United States
The United States, now designated a “flawed democracy,” is showing increasing authoritarian rule and threats to basic health protections, especially in combatting communicable diseases. Most concerning is the presidentʼs embrace of authoritarian leaders and the real possibility of major pandemic prevention funding, including the Emergency Reserve Fund, which is designed to be “quickly deployed to respond to pandemic outbreaks.” President Trump has mimicked other autocratic leaders’ positions in managing any serious outbreak. He has praised President Xiʼs rulings and failed to comment on the Chinese rulerʼs decision to punish physicians for grossly delaying international warnings and calling attention to the public health threat for which Xi was totally responsible. Trumpʼs narcissistic personality will force him to be defensive and again lie to save face. Peter Navarro, Trumpʼs senior trade advisor, is quoted: “This delay allowed the virus to proliferate much faster than it otherwise would have and reach other countries that it might otherwise have not.”77 Trump does not possess the knowledge base or intellectual capacity to be the spokesperson for any North American outbreak.
Most critically, Trump has set up a narrative that will impair the USʼs ability to manage any serious outbreak. He has argued for cutting spending for the CDC, National Institutes of Health (NIH; Bethesda, Maryland USA), and Medicare directly related to communicable diseases and will directly hinder any public health response. He is oblivious to the current status of emergency medicine departments in all hospitals, rural and urban, which are currently overloaded and have no beds for influenza patients. Patients must remain in emergency rooms until critical care beds open somewhere in the system, and that may take days. In no manner is our current health system capable of handling a serious outbreak, and the failure to begin a dialogue with practicing medical professionals is being ignored.