US President Trump comments on Mike Pence's press secretary Katie Miller testing positive for Covid-19 but remains confident the virus "is going to go away." Video / AP
The United States has suffered the largest coronavirus outbreak in the world by far, with five times as many reported cases as any other country and more than twice as many deaths.
The numbers are astonishing. America has 1.3 million confirmed cases. The next-highest tally is Spain's 257,000. New York State, on its own, has more cases of the virus than any other country.
The answer is a long, bumbling series of mistakes, committed by everyone from the President to federal agencies, state governments and the American people themselves.
A President in denial
Back in January, when US intelligence agencies first started to warn Donald Trump about the threat the virus posed, his instinct was to brush it off.
Donald Trump. Photo / AP
Trump did not want to spook the financial markets. Even after China finally acknowledged there was significant human-to-human transmission of the virus, he consistently downplayed the danger.
On January 22, CNBC asked the President whether he was worried about the virus becoming a pandemic.
"No, not at all," he said.
"We have it totally under control. It's one person coming in from China, and we have it under control. It's going to be just fine."
At the start of February, having been convinced by his staff to announce restrictions on travel from China, Trump said the problem had been dealt with. On February 2, he told Fox News host Sean Hannity partial travel ban had "pretty much shut it down".
On February 14, he suggested the virus would simply go away as the United States headed into its summer months.
"There's a theory that, in April, when it gets warm – historically, that has been able to kill the virus," said Trump.
By February 26, there were 60 confirmed cases in the United States, and that number was rising steadily.
"We're going down, not up. We're going very substantially down, not up," Trump claimed, contradicting his own administration's health officials.
"As they get better, we take them off the list, so that we're going to be, pretty soon, at only five people. And we could be at just one or two people over the next short period of time."
He also compared the coronavirus to influenza, arguing the latter kills tens of thousands of people a year without sparking any economic shutdowns.
We could keep going for some time, but you get the picture. Trump repeatedly downplayed the virus, and dismissed fears about its potential spread in the United States as media "hysteria".
He did this until mid-March, when he finally started to take the pandemic seriously – and abruptly switched to claiming he'd known how bad it was all along.
"I've always known this is a, this is a real, this is a pandemic," he said on March 16.
"I felt it was a pandemic long before it was called a pandemic.
"I've always viewed it as serious."
That simply wasn't true. As other world leaders did their best to prepare for the crisis, Trump pretended there was nothing to worry about.
When the virus did reach the US, it was allowed to spread virtually undetected for weeks. That was the result of a catastrophic shortage of coronavirus test kits.
Our own Government has spoken repeatedly about the importance of widespread testing. Without it, health officials can't track the virus. With it, they can pinpoint outbreaks and shut them down far more efficiently by isolating the people exposed to possible infection.
"Nobody else in the world got on to all those original cases out of Wuhan in January and contained them. That's why we are now dealing with what we know, rather than a huge community transmission that happened all through February in countries like Italy and the US," Australia's chief medical officer Brendan Murphy said last month.
As Prof Murphy alluded to there, the US was essentially flying blind throughout all of February. It had no idea where the virus was or how widely it had spread.
So, why was there a shortage of test kits?
Remember, Covid-19 is a new strain of coronavirus, which means when the outbreak started, health authorities had to develop a new test to detect it. There wasn't an existing stockpile just lying around.
The US chose not to accept test kits offered by the World Health Organisation, and instead the relevant government agency, the Centres for Disease Control (CDC), set about creating its own.
Meanwhile, the Food and Drug Administration (FDA) took a remarkably conservative approach to testing.
First, it prevented private laboratories from developing and manufacturing their own kits, compelling them to use only the CDC's. And second, it issued narrow guidelines for who should be tested – only people who had recently been to Wuhan, or had come into contact with a confirmed case.
By February 7, the CDC had distributed test kits to state labs. But there was a problem – the tests were faulty. Too many of them were returning inconclusive results, and they had to be fixed.
The FDA loosened its restrictions on private labs at that point, but it took another fortnight, until the end of the month, for the rate of testing to start picking up.
Then, because of the sudden flood of testing, the labs responsible for analysing the results were overwhelmed. That created delays, and some patients had to wait as long as a week to learn whether they had the virus.
While his Government's agencies were so thoroughly screwing up the testing issue, the President was rather unhelpfully bombarding the public with misinformation.
