Public Health -Thought Paper

The COVID-19 pandemic was declared a global pandemic on March 11, 2020, by the World Health Organization. The pandemic plagued not only the United States but over 100 countries within a matter of weeks thus increasing our sense of vulnerability and human frailty. In some countries, the effects of the pandemic were more devastating than others and many countries are still recovering from the effects of the pandemic. According to the CDC, the effects of the COVID-19 pandemic include loss of human lives, the closure and permanent loss of businesses, loss of employment and livelihood, loss of social connections, long-lasting post covid effects on health even after recovery which includes shortness of breath, chest or stomach pain, loss of smell or taste, organ damage to the lungs and so much more.

As a country that makes up only 4% of the global population, the number of U.S. COVID-19 cases made up a significant portion of global cases (20% as of October 2020) (Redlener, 2020). In the United States over 120,000 American lives have been lost because of the Covid-19 pandemic and this is even much more than the total number of lives of Americans that were lost during World War I (Sebenius, 2020). According to the Centers for Disease Control and Prevention, the total number of deaths from the COVID-19 pandemic is 604,710 as of July 12, 2021. The U.S has fared very poorly in comparison to other high-income nations like Japan, Singapore, Germany, Canada, and South Korea.

There are many ways this massive loss of lives could have potentially been avoided or at least curtailed in 2020. I would argue that if the U.S. government responded quicker to the threat of a pandemic, there could have had been some substantial reduction in the impact of the COVID-19 pandemic. Had the U.S. leadership taken heed to the information about the COVID-19 virus in late 2019, it could have prompted the need for more investigation into the evolving infectious and highly transmissible disease and could have prompted earlier enforcement of our already present mandates.

Per the CDC, the first case of COVID-19 in the U.S. was confirmed on January 21, 2020. The outbreak then accelerated throughout February. By February 23, 15 cases of covid-19 had been confirmed in 6 U.S states and 12 were from inbound travels to the US from China, and 2 were from household contact with confirmed cases. In 3 weeks between late February and early March, the total number of COVID-19 cases in the U.S. increased over 1000-fold. According to the CDC what contributed to this quick spread were large gatherings, high-risk workplaces still being open, highly populated areas, the continuation of travel, importation, inadequate testing, and symptomatic and asymptomatic spread of the virus. Travel restrictions of non-US citizens from china began in early February and limitations on mass gatherings were not placed until mid-March and mandates on the use of cloth face coverings were not issued until April 3rd, 2020. It is believed that between 70-90% of lives may have been saved in the United States had there been a quicker response to the emerging pandemic and had the public health mandates been enacted once information about COVID-19 was available in early 2020 (Sebenius, 2020). This belief is based on information gathered from a comparison of the US to other developed countries like Australia, Germany, Canada, Singapore, and South Korea that enforced their public health policies earlier and had fewer fatalities. 

In the article “How many needless Covid-19 deaths were caused by delays in responding? Most of them” a comparison of other developed nations to the US was made using 3 factors. The first involved scaling the population sizes and covid-19 deaths of each nation to match that of the U.S. The second factor was based on the fact that similar to the US, the majority of the population in each country lived in urbanized areas that are at increased risk for high transmission rates. The last factor involved establishing the timelines for the beginnings of the outbreak of the virus in each country, and this was determined using the date that a 15th case was confirmed in each country. The 15th case in Singapore was confirmed in February 2020, for Australia it was confirmed on February 6th, in South Korea, the 15th case was confirmed on February 2nd, in Germany it was confirmed on February 12th, and in the U.S., it was confirmed on February 14th. When scaled to the population size of the U.S., it was found that while 117,858 lives were lost in the US, fourth months following the 15th confirmed case, only 1,358, 1,324, 1,758, and 35,049 lives would have been lost in Singapore, Australia, South Korea, and Germany respectively following their confirmation of a 15th COVID-19 case. The actual numbers of deaths in each country were 24, 102, 272, and 8863 for Singapore, Australia, South Korea, and Germany respectively, 4 months following the confirmation of the 15th case in each country. This last factor for comparison shows that the spread of COVID-19 to these other developed countries (South Korea, Singapore, Australia, and Germany) occurred earlier than the U.S. but even still the leaders in these countries acted much more quickly than the U.S. with less information and were able to reduce the mortality rate in each country. 

