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The growth of the GDP is primarily driven by government spending on mega infrastructure projects (spearheaded by the military), leading to a boom in the construction sector. Government spending is financed by a bloated public debt, the burden of which is disproportionality shouldered by the lower segments of society.

the regime did not invest in the development of the manufacturing sector, and it did not lay down the foundation for sustainable, long-term economic growth

The decline in the level of consumption was not counteracted by an increase in the level of exports in goods and services. This is reflected in the value of Egyptian exports, which reached 47.45 billion USD in 2018, a decrease of 1.66 billion USD compared to 2013. Other indicators also reflect a worsening international competitive position. For example, the trade deficit ballooned from -6.34% of the GDP in 2013 to -10.45% of the GDP in 2018

the military directly employs 19.2% of the labour force. This makes the military the second largest employer in the country, after the public sector that employs 5.6 million.

projects include much-publicised mega infrastructure projects, with dubious economic benefit, the most notable of which is the new administrative capital. The construction sector, which is closely connected to the military led projects, played an important role in generating economic growth. In 2018, it is estimated to have grown by 8.9%, making it the number one contributor to the GDP growth

growth of the GDP is not driven by a dynamic private sector, but mainly by a massive military led construction spree, and mega-infrastructure projects that have little positive impact on increasing the competitiveness of the Egyptian economy

the unemployment rate, which reached 8.1% by the first quarter of 2019, the lowest in 10 years. This drop in the level of unemployment, however, requires some additional qualification. The rate of utilization, which measures the number of workers employed for at least one hour per week as a percentage of the population, has dropped from 44.5% to 39%. This is also accompanied by a reduction in the level of workforce participation from 46.4% to 41.6%, indicating a reduction in the level of those seeking work, rather than an increase in the number of available jobs. Loss of hope should be credited with the drop in the level of unemployment, not improved economic conditions.

profits generated from business owned by the armed forces are exempt from taxation, under law 96 (2015). This means that the government is shifting the burden on the shoulders of the poor, as they finance the military construction spree, which in-turn is used to enrich the military elites and other regime insiders

as debt continues to pile up, the pressure on the poor will continue to rise, as the government continues to cut social spending. This will reduce the level of effective local demand, leading to greater pressure on the private sector. In addition, if the construction spree continues, the possibility of overcapacity and over-accumulation of capital in the construction sector becomes more prominent. In essence, a bubble that is bound to burst.

This growth in immigration, in turn, is changing the image of Japan from ethnically homogenous to moderately diverse. Among Tokyo residents in their 20s, 1 in 10 is now foreign-born. And Tokyo is no longer an outlier. Much of the migration is happening in small industrial towns around the country, such as Shimukappu in central Hokkaido and Oizumi in Gunma prefecture, where migrant populations make up more than 15 percent of the local population. In the mostly rural Mie prefecture, east of Osaka and Kyoto, foreign migration has reversed years of population loss.

Conservative Prime Minister Shinzo Abe has based his support for the changing immigration policy not on any humanitarian concerns but rather on pragmatic, demographic arguments. By 2050, the world population is expected to increase by 2 billion people, according to the United Nations, but Japan’s population is expected to shrink by at least 20 million. Meanwhile, the fertility rate in Japan has fallen to 1.4 children per woman, while 28 percent of the country is over 65 years old. This means that the country’s population has been dropping by around 400,000 people a year

With unemployment consistently below 3 percent in recent years, even after the pandemic, employers are increasingly raising alarms about labor shortages. Last year, for the first time in Japan’s history, there were more jobs available than the number of job seekers in all of Japan’s 47 prefectures. In a country long known for its restrictive borders, immigration is now seen as the most obvious solution to that demographic challenge.

