The coronavirus faces Trump and a fragile health system in the US | Society

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The president of the United States, Donald Trump.MANDEL NGAN / AFP

Apart from serious errors such as the poor distribution of diagnostic tests, which makes the real number of infected in the country little less than an unknown, the coronavirus crisis has hit the United States with two serious problems. First, the volcanic personality of a president in the middle of an election year, fearful of the impact of the epidemic on the economy, whose strength he regards as his main argument for reelection. And second, the weaknesses that weigh down health care in one of the only developed economies that lacks universal public health, and where millions of citizens avoid visits to the doctor for fear of the costs involved.

In his public communications since the beginning of the crisis, Donald Trump has spread skepticism, has downplayed the scale of the crisis and criticized the alarmist version that he considers offered by the media. This Monday he pointed out on Twitter the alleged responsibility of the "fake news" in the crisis, and insisted on minimizing the scope of it. Last year 37,000 Americans died from the common flu. It is an average of between 27,000 and 70,000 deaths per year. Nothing has been closed, life and the economy go on. There are currently 546 confirmed coronavirus cases, with 22 deaths. Think about it! ”He tweeted. His campaign to deny the crisis has led some columnist to refer to the coronavirus as "Trump's Chernobyl."

During a visit last week to the headquarters of the Centers for Disease Control and Prevention (CDC), charged with protecting the country from threats to health and safety, the president displayed his usual lack of humility. “I like this thing. I really understand it. People are surprised that he understands it. Each of these doctors says, "How do you know so much about this?" Maybe I have a natural ability. Maybe I should have done that instead of running for president, "he said. But his public statements have shown a deep and uncomplexed ignorance of what is, for example, the commercialization process of vaccines (whose efficacy he has not hesitated to question in the past) and, more generally, of the nature and scope real of the crisis produced by the coronavirus. "Come April, in theory, when the weather is a little warmer, it will go away miraculously," he defended on February 12, contradicting the director of the CDC himself, who days before predicted that the virus would remain active much longer.

"We are going down quite substantially, not increasing. We have it very under control," Trump said on February 26. But there are already more than 730 confirmed infections and 27 deaths from the coronavirus, which is now spread across 32 states. In addition, Experts fear that the actual situation could be much worse, as faulty kits were initially distributed, and very strict guidelines for testing were established, which were later expanded. The CDC published Tuesday that it has analyzed 8,500 specimens to date. date. But multiple specimens are tested per patient, so the number of patients examined will be less. In any case, the extent of testing is much more limited than in countries like South Korea, where 10,000 are tested. patients a day.

Dealing with the skepticism of the president of the United States, which has become a source of dissemination of misinformation, is an added challenge for health officials, forced to strike a delicate balance in their public appearances and interactions with the Administration, which only hinders the response of the federal government to the crisis. A response that faces another problem, this one of a structural nature, related to the weaknesses that weigh down healthcare in the United States.

There are 29 million people without health insurance in the country. Many others have policies that include franchises, which in 2019 averaged $ 1,655. That is why many people do not consider going to the doctor even if they have symptoms similar to those caused by the coronavirus. “Studies indicate that in 2017, 9% of American adults delayed or did not seek medical assistance due to its cost. In adults with relatively poorer health, the figure rises to 19%, and in people without health insurance, to 29%. Not everyone needs to see a doctor, of course, but those numbers say a lot about the problem we are facing, ”explains Christen Linke Young, a member of the Public Health Initiative at the University of Southern California and the Brookings Institute, and former White House Health Adviser.

In theory, the CDC offers the test for free, as long as it is prescribed by a doctor, and large insurers have said they will not charge for the service in some states either. But discouraging stories circulate in the press. Like that of Osmel Martinez Azcue, who told the Miami Herald how, when he returned with flu symptoms from a trip to China, he went to a Miami hospital to get tested for coronavirus. It turned out that what he had was the flu. And also a bill for $ 3,270 when he got home.

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