"Anybody that wants a test can get a test," Trump claimed on March 6. That wasn't even remotely close to being true.
A month later, in early April, Trump said the US was testing "more than any other country in the world, both in terms of the raw number and also on a per capita basis".
"The most," he insisted.
It was half true. By that point, things had improved considerably, and America was conducting a higher raw number of tests than any other country. However, it was still lagging well behind other countries on the number of tests per capita.
How much testing, exactly, does the US need to do? According to a study from Harvard University, it should aim to be conducting five million tests a day by June, if the economy is to start reopening.
Trump's Assistant Secretary of Health has called that target "unreasonable". But in late April, the President said it was within reach.
"We're going to be there very soon. If you look at the numbers, it could be that we're getting very close," he said.
"We're going to be there very soon."
Again, he was talking nonsense. The US has been averaging 150,000 to 200,000 coronavirus tests per day. Even now, it is still falling well short of what's required.
In the early weeks of the pandemic, hospitals and doctors warned of impending shortages of crucial supplies they needed to treat coronavirus patients – ventilators, masks, gloves and other forms of personal protective equipment (PPE).
The testing shortage was perhaps America's most catastrophic failure. Photo / Getty Images
The shortages were caused by a few different factors.
For example, usually China manufactures and exports a massive percentage of the world's face masks. For obvious reasons, that was no longer happening.
And America's national stockpile of N95 masks had been left depleted by previous administrations, including Barack Obama's. The Trump administration had not thought to replenish it in its first three years.
Healthcare workers had to make do. Some tried to reuse the PPE they did have. Others created makeshift supplies. Neither solution was ideal.
Meanwhile, the Federal and State Governments bickered over who was ultimately responsible for obtaining more equipment.
"The Federal Government is not supposed to be out there buying vast amounts of items and then shipping. You know, we're not a shipping clerk," Trump said in mid-March.
He put his son-in-law Jared Kushner in charge of the issue, without success. This week The New York Times outlined – in excruciating detail – the fruitless and farcical hunt for supplies Kushner and his "confused and overwhelmed" team embarked on.
Kushner eventually fronted the cameras at a White House briefing and lectured the states on their own failures.
"The notion of the federal stockpile is that it's supposed to be our stockpile. It's not supposed to be states' stockpiles that they then use," he told reporters.
"When you have governors saying that the Federal Government hasn't given them what they need, I would encourage you to ask them, have you looked within your state to make sure you haven't been able to find the resources?"
The states argued the Federal Government's absence had forced them to compete with each other for supplies on the open market, driving up prices.
"It's like being on eBay with 50 other states, bidding on a ventilator," New York Governor Andrew Cuomo said at one point.
We mentioned earlier that New York has more confirmed cases of the virus than any country in the world outside the US. Even that extraordinary statistic understates its role in the crisis.
This week geneticists from the Yale School of Public Health determined a majority of America's infections – "60 to 65 per cent" – could be traced back to New York. It served as the "primary gateway" for the disease to enter and then spread through the country.
New York Governor Andrew Cuomo. Photo / Getty Images
Speaking to The Times, immunology professor Kristian Andersen said Yale's research was proof the scale of America's outbreak was its "own fault".
"It means that we missed the boat early on, and the vast majority in this country is coming from domestic spread," Prof Andersen said.
In other words, officials were too slow to implement measures to contain the virus. New York was an open door; an easy point of entry.
Trump restricted some travel from China at the start of February, but waited until March 11 to ban travel from Europe. It turns out most of the infections in New York came via Europe, rather than straight from China.
Incidentally, mid-March was also when the White House finally issued a set of social distancing guidelines as part of its plan to "slow the spread".
By then, it was already too late. In the fortnight after Trump announced the Europe travel ban, the official tally of cases skyrocketed from fewer than 2000 infections, largely limited to Washington state and New York, to more than 68,000, spread across the entire country.
But the Federal Government was not the only one at fault. Authorities in New York also failed to act swiftly.
The state's first confirmed case came on March 1. Research has suggested that by that point there were actually 10,000 undetected infections there.
Cuomo declared a state of emergency on March 7. He did not implement a full lockdown until almost two weeks after that, on March 20.
Again, we now know that was too late. For weeks, thousands upon thousands of people continued to travel in and out of New York City, quietly spreading the virus to all corners of the US.
Trump has fluctuated back and forth between wildly different messages, predictions and priorities.