Japan has developed a unique program of customized immigration, based on specific requests for workers from various countries

Japan custom-orders a labor force in the 14 sectors where they are most urgently needed, including nurses and care workers, shipbuilders, farm workers, car mechanics, and workers in the fishing and construction industries

he said he prefers the casual xenophobia of Japan to the structural racism of America

most of Japanese society supports the changing immigration policy. In a recent survey by Nikkei, almost 70 percent of Japanese said it is “good” to see more foreigners in the country. “The nationalist, anti-immigrant groups here only make up perhaps 1-2 percent of voters. It’s not like Europe. And they have not raised their voices about this so far,”

given that latest bill allows an easier pathway for skilled foreign workers to apply for permanent residency and, eventually, Japanese citizenship—it may do more than simply sustain society. “More workers will try to stay here permanently,” Oguma said. “So even if the bill is not meant to change Japan, it certainly has the potential to change Japanese society in the long term.”

opposition has largely come from Abe’s left, over concerns about a lack of regulation on employers, which they fear could lead to exploitation. Many foreign workers are already forced to work overtime, receive less pay, and risk having their passports and travel documents confiscated by employers

some factories in the mostly rural Gifu prefecture have implemented segregated bathrooms and locker rooms for domestic and foreign workers

This dynamic was common in the immigration debate in Europe and the United States in the 1980s and ’90s, when pro-business conservatives often pushed for more immigrants and guest workers, while labor unions raised concerns for workers’ rights and downward pressure on wages.

The widespread xenophobia in Japan is hardly a myth. In 2010, the U.N.’s human rights experts called out Japan for racism, discrimination, and exploitation of migrant workers. Increased immigration has not changed the country’s notoriously strict asylum policies. In 2018, only 42 asylum-seekers were approved, out of around 10,000 applicants.

bilateral agreements Japan has drafted with countries such as Indonesia and the Philippines, which will allow them to send tens of thousands of care workers to Japan annually. Both countries see this as a win-win proposition. Japan gets much-needed labor, the Philippines gets an increase in foreign remittances, and many workers will eventually return, having learned new valuable skills

Sooner or later, Japan may face nationwide debate on what it means to be Japanese in the 21st century. Few countries undergoing demographic shifts are able to avoid these challenges.

When South Korea accepted 500 Yemeni refugees in 2018, it created storms of protests, with street rallies demanding that the Yemenis be sent back, calling them “fake refugees.”

In early June, thousands of people participated in Black Lives Matter protests in Tokyo, which has contributed to a nationwide debate on harassment of migrants and foreigners—as well as race.

“Xenophobic nationalists are generally irrelevant in politics. If there is a backlash, it will most likely begin as a local uprising against Tokyo, a populist revolt against the central government, just as in the EU,” Oguma said. “But I don’t see it happening right now. The far-right here is too atomized, each faction want different things. So I don’t really worry about an organized uprising.”

With massive stimulus spending and a robust, universal health care system, Japan has weathered the pandemic fairly well. Unemployment in April was 2.5 percent. While there has been some anecdotal evidence of increased racist harassment of foreign workers, coupled with an emerging skepticism toward globalization and migration, Japan at the moment is one of the few countries where resentment against immigrants is not the defining feature of politics.

northern Mozambique is a commercial and migration hub in the region, so multinational membership is not surprising, nor should it be taken as a sign that ASWJ is a transnational jihadist insurgent group

tensions are particularly acute in Cabo Delgado, which holds the unenviable distinction of being the country’s poorest province

objectives remain unclear and information about the group’s targeting patterns and membership base is limited

discovery of vast stores of natural gas in the area

According to ACLED, more than 80 percent of the group’s attacks have been directed at civilians, and attacks on civilians are on the rise. There have been more than 70 instances of violence against civilians in 2019 to date—more than there were in all of 2018 (when just over 44 events were recorded)

Alleged abuses at the hands of corporate security guards, issues over land, widespread youth unemployment and high levels of distrust in the government are also contributing factors to the development of an insurgency in the region. ASWJ has sought to capitalize on these tensions: In February the group attacked an Anadarko convoy, leading the multinational oil and gas company to suspend construction of a liquefied natural gas plant.