For a direct comparison, the U.S. and South Korea both confirmed their first case of covid-19 around a similar time frame but South Korea, however, enforced more aggressive public health policies and implemented plans for massive public education, information campaigns, isolation, and quarantine of infected cases, and the mobilization of the private sectors to produce testing kits and carry out aggressive diagnostic testing (the private sectors provided testing kits within a week). South Korea also created both COVID-19 and non-COVID-19 health sectors to address each area of health concern separately. South Korea immediately focused its attention on widespread testing and contact tracing, whereas about 2 months after the emergence of COVID-19 the US sought strategies for testing. Within three weeks after the 15th confirmed case, South Korea had banned large gatherings, closed down schools and public spaces. South Korea had about 26,000 tests administered within 3 weeks following the 15th confirmed case whereas the U.S had only 10,000 tests carried out within the same period (Sebenius, 2020). State by state infection control measures was also implemented in different stages in the U.S. which led to a lack of uniformity in containing the spread of COVID-19 e.g., Georgia waited until April 3rd to enforce their stay-at-home orders while other states enforced theirs earlier or later. Throughout April of 2020, 85 South Koreans died in total while per hour an average of about 85 Americans died during this time and the numbers kept increasing over time.

Using the Oxford University, Covid-19 government response tracker, a comparison of the stringency index (based on policy responses such as lockdowns, border closing, contact tracing, vaccine policies and the strictness of said policies, etc.) of various countries was done to compare the degree of response to the pandemic. The U.S. had a much lower stringency index (5.7) than other developed countries like South Korea (38), Germany (25), Australia (23) but these other nations had greater success in protecting their populations from the impact of COVID-19. Nevertheless, I will acknowledge that part of the reason why the U.S. may not have had as much of a positive outcome is because making a noticeable impact depends on the social and political status, of a country (Redlener, 2020). While many of the other countries have a more centralized unitary government like South Korea and Japan, the U.S is liberal and lacks political and social unity. So even with public guidance, it may be hard to carry out optimal public health interventions within a population that is not very compliant.

Nevertheless, I believe that a quicker response to the emerging pandemic could still have helped reduce the overall effects of the pandemic. In regard to public health interventions, according to the article “What we learned from tracking every COVID policy in the world” based on findings from the Oxford University, Covid-19 government response tracker, it seems that many countries employed similar policies during the first few months of the covid-19 pandemic (Mid-March) and most countries followed a similar sequence for implementation. However, as mentioned earlier, other developed nations like South Korea, Germany, Australia, and Singapore which responded sooner to the impending threat of COVID-19 had far lower mortality rates than the U.S. which goes to show that even though similar infection control measures, like identifying and isolating cases, restricting visitors and large gatherings, physical distancing at work, and appropriate use of personal protective equipment were followed by most countries, those that acted much quicker seemed to perform better as seen in the example of the U.S and South Korea. So, while it is obvious that public health interventions play a major role in creating a safer and healthier environment for the public, it is also necessary to highlight the importance of investigating threats to human health quickly and implementing our prevention and control strategies as soon as we can to reduce the detrimental effects of disease and illness on the population, just as we have learned from the experience with the COVID-19 pandemic.


  1. Centers for Disease Control and Prevention. (n.d.). CDC COVID Data Tracker. Centers for Disease Control and Prevention. 
  2. Centers for Disease Control and Prevention. (2020, May 7). Public Health Response to the Initiation and Spread of Pandemic COVID-19 in the United States, February 24–April 21, 2020. Centers for Disease Control and Prevention. 
  3. Centers for Disease Control and Prevention. (n.d.). Post-COVID Conditions. Centers for Disease Control and Prevention. 
  4. Redlener, I., Sachs, J., Hansen, S., & Hupert, N. (2020). 130,000 – 210,000 Avoidable Covid-19 Deaths – And Counting – In The U.S. National Center for disaster preparedness, Columbia University.
  5. Hale, T., Angrist, N., Goldszmidt, R., Kira, B., Petherick, A., Phillips, T., Webster, S., Cameron-Blake, E., Hallas, L., Majumdar, S., & Tatlow, H. (2021). A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker). Nature Human Behaviour5(4), 529–538. 
  6. Sebenius, J. K., (2020, June 19). A faster response could have prevented most U.S. Covid-19 deaths. STAT.