Here is why we will suffer terribly under this disease, even compared to other countries:

not enough paid sick days

no nationalized healthcare

insufficiently-coordinated response

perfect-storm of supply chains and debt

These are all political choices, not features of the virus. This virus will be worse here because it has been set up to be worse.

Not enough paid sick days

Photo by Umari Bethan on Unsplash

America does not have enough paid sick days, especially not for food service workers, and these people do not own their own homes or have other sources of basic subsistence — and so they will work when they are sick, because they have to. They cannot afford to be publically-minded. They do not have the luxury of being nice.

And because they will work when they are sick, they will infect you. They will infect the food that you eat — stop eating out! Anywhere! — they will infect your packages, and so on. Even if you are oh-so-cautious, other people will not be. And they will be infected.

More than that, people will work through their infections. And so more of these cases will become acute. Which will mean more long-term organ damage and more deaths.

No nationalized healthcare

Sick people will not get treatment, and so they will infect more people than they otherwise would have, and be more likely to die. Those that survive will in many cases be saddled with medical debt, weighing down any future economic recovery.

I really do not know what more to say about this. Even if you are wealthy and/or hate poor people, a bunch of people who are sick and can’t afford treatment can get you sick — there are very clear reasons of self-interest for having a health-care system that takes care of everyone.

Photo by Sharon McCutcheon on Unsplash

Insufficiently coordinated response

The American health system… isn’t.

This is worse than just the CDC avoiding testing people, to keep the official numbers low — though that is a great example of how bureaucratic incentives can kill. Most of the know outbreaks in the US seem to simply be places where local health authorities circumvented the CDC and did their own tests — it seems likely that there are many more outbreaks and many more cases in the US than it would appear on paper.

There are multiple federal-level bureaus and NGOs responsible for the country-wide picture, and they are not set-up to coordinate properly. There are 50 state-level bureaus, each of which will do different things, and none of them are allowed to close state borders without congressional approval. There are about 3000 county-level health boards, and they all have different standards and different funding mechanisms. In addition, there are city-level efforts, and efforts being taken by private institutions. None of these are in any way coordinated.

Perfect Storm of Supply Chains and Debt

Automation hasn’t made production or distribution or service more resilient, because it’s been put toward further centralization — rather than requiring a large proportion of blue-collar workers to stop work in order to stop production, a smaller proportion of a smaller number of white-collar workers control the machinery by which work is distributed to the blue-collar workers. That machinery is fragile enough that without monitoring it, it will become dysfunctional. It is possible that the flow of consumer goods into stores might be disrupted temporarily, making it hard to obtain some goods needed for daily life.

Photo by Ramon Cordeiro on Unsplash

The idea of a deadly disease that can spread not only through face-to-face contact but through the semi-automated alternatives we have redirected most of our commerce towards (mail order with packages sorted by people who certainly won’t be taking sick days, & takeout delivered by the same) is uniquely suited to screwing up an economy in which both visible and hidden labor is largely performed by a growing precariat whose contract with capital is based on the presumption of a happy path in which no catastrophes are permitted.

Since the great recession, many firms have reoriented to operate at much higher ratios of debt to income. This, plus the just-in-time supply chains that have become common in the last few decades, makes these firms extremely fragile — they have no buffer. Thus, a big disruption to a bunch of firms at once can make many of them be unable to service their debts or even go out of business, which disrupts supply chains further, which can cause more of these companies to become insolvent. This is all much more of a problem for smaller firms than it is for larger, richer, firms with more resources and more confidence from lenders: the eventual recovery will be one in which the big firms have had their smaller competitors eliminated.