Mozambique’s response to the spate of ASWJ attacks has been extremely heavy handed and militarized, with allegations of widespread human rights abuses by security forces. After the group’s first attack in October 2017, the government shuttered mosques and detained up to 300 people without charging them. The government has not let up. In late 2018, the government again carried out large-scale arbitrary detentions, and the counterinsurgency campaign as a whole has been characterized not just by mass arrests but also by torture and extrajudicial killings.

detaining or killing religious leaders usually only inflames tensions and accelerates the threat

Both Nigeria and Kenya responded to similar threats with repressive tactics, but this only amplified religious and ethnic tensions and provided fodder for extremist recruiting. The rise of Boko Haram—the deadliest group in Africa in 2015—and the enduring threat from al-Shabaab in Kenya show how these approaches proved counterproductive in the long run.

A 2014 study looking at al-Shabaab recruitment in Kenya, found that the “single most important factor that drove respondents to join al-Shabaab, according to 65% of respondents, was government’s counterterrorism strategy.”

recent United Nations report found that this pattern holds beyond just Nigeria and Kenya, concluding that those who join extremist groups very commonly hold grievances against the government and particularly distrust the police and military.

it is particularly worrying how far the coronavirus is spreading within the political elite in countries where many senior politicians are over 60, making them especially at risk. In Burkina Faso, a country that has experienced more than its fair share of instability in recent years—and which is currently struggling against an insurgency—the ministers of foreign affairs, education, the interior, and mines have all tested positive.

In Nigeria, one of the most economically and politically important countries on the continent, Abba Kyari, the chief of staff to 77-year-old President Muhammadu Buhari, has come down with the disease. Although media outlets have reported that Buhari tested negative, this has not stopped damaging rumors that the often ill president has been incapacitated from circulating in Twitter.

The world should also be paying close attention to Iran, where media censorship has obscured the extent of the crisis. So far, two vice presidents and three cabinet officials are known to have gotten the virus. It is also estimated that 10 percent of parliament and many prominent figures within the Islamic Revolutionary Guard Corps are sick—including a senior advisor to the 80-year-old supreme leader, Ayatollah Ali Khamenei, raising questions about his health.

A leadership crisis is just one of the potential sources of political instability the coronavirus could spark. Others include the risk of popular unrest and the debt crises that will soon engulf many countries around the world. Along with the fact that some of the main providers of foreign aid are now preoccupied with their own financial crises, there is a serious risk that politically and economically weak states will face a perfect storm of elite deaths, debt, mass unemployment, and social unrest

In countries where poverty is widespread, health systems are weak, and the cost of food is high, citizens are already under intense financial pressure. Despite earning the least, those who live in slum areas around capital cities often have to pay more for access to water and food than those who have valuable properties in the city centers. While the cramped conditions of slum living make it implausible to self-isolate, limited and inconsistent income make it impossible to buy in bulk—or to stay home for weeks on end without working and risk starvation. For many of the poorest people in the world, hunger is just a few days away

Already, there have been sporadic incidents of unrest in a number of countries, including prison protests in Italy. Meanwhile, heavy-handed efforts to enforce the curfew threaten to further erode public confidence in the government and the security forces. There are reports of widespread human rights abuses being committed in Kenya and South Africa, where the police have been using water cannons and rubber bullets to enforce the lockdown.

Unless the deferral of debt goes hand in hand with debt cancellation and long-term rescheduling, the end of the coronavirus crisis could be followed by a series of economic collapses across the developing world. In turn, this will undermine the ability of governments to provide affordable fuel and food, further increasing the risk of public unrest.

Civil wars, political instability, and poverty kill millions of people every year. These deaths rarely elicit the kind of comprehensive media coverage that COVID-19 has received, but they are no less important. It is possible to prevent the worst political consequences of the coronavirus but only if governments and institutions act now. Wealthy nations must increase their aid budgets rather than cut them, and international organizations must anticipate and work to avoid political crises more proactively than ever before. That is the only way to collectively survive the present in a way that does not undermine the future.

