As a physician working in the field of patient care quality and safety, I have been asking: Why is the U.S. leading the world in COVID-19 cases and deaths?

The question led me to recall the case of my former wife, Mary, who ended up in the ICU with less than a 10% chance of survival because of a physician’s errors. These errors are similar to the mistakes made by public officials in the management of the pandemic.

I have concluded that the United States has the world’s highest rate of COVID-19 cases and deaths because we failed to consistently apply infection-control practices. Implementation varied from state to state because governors in some states, including Texas and Florida, prohibited measures to control the spread of SARS-CoV-2.

They made cognitive errors, or errors in thinking that resulted in harmful decisions. They failed to apply the principles of metacognition, the process by which the brain analyzes information and makes decisions.

Decision errors are a leading cause of preventable deaths in our health systems. These errors can be classified into two major categories: hasty judgments and biased judgements. In the first category the most common error is anchoring — fixing on a diagnosis.

My former wife Mary ended up in the ICU because of cognitive errors. She initially experienced pain in her right foot before her leg began to swell. A general internist anchored on the diagnosis of thrombophlebitis (inflammation from blood clots), ignoring signs of a systemic vasculitis (inflammation of the blood vessels).

In the case of COVID-19, early in the pandemic several governors embraced “the Great Barrington Declaration” that promoted the opening of society to normal activity, claiming that societal harm from implementing infection-control practices was greater than the harm of deaths caused by COVID-19.

Basically the Americans prefer freedom of movement. They don’t like restriction. During the early stage of Covid 19 pandemic, former US President Donald Trump did not want to wear face mask.

Unlike the Americans, the Chinese consider human lives is far more valuable and important than freedom of movement. That is why China has the lowest number of Covid 19 cases per capita in the world.

Covid 19 cases in China and USA comparison

The first case of Covid 19 coronavirus was first discovered in China in December 2019 and after one month USA discovered the first case of Covid 19 coronavirus. Since then, China managed to control the spread of the virus much better than the USA.

Currently USA has far more Covid 19 cases than China as shown by the figures below:     

• China
  • Coronavirus Cases: 254,483
  • Deaths: 5,226
  • Recovered: 244,997

• United States
  • Coronavirus Cases: 98,608,431
  • Deaths: 1,088,471
  • Recovered: 95,856,007

What are the long term effect of the recovered Covid 19 patients?

Research suggests that between one month and one year after having COVID-19, 1 in 5 people ages 18 to 64 has at least one medical condition that might be due to COVID-19. Among people age 65 and older, 1 in 4 has at least one medical condition that might be due to COVID-19.

The most commonly reported symptoms of post-COVID-19 syndrome include:

• Fatigue
• Symptoms that get worse after physical or mental effort
• Fever
• Lung (respiratory) symptoms, including difficulty breathing or shortness of breath and cough

Other possible symptoms include:

• Neurological symptoms or mental health conditions, including difficulty thinking or concentrating, headache, sleep problems, dizziness when you stand, pins-and-needles feeling, loss of smell or taste, and depression or anxiety
• Joint or muscle pain
• Heart symptoms or conditions, including chest pain and fast or pounding heartbeat
• Digestive symptoms, including diarrhea and stomach pain
• Blood clots and blood vessel (vascular) issues, including a blood clot that travels to the lungs from deep veins in the legs and blocks blood flow to the lungs (pulmonary embolism)
• Other symptoms, such as a rash and changes in the menstrual cycle

As mentioned above, Covid 19 recovered patients will have prolonged sicknesses. Currently USA has 96 million recovered Covid 19 cases. The US Government will have additional burden/expenditure to provide healthcare to those 96 million recovered Covid 19 patients for a very long time.