America's national Coronavirus comorbidities

SARS-CoV-2, or Coronavirus, is a virus that infects both individuals and nations. In human bodies, it infects cells of the lungs, creating an immune response that interferes with breathing in serious cases. In some patients, it goes on to attack other organs such as the heart. Some traits, such as age and weight, make individuals more or less vulnerable. The virus infects nations in ways that we're only beginning to understand. Individuals, even those not infected, seek distance from each other, making most kinds of work impossible. Entire sectors of the economy cease to operate, a cascading process that is hard to stop. Here too, certain traits make nations more or less vulnerable. As it turns out, the traits that allow nations to weather Coronavirus are the same ones that would help them eliminate poverty, create good jobs, provide universal health care, and help prevent global warming. It's looking like the U.S. has just about all the bad traits and few of the good ones. Though we can't change that in the next few weeks, we can get started in the way we respond to the immediate crisis, and then we can finish the job as we rebuild in the aftermath of the coming devastation. The big question, whose answer will either save or cost millions of lives, is: will either president Trump or Biden have the political will and awareness to make these deep, systemic changes?

The traits that make nations more or less vulnerable to Coronvirus aren't matters of "national character" or culture, but rather of physical infrastructure, political and economic institutions, and to some degree ideas. Some of these are tragicomically simple, like capacity to produce masks. Some nations facing Coronavirus had the capacity to quickly ramp up production of tens of millions of face masks almost instantly. The nations that quickly got the virus under control all had this in common, which allowed them to encourage their entire populations to wear face masks in public at all times. In nations that lacked this capacity, authorities encouraged the public to refrain from wearing masks, to conserve them for healthcare workers. Issuing contradictory instructions, authorities told their people that ordinary face masks would not protect them from the virus (but then why would healthcare workers need them?). In fact, ordinary facemasks can prevent contagious people from spreading the disease. And since most spreading seems to be driven by asymptomatic people, universal facemask wearing may have massively reduced transmission in the nations able to do it.

The capacity to produce masks is a specific instance of a more general capacity to produce things, and to quickly ramp up production of any kind of thing at will, including things you didn't used to make. It's not an exaggeration to say that America was the nation that invented this capacity. It's more than a capacity for mass production, it's the capacity to quickly reconfiguring mass production lines. The U.S. invented systems for this in the early 20th century, for example at General Motors, which out-competed Henry Ford's unchanging Model T by releasing exciting new car models every year or two. This capacity is what allowed the U.S. to bring a flood of new vehicles and weapons to World War II.

In World War II, political and military leaders went to corporations that, for example, produced diesel engines and asked them to produce tanks. They went to automakers and asked them to produce airplanes. The stories of how those companies transformed to succeed with the missions they were given are amazing. The reason leaders were able to make those requests, and the reason the manufacturers were able to succeed, was that America had just spent several decades inventing new industries and retooling them on a regular basis. Americans in the 1940s thought of business's capacity to make new kinds of physical objects the way we today think of Silicon Valley's ability to make new websites--which explains why Google's testing screener website is the one new thing this country seems to be able to imagine producing (and only barely!).

The truth is that we could have ramped up to make millions of masks if we had tried. We have the know-how, machines and materials to do it. In this case, it's true, we are missing the physical capacity to make hundreds of millions of masks immediately, but we're not missing the capacity to ramp production to those levels over a matter of months. If we had started that process when we first saw what was happening in Wuhan, everyone in America would be receiving their shipment of masks right now.

What we lacked, and still lack, is the awareness that this is something we can do, or that it is something that any nation can do. There was an old BBC April fools joke mockumentary that visited the "spaghetti fields" of Italy, where noodles were harvested from pasta bushes. A huge number of British viewers fell for it. Today in America we are so alienated from the knowledge of how things are made that American viewers might fall for a similar spoof about the facemask farms of China. That is why, even with the knowledge that millions of Americans may die for lack of facemasks, that we're sitting on our hands as a nation, with no serious plans to ramp up production, and are instead waiting for our donations of masks from Alibaba founder Jack Ma.

Facemasks are just one thing among a whole set that nations need to confront Coronvirus. Others include test kits, and countless other types of medical supplies and equipment, from IV bags to ventilators.

The problem isn't simply that we don't remember that we can make new things. We have an institutional fear of doing anything out of the ordinary. When some volunteers started using 3D printers to make replacement parts for ventilators, the ventilator companies threatened to sue, and the hospitals balked for fears of liability. By the end of this mess, many thousands will have died for lack of access to a ventilator, which raises a much greater risk of liability for hospitals – but no one in charge of anything in this country seem to be able to think two steps ahead.

That is just to scratch the surface of the ways that the U.S. and other nations are lacking the physical, political and mental capacity to contend with a crisis like Coronavirus. If there's any silver lining here, it is that leaders from both parties and all sectors of society are gradually stumbling toward epiphanies about all of these things. For example, right now there's a surge of references to the WWII experience, and mainstream publications such as Politico are publishing accounts by WWII economic historians. By the time we've gotten the virus under control, we will be able to use the capacities we've rediscovered to prevent future pandemics and to deal with other existential threats, such as global warming, that are unfolding more slowly but may be even more deadly if unchecked.