As sources of information proliferated, long-standing sources of authority (monarchy, aristocracy, and the established Church) feared losing power and turned reactionary. At the same time, the longer-term transformations on which these social and cultural innovations were built—the growth of European overseas empires and the emergence of settler colonialism, massive silver exports from South and Central America, the trans-Atlantic slave trade—continued, and in ever more brutal forms. More than 6 million Africans were sold into slavery in the 18th century—a time that some still call the “Age of Enlightenment.”

Today, as in the 1790s, an old order is ending in convulsions. Even before the coronavirus prompted flight cancellations and entry bans, climate activists were rightly telling us to change our modes and patterns of travel. Even before nonessential businesses were shut by government orders, online shopping and same-day deliveries were rapidly remaking retail commerce, while environmental concerns and anti-consumerism were revolutionizing the fashion industry.

real revolutions are the ones that nobody sees coming

The men and women who made the French Revolution—a revolution which, in a few short and hectic years, decriminalized heresy, blasphemy, and witchcraft; replaced one of the oldest European monarchies with a republic based on universal male suffrage; introduced no-fault divorce and easy adoption; embraced the ideal of formal equality before the law; and, for a short time at least, defined employment, education, and subsistence as basic human rights—had no model to follow, no plans, no platform agreed upon in advance. As the UCLA historian Lynn A. Hunt has argued, they made it up as they went along. Yet for more than two centuries, elements of their improvised politics have been revolution’s signature features: a declared sovereignty, devised symbols, an anthem, war. At the junction Americans face today, however, we need to imitate not the outcome of the French revolution but the energy, creativity, and optimism of the French revolutionaries.

In hindsight a revolution may look like a single event, but they are never experienced that way. Instead they are extended periods in which the routines of normal life are dislocated and existing rituals lose their meaning. They are deeply unsettling, but they are also periods of great creativity.

In recent days, Namibians expressed frustration over what they considered to be a slow pace of vote-counting. In 2014, provisional results were announced a day after voting took place. Opposition parties also complained about the use of electronic voting machines, fearing the lack of paper could facilitate fraud. 

economic inequality among the country's black and white population is glaring. About 6 percent of the country's inhabitants are white, with some German-speaking descendants from the colonial era and others originally from South Africa.

The country is also experiencing one of its worst droughts in history, wreaking havoc on crops, scorching grazing lands and threatening the food supply.

some of the continent’s more democratic states have failed to end corruption or deliver high levels of economic growth. On the other hand, Ethiopia and Rwanda achieved impressive successes, attracting international praise for reducing poverty and unemployment while consistently securing high economic growth

Ethiopia received almost $5 billion in foreign aid in 2018, while Rwanda received just over $1 billion. The figure for Rwanda is particularly striking when one considers that democratic Malawi, which saw a peaceful transfer of power to the opposition in June 2020, receives considerably less aid per person: $70 for each Malawian in 2018, compared with almost $91 for every Rwandan

recent trends in academic and policy research have played an important role in the rise of authoritarian development. These trends provided donors with an intellectual foundation for investing in countries that, on the basis of their human rights records, the EU and the UK might have been expected to avoid.

researchers suggested that when patrimonial systems are tightly controlled, waste can be minimized and resources channeled toward productive investments to support developmental outcomes

The combination of the rise of China, democratic malaise in the West, and the economic struggles of many African democracies has led citizens and political elites to increasingly question the value of democracy for development

there is some evidence that the empirical data used to identify Ethiopia and Rwanda as success stories may not be as impressive as it was first thought

official figures are part of a broader propaganda campaign designed to sell the regime both at home and abroad

The Tiger economies of East Asia, such as South Korea and Taiwan, entrenched the economic progress they achieved in the 1970s and 1980s by undergoing relatively smooth transitions to more open and inclusive—and hence legitimate and stable—political systems in the 1990s. The prospects for such transitions have always seemed less likely in Ethiopia and Rwanda, where opposition parties are not allowed to operate effectively and limited social and political cohesion remains a cause for concern.

