore a mask, including Joe Biden, his Democratic rival in the 2020 presidential election, during a live debate. Even when he arrived back at the White House after falling ill with COVID-19, Trump was seen taking off his mask defiantly in front of the nation.

Early on, the CDC and WHO gave mixed advice on face coverings, initially saying they were ineffective unless a person was experiencing symptoms or caring for someone who was ill.

US citizens were also advised against purchasing N95 masks because they were desperately needed to protect the healthcare workers caring for coronavirus patients.

However, by April 2020, the CDC made a U-turn and said homemade cloth face coverings could be worn in public spaces such as grocery stores and on public transportation to prevent those who might have the virus from infecting others. The WHO followed suit in June 2020.

If 95 percent of US citizens had worn face masks, it could have saved 130,000 lives in the fall of 2020 and the following winter, according to an October study published in Nature Medicine.

The virus also spread nationwide among people who took the unnecessary risk of attending COVID-19 parties, where the host had been diagnosed with the virus, to see if they would catch it.

Others broke social distancing rules by attending large public gatherings that acted as superspreader events, such as a church camp in South Texas in June last year, where an outbreak resulted in 125 cases. Some 649 cases were also traced back to a Sturgis Motorcycle Rally in South Dakota in August 2020, which nearly 500,000 bikers attended.

Birx, the former Trump adviser, said that tens of thousands of lives could have been saved if things were done differently.

In October, she testified before the House select subcommittee on the coronavirus crisis: "I believe if we had fully implemented the mask mandates, the reduction in indoor dining, the getting friends and family to understand the risk of gathering in private homes, and we had increased testing, that we probably could have decreased fatalities into the 30 percent less to 40 percent less range."

COVID-19 vaccines became available in the US in March 2021. A few months later, a new surge from the Delta and Omicron variants hit, taking more lives.

As of May 17, at least 220.7 million US citizens were fully vaccinated, about two-thirds of the population.

Still, many fear taking the shot. Some are vaccine-hesitant due to conspiracy theories online that say the pandemic is a hoax. Others believe that former Microsoft head Bill Gates put microchips in the COVID-19 vaccines to track them.

Jonathan Berman, a scientist and science educator, and author of the book Anti-vaxxers: How to Challenge a Misinformed Movement, told China Daily: "People are responding to some basic fears that almost everyone shares to a degree. People fear governments and corporations making decisions about their health."

Racial imbalance

Another issue that hurt the US response to coronavirus was that COVID-19 disproportionately affected blacks and Latinos. It led some white Americans to believe it wouldn't affect them. But many of the people of color who died had underlying health issues due to decades of underinvestment in their local healthcare systems.

"Many of our tragic deaths were actually over the past 15 months when we had vaccines," said Gandhi. "I do think that the politicization of the vaccines in our country was most responsible for our higher death rates compared to European countries."

The states with the lowest vaccination rates include Montana, West Virginia, Louisiana, Idaho and Alabama, mostly conservative states.

In July last year, Brytney Cobia, an internal medicine specialist in Birmingham, Alabama, wrote on Facebook that young healthy people were being admitted to her hospital with COVID-19 and often regretted not getting the vaccine on their deathbeds.

"One of the last things they do before they're intubated is beg me for the vaccine," Cobia wrote. "I hold their hand and tell them that 'I'm sorry, but it's too late.' A few days later when I call time of death, I hug their family members and I tell them the best way to honor their loved one is to go get vaccinated and encourage everyone they know to do the same.

"They cry. And they tell me they didn't know. They thought it was a hoax. They thought it was political. They thought because they had a certain blood type or a certain skin color they wouldn't get as sick. They thought it was 'just the flu'."