He said he wanted to have the American economy "opened up and raring to go" by Easter, on April 12. Days later, he extended the Federal Government's social distancing guidelines for another month, until the end of April.
He told Americans to follow those social distancing rules, then voiced support for people protesting against state governors for implementing them.
He told people they should wear face masks, and seconds later said he had no intention of wearing one himself.
He claimed the coronavirus was no worse than the regular flu, then decided any death toll below 100,000 would be a "good" result.
One moment Trump says the world was "blindsided" by the virus and nobody could have seen it coming; the next he claims to have known it was a pandemic weeks before the declaration by the World Health Organisation.
In February he praised China for its "transparency", and now he blames others for swallowing the country's lies.
He has claimed a vaccine will be ready before the end of the year, contradicting his own officials' estimates that it will take 12 to 18 months.
The President privately expressed support for a Republican governor's plan to reopen his state's economy, then slammed the plan in public.
He posted a vague tweet late at night saying he was shutting down immigration into the US, only to clarify the next day that it was a two-month pause in issuing green cards.
He said he was considering quarantining New York and closing it off from the rest of the country, then ditched the idea hours later.
Trump declared he had "total authority" to do anything as President, then said the states "call their own shots".
His predicted death toll has shifted repeatedly, depending on which model catches his eye at any given time.
We could keep going, but you get the idea. Clear messaging is essential in a crisis, and in the US, it has been sorely lacking.
The hunt for a miracle cure
Twice, Trump has been distracted from the daily slog of managing the pandemic by his apparent eagerness to find a quick and easy cure.
The first instance of this was his fixation on the anti-malaria drug hydroxychloroquine in late March and early April.
Latching onto a very limited, early study from France which suggested the drug might be an effective treatment for the coronavirus, Trump went all in, saying it had "a real chance to be one of the biggest game changers in the history of medicine". He said it should be used to treat the virus "immediately.
Doctors quickly responded to that question, pointing out that hydroxychloroquine can have severe side effects in some situations, including death.
Trump hasn't mentioned the drug much lately. Subsequent studies have shown it is not effective at treating the virus, and might even increase people's risk of death.
His second dalliance with experimental medicine came late last month, when he suggested bringing ultraviolet light "inside the body" or maybe even injecting disinfectant.
Dr Deborah Birx. Photo / AP
"Supposing we hit the body with a tremendous – whether it's ultraviolet of just very powerful light?" he said during a White House briefing, after listening to a presentation from one of his Government's officials.
"I think you said, that hasn't been checked but you're going to test it. And then I said, supposing you brought the light inside the body, which you can do either through the skin or in some other way.
"And I think you said you're going to test that too. Sounds interesting.
"And then I see the disinfectant, where it knocks it out in a minute, one minute, and is there a way we can do something like that? By injection inside or almost a cleaning.
"As you see, it gets in the lungs, and it does a tremendous number on the lungs. So it would be interesting to check that.
"So we'll see. But the whole concept of the light, the way it kills it in one minute – that's pretty powerful."
He urged Dr Deborah Birx, a senior member of his coronavirus task force, to "talk to the medical doctors" about the possibility of applying light and heat "to cure".
"Maybe you can, maybe you can't. I'm not a doctor. But I'm like, a person who has a good you know what," he added, pointing to his head.
Needless to say, none of this was particularly helpful.
Every country has seen a number of people oppose and, occasionally, break social distancing rules. Australia is no different in that regard.
But Americans have struggled with their discipline more than most.
Polling shows most people there agree with the restrictions and do not want them to be lifted prematurely. That has not stopped some Americans from defying the authorities.
"If I get corona, I get corona," one student on Spring Break famously told Reuters.
"At the end of the day, I'm not going to let it stop me from partying."
Images of anti-lockdown protesters have consistently drawn attention around the world.
This month, thousands of people flocked to Huntington Beach in California to rail against Governor Gavin Newsom's stay-at-home order, along with his decision to temporarily close down beaches.
And in one particularly controversial protest, heavily armed men stormed the state capital in Michigan, posing for photos with their rifles outside Governor Gretchen Whitmer's office.
Trump has sporadically egged on the protesters, even though they are technically flouting his own government's guidelines.
He has tweeted that Democratic governors should "liberate" their states.
"The Governor of Michigan should give a little, and put out the fire," he said of the protesters in Michigan.
"These are very good people, but they are angry. They want their lives back again, safely! See them, talk to them, make a deal."