While the jury is still out on Rwanda, the political foundations of economic development in Ethiopia appear to be crumbling. When the Ethiopian People’s Revolutionary Democratic Front (EPRDF) came to power in 1991, it initially appeared to have broken out of Ethiopia’s damaging cycle of repression and rebellion. Rather than seeking to enforce one ethnic identity over the others, the EPRDF committed to giving the country’s different communities the freedom and self-respect they had always desired. The government enshrined a right to self-determination in the Ethiopian constitution. However, the reality was very different

the ruling party kept itself in power by rigging elections and repressing opponents. As a result, many ethnoregional groups felt that in addition to being politically marginalized, they were denied the opportunity to press their concerns through democratic channels.

although he quickly won the 2019 Nobel Peace Prize for moving to end a long-running dispute with Eritrea and promising a raft of democratic reforms, Abiy was unable to return Ethiopia to political stability. Most notably, the growing political marginalization of the TPLF left the former dominant clique increasingly frustrated. Tigrayan leaders ultimately quit the government, while Abiy disbanded the EPRDF and replaced it with his own political vehicle, the Prosperity Party. From that moment on, civil conflict between the federal government and the TPLF, whose role was now limited to control over the Tigrayan regional government, became increasingly likely.

Since civil conflict began in November 2020, Ethiopia has had a new set of developmental challenges. Hundreds of thousands of citizens have been displaced, major infrastructure has been destroyed, and Abiy’s reputation as a reformer has been undermined. Moreover, there is a serious risk that even though federal government troops have regained overall control of Tigray, the TPLF will be able to wage guerrilla attacks that will continue to weaken political stability and investor confidence.

Abiy, like his predecessors, will use coercion to maintain political control, building up more problems for the future. Although negotiated and smooth political transitions are not impossible, they are less likely in heavily divided societies and have been rare in sub-Saharan Africa.

Although Ethiopia and Rwanda are often mentioned in the same sentence, Ethiopia is the more important example for the argument that authoritarian government models would serve Africa better than democratic ones. With a small population, a distinctive history, and an intensely authoritarian government, Rwanda is not a promising case from which to generalize. By contrast, Ethiopia, with a large and extremely ethnically diverse population, provides a more compelling example.

The empirical evidence in favor of authoritarian development models in Africa has always been remarkably thin. The vast majority of African states were authoritarian in the 1970s and 1980s, and almost all had poor economic growth. Fast-forward to today, and there are very few authoritarian regimes with the potential to join Ethiopia and Rwanda as notable success stories. Instead, most studies have found that democratic governments perform better when it comes to providing public services or economic growth.

On its own, Rwanda’s small and aid-dependent economy cannot sustain the narrative that authoritarian regimes perform better on development—and if it does not, there is no justification at all for supporting repressive regimes.

Remittances from Yemeni workers abroad had dropped by 80% – $253m (£200m) – in the first four months of 2020 as a result of job losses across the Gulf region. The closure of supply routes has led to food shortages and food price hikes in the country, which imports 90% of its food.

Democratic Republic of the Congo, Venezuela, the west African Sahel, Ethiopia, Sudan, South Sudan, Syria, and Haiti as extreme hunger hotspots.

Oxfam said countries with existing problems, such as South Sudan and Syria, were already seeing hunger worsen but there was also concern for middle-income countries such as India and Brazil. Mass unemployment was affecting all countries, but informal labourers were suffering the most, often unable to travel to work. Travel restrictions were also hitting food supplies by preventing farmers from hiring workers and small-scale producers from accessing their own fields.

humanitarian assistance around the world had been curtailed by restrictions on movement and other precautions to prevent the virus spreading

a crisis in Africa’s Sahel region, where at least 4 million people have been displaced by extreme climate conditions that were damaging crops, causing greater tension between communities sharing resources.

bloated, inefficient health-care system

Racist policies that have endured since the days of colonization and slavery left Indigenous and Black Americans especially vulnerable

decades-long process of shredding the nation’s social safety net

same social-media platforms that sowed partisanship and misinformation during the 2014 Ebola outbreak in Africa and the 2016 U.S. election became vectors for conspiracy theories

the COVID‑19 debacle has also touched—and implicated—nearly every other facet of American society: its shortsighted leadership, its disregard for expertise, its racial inequities, its social-media culture, and its fealty to a dangerous strain of individualism.

