In 2019, the Global Health Security Index - a detailed study published by Johns Hopkins University and the Nuclear Threat Initiative - judged the US better placed than any other nation to respond to a pandemic or epidemic. But that's not how things have turned out. The Trump administration moved quickly to restrict arrivals from China, but did little to prevent the spread of the virus domestically. Donald Trump spent weeks downplaying the seriousness of the coronavirus as it was spreading through the US. Credit:Bloomberg The virus is now killing almost 2000 Americans each day - more than anywhere else in the world. Almost 16,000 people have died in the US after contracting the virus, putting it second only to Italy. (Update: By Sunday the US death toll was more than 20,000, surpassing Italy.) Rather than affirming American exceptionalism, the pandemic has fed into a narrative of American decline.

"Long before COVID-19 ravaged the earth, there had already been a precipitous decline in the appeal of the American model," Richard Haass, president of the Council on Foreign Relations, wrote in Foreign Affairs this week. "The federal government’s slow, incoherent, and all too often ineffective response to the pandemic will reinforce the already widespread view that the United States has lost its way." Unheeded warnings On January 30, Peter Navarro, Donald Trump's top trade adviser, wrote a memo warning that the coronavirus could create a pandemic. In late February, he wrote a second memo saying the virus could kill up to 2 million Americans.

Loading On the day Navarro sent his first memo, Trump was assuring Americans that everything would be fine. "We think we have it very well under control," the President said. A few days later Trump said the number of cases in the US would soon be "down to zero". As late as March 6, he was favourably comparing the coronavirus to the regular flu. Trump's relaxed rhetoric set the tone for Republican politicians and prominent media figures. It was not until March 17 that the President publicly grasped the seriousness of the virus, describing it as a highly contagious "invisible enemy" and announcing tough social distancing guidelines.

Loading At the state and local level, some leaders have been more proactive than others. San Francisco implemented a stay-at-home order on March 16. Despite being the country's second most densely-populated city, it has only recorded 10 deaths from the virus. New York Governor Andrew Cuomo didn't issue a similar order until a week later. The virus was already running rampant in his state, but that was only beginning to become clear. Testing failures The signature failure of the US response to the coronavirus was the slow rollout of mass testing. Because of technical glitches and bureaucratic bungling, the US was flying blind as the virus spread through the country in February and early March.

Instead of using a test developed by the World Health Organisation, the US Centres for Disease Control and Prevention (CDC) opted to develop its own test. This wasn't particularly unusual. It’s common for nations with strong scientific expertise to develop their own diagnostics. The CDC was indeed able to quickly develop a viable coronavirus test, but struggled to ramp up production. When it started sending out test kits to public health laboratories in early February, problems emerged immediately. Trial runs produced inconclusive results in more than half the labs, meaning the tests couldn’t be relied upon. The CDC implemented a workaround solution, which required the labs to send tests back to the organisation's headquarters in Atlanta. This resulted in days-long delays. By mid-February, the nation was testing only about 100 samples per day. Top researchers at prestigious universities were also hindered in their efforts to roll out their own COVID-19 tests. On January 31 Health and Human Services Secretary Alex Azar declared the coronavirus a public health emergency. It was an important declaration but had unintended consequences.

Hospitals and private laboratories that usually face minimal federal regulation were now subject to new rules that required them to obtain permission from the Food and Drug Administration (FDA) before using their own tests. It wasn't until late February that the FDA relaxed its rules and allowed certain laboratories to develop and use their own tests before authorisation. A tale of two countries Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, right, helped make the case for a longer shutdown to US President Donald Trump. Credit:Bloomberg The testing failures in the US can be vividly seen by comparing it to South Korea. Both countries recorded their first case of COVID-19 on January 20.

By the middle of March, South Korea had conducted 290,000 coronavirus tests. At that time the US had only performed an estimated 60,000. The difference is even more damning when you take into account that the US population is seven times larger than South Korea's. Loading Asked about the testing shortage at a congressional hearing in March, Dr Anthony Fauci, the federal government's top infectious disease expert, said: "It is a failing, let's admit it." The pace of testing has increased dramatically over recent weeks. Around 100,000 people are now being tested each day. But the surge came too late to identify emerging hotspots such as New York. The Wild West

For frontline health workers in the US, the biggest concern during the pandemic has been the dire lack of personal protective equipment and ventilators. Hospital staff have held protests outside hospitals pleading for more protective gear. In New York, Broadway costume designers have been sewing masks to donate to hospital workers. Some nurses have been wearing bin bags over their scrubs, while doctors have resorted to wearing ski goggles. Skiers and snowboarders are asked to donate goggles for medical use outside a ski shop in Vermont. Credit:GogglesForDocs Countries around the world have struggled to secure medical supplies, but in the US the problem has been exacerbated by government failures. Trump was slow to invoke the Defence Production Act, a law that allows him to order private companies to manufacture supplies necessary for a national emergency.

An official jumped into her car and hit the highway carrying a cheque for $US3.5 million ($5.6 million). She and the ventilator supplier met in a McDonald’s carpark and he was able to bank the cheque with 20 minutes to spare. And the lack of planning and co-ordination from the federal government has forced states to compete for vital supplies. This has driven up prices and led to what has been dubbed a "Wild West" environment for procurement. The Chicago Sun-Times reported on the remarkable example of officials in Illinois who tracked down a supply of 1.5 million N95 respirator masks in China through a middleman. One day before they expected to complete the purchase, the officials got a call from the supplier saying he had to get a cheque to the bank by 2pm that day or the deal was cancelled.

In order to meet the deadline, an official jumped into her car and hit the highway carrying a cheque for $US3.5 million ($5.6 million). She and the supplier met in a McDonald’s carpark and he was able to bank the cheque with 20 minutes to spare. Never again Republican and Democratic politicians, who agree on little else, believe the pandemic has exposed America's over-reliance on foreign manufacturers for essential medical supplies. The US now imports half of its personal protective equipment from China and the figure for many vital pharmaceuticals is even higher. 'Never again should we rely on the rest of the world for our essential medicines and countermeasures.' Peter Navarro, Trump's trade adviser Chinese pharmaceutical companies supply an estimated 90 per cent of US antibiotics, vitamin C, ibuprofen and hydrocortisone.

"Never again should we rely on the rest of the world for our essential medicines and countermeasures," Navarro said last week. He has been pushing Trump to force government agencies to procure all of their medical supplies from US manufacturers. Last month Republican Senator Marco Rubio and Democrat Elizabeth Warren introduced a bill that, if passed, will direct the Department of Defence to determine whether America's reliance on China for pharmaceuticals is a national security concern. A patient is transferred to a waiting ambulance in New York. Credit:AP Glimmers of hope Last week the White House projected that between 100,000 to 240,000 people could die from the virus in the US - a figure that stunned Americans.