SARS‑CoV‑2 is neither as lethal as some other coronaviruses, such as SARS and MERS, nor as contagious as measles. Deadlier pathogens almost certainly exist. Wild animals harbor an estimated 40,000 unknown viruses, a quarter of which could potentially jump into humans. How will the U.S. fare when “we can’t even deal with a starter pandemic?,”

The U.S. cannot prepare for these inevitable crises if it returns to normal, as many of its people ache to do. Normal led to this. Normal was a world ever more prone to a pandemic but ever less ready for one. To avert another catastrophe, the U.S. needs to grapple with all the ways normal failed us

Many conservationists jump on epidemics as opportunities to ban the wildlife trade or the eating of “bush meat,” an exoticized term for “game,” but few diseases have emerged through either route. Carlson said the biggest factors behind spillovers are land-use change and climate change, both of which are hard to control. Our species has relentlessly expanded into previously wild spaces. Through intensive agriculture, habitat destruction, and rising temperatures, we have uprooted the planet’s animals, forcing them into new and narrower ranges that are on our own doorsteps. Humanity has squeezed the world’s wildlife in a crushing grip—and viruses have come bursting out.

This year, the world’s coronavirus experts—and there still aren’t many—had to postpone their triennial conference in the Netherlands because SARS‑CoV‑2 made flying too risky.

In 2003, China covered up the early spread of SARS, allowing the new disease to gain a foothold, and in 2020, history repeated itself. The Chinese government downplayed the possibility that SARS‑CoV‑2 was spreading among humans, and only confirmed as much on January 20, after millions had traveled around the country for the lunar new year. Doctors who tried to raise the alarm were censured and threatened. One, Li Wenliang, later died of COVID‑19. The World Health Organization initially parroted China’s line and did not declare a public-health emergency of international concern until January 30. By then, an estimated 10,000 people in 20 countries had been infected, and the virus was spreading fast.

Even after warnings reached the U.S., they fell on the wrong ears. Since before his election, Trump has cavalierly dismissed expertise and evidence. He filled his administration with inexperienced newcomers, while depicting career civil servants as part of a “deep state.” In 2018, he dismantled an office that had been assembled specifically to prepare for nascent pandemics. American intelligence agencies warned about the coronavirus threat in January, but Trump habitually disregards intelligence briefings. The secretary of health and human services, Alex Azar, offered similar counsel, and was twice ignored.

“By early February, we should have triggered a series of actions, precisely zero of which were taken.”

Travel bans make intuitive sense, because travel obviously enables the spread of a virus. But in practice, travel bans are woefully inefficient at restricting either travel or viruses. They prompt people to seek indirect routes via third-party countries, or to deliberately hide their symptoms. They are often porous: Trump’s included numerous exceptions, and allowed tens of thousands of people to enter from China. Ironically, they create travel: When Trump later announced a ban on flights from continental Europe, a surge of travelers packed America’s airports in a rush to beat the incoming restrictions. Travel bans may sometimes work for remote island nations, but in general they can only delay the spread of an epidemic—not stop it.

countries “rely on bans to the exclusion of the things they actually need to do—testing, tracing, building up the health system,”

genetic evidence shows that the specific viruses that triggered the first big outbreaks, in Washington State, didn’t land until mid-February. The country could have used that time to prepare. Instead, Trump, who had spent his entire presidency learning that he could say whatever he wanted without consequence, assured Americans that “the coronavirus is very much under control,” and “like a miracle, it will disappear.” With impunity, Trump lied. With impunity, the virus spread.

it found a nation through which it could spread easily, without being detected

sluggish response by a government denuded of expertise

In response to the global energy crisis of the 1970s, architects made structures more energy-efficient by sealing them off from outdoor air, reducing ventilation rates. Pollutants and pathogens built up indoors, “ushering in the era of ‘sick buildings,’ ” says Joseph Allen, who studies environmental health at Harvard’s T. H. Chan School of Public Health. Energy efficiency is a pillar of modern climate policy, but there are ways to achieve it without sacrificing well-being. “We lost our way over the years and stopped designing buildings for people,”

As of early July, one in every 1,450 Black Americans had died from COVID‑19—a rate more than twice that of white Americans. That figure is both tragic and wholly expected given the mountain of medical disadvantages that Black people face

The indoor spaces in which Americans spend 87 percent of their time became staging grounds for super-spreading events. One study showed that the odds of catching the virus from an infected person are roughly 19 times higher indoors than in open air. Shielded from the elements and among crowds clustered in prolonged proximity, the coronavirus ran rampant in the conference rooms of a Boston hotel, the cabins of the Diamond Princess cruise ship, and a church hall in Washington State where a choir practiced for just a few hours.

Between harsher punishments doled out in the War on Drugs and a tough-on-crime mindset that prizes retribution over rehabilitation, America’s incarcerated population has swelled sevenfold since the 1970s, to about 2.3 million. The U.S. imprisons five to 18 times more people per capita than other Western democracies. Many American prisons are packed beyond capacity, making social distancing impossible. Soap is often scarce. Inevitably, the coronavirus ran amok. By June, two American prisons each accounted for more cases than all of New Zealand. One, Marion Correctional Institution, in Ohio, had more than 2,000 cases among inmates despite having a capacity of 1,500.

America’s nursing homes and long-term-care facilities house less than 1 percent of its people, but as of mid-June, they accounted for 40 percent of its coronavirus deaths. More than 50,000 residents and staff have died. At least 250,000 more have been infected. These grim figures are a reflection not just of the greater harms that COVID‑19 inflicts upon elderly physiology, but also of the care the elderly receive. Before the pandemic, three in four nursing homes were understaffed, and four in five had recently been cited for failures in infection control. The Trump administration’s policies have exacerbated the problem by reducing the influx of immigrants, who make up a quarter of long-term caregivers.

the Department of Health and Human Services paused nursing-home inspections in March, passing the buck to the states. Some nursing homes avoided the virus because their owners immediately stopped visitations, or paid caregivers to live on-site. But in others, staff stopped working, scared about infecting their charges or becoming infected themselves. In some cases, residents had to be evacuated because no one showed up to care for them.

its problematic attitude toward health: “Get hospitals ready and wait for sick people to show,” as Sheila Davis, the CEO of the nonprofit Partners in Health, puts it. “Especially in the beginning, we catered our entire [COVID‑19] response to the 20 percent of people who required hospitalization, rather than preventing transmission in the community.” The latter is the job of the public-health system, which prevents sickness in populations instead of merely treating it in individuals. That system pairs uneasily with a national temperament that views health as a matter of personal responsibility rather than a collective good.

“As public health did its job, it became a target” of budget cuts,

Today, the U.S. spends just 2.5 percent of its gigantic health-care budget on public health. Underfunded health departments were already struggling to deal with opioid addiction, climbing obesity rates, contaminated water, and easily preventable diseases. Last year saw the most measles cases since 1992. In 2018, the U.S. had 115,000 cases of syphilis and 580,000 cases of gonorrhea—numbers not seen in almost three decades. It has 1.7 million cases of chlamydia, the highest number ever recorded.

In May, Maryland Governor Larry Hogan asserted that his state would soon have enough people to trace 10,000 contacts every day. Last year, as Ebola tore through the Democratic Republic of Congo—a country with a quarter of Maryland’s wealth and an active war zone—local health workers and the WHO traced twice as many people.

Compared with the average wealthy nation, America spends nearly twice as much of its national wealth on health care, about a quarter of which is wasted on inefficient care, unnecessary treatments, and administrative chicanery. The U.S. gets little bang for its exorbitant buck. It has the lowest life-expectancy rate of comparable countries, the highest rates of chronic disease, and the fewest doctors per person. This profit-driven system has scant incentive to invest in spare beds, stockpiled supplies, peacetime drills, and layered contingency plans—the essence of pandemic preparedness. America’s hospitals have been pruned and stretched by market forces to run close to full capacity, with little ability to adapt in a crisis.

Sabeti’s lab developed a diagnostic test in mid-January and sent it to colleagues in Nigeria, Sierra Leone, and Senegal. “We had working diagnostics in those countries well before we did in any U.S. states,”

American hospitals operate on a just-in-time economy. They acquire the goods they need in the moment through labyrinthine supply chains that wrap around the world in tangled lines, from countries with cheap labor to richer nations like the U.S. The lines are invisible until they snap. About half of the world’s face masks, for example, are made in China, some of them in Hubei province. When that region became the pandemic epicenter, the mask supply shriveled just as global demand spiked. The Trump administration turned to a larder of medical supplies called the Strategic National Stockpile, only to find that the 100 million respirators and masks that had been dispersed during the 2009 flu pandemic were never replaced. Just 13 million respirators were left.

The supply of nasopharyngeal swabs that are used in every diagnostic test also ran low, because one of the largest manufacturers is based in Lombardy, Italy—initially the COVID‑19 capital of Europe. About 40 percent of critical-care drugs, including antibiotics and painkillers, became scarce because they depend on manufacturing lines that begin in China and India. Once a vaccine is ready, there might not be enough vials to put it in, because of the long-running global shortage of medical-grade glass—literally, a bottle-neck bottleneck.

As usual, health care was a matter of capitalism and connections. In New York, rich hospitals bought their way out of their protective-equipment shortfall, while neighbors in poorer, more diverse parts of the city rationed their supplies.

A study showed that the U.S. could have averted 36,000 COVID‑19 deaths if leaders had enacted social-distancing measures just a week earlier. But better late than never: By collectively reducing the spread of the virus, America flattened the curve. Ventilators didn’t run out, as they had in parts of Italy. Hospitals had time to add extra beds.

the indiscriminate lockdown was necessary only because America’s leaders wasted months of prep time. Deploying this blunt policy instrument came at enormous cost. Unemployment rose to 14.7 percent, the highest level since record-keeping began, in 1948. More than 26 million people lost their jobs, a catastrophe in a country that—uniquely and absurdly—ties health care to employment

In the middle of the greatest health and economic crises in generations, millions of Americans have found themselves disconnected from medical care and impoverished. They join the millions who have always lived that way.

Elderly people, already pushed to the fringes of society, were treated as acceptable losses. Women were more likely to lose jobs than men, and also shouldered extra burdens of child care and domestic work, while facing rising rates of domestic violence. In half of the states, people with dementia and intellectual disabilities faced policies that threatened to deny them access to lifesaving ventilators. Thousands of people endured months of COVID‑19 symptoms that resembled those of chronic postviral illnesses, only to be told that their devastating symptoms were in their head. Latinos were three times as likely to be infected as white people. Asian Americans faced racist abuse. Far from being a “great equalizer,” the pandemic fell unevenly upon the U.S., taking advantage of injustices that had been brewing throughout the nation’s history.

Of the 3.1 million Americans who still cannot afford health insurance in states where Medicaid has not been expanded, more than half are people of color, and 30 percent are Black.* This is no accident. In the decades after the Civil War, the white leaders of former slave states deliberately withheld health care from Black Americans, apportioning medicine more according to the logic of Jim Crow than Hippocrates. They built hospitals away from Black communities, segregated Black patients into separate wings, and blocked Black students from medical school. In the 20th century, they helped construct America’s system of private, employer-based insurance, which has kept many Black people from receiving adequate medical treatment. They fought every attempt to improve Black people’s access to health care, from the creation of Medicare and Medicaid in the ’60s to the passage of the Affordable Care Act in 2010.

A number of former slave states also have among the lowest investments in public health, the lowest quality of medical care, the highest proportions of Black citizens, and the greatest racial divides in health outcomes

“We’re designed for discrete disasters” like mass shootings, traffic pileups, and hurricanes, says Esther Choo, an emergency physician at Oregon Health and Science University. The COVID‑19 pandemic is not a discrete disaster. It is a 50-state catastrophe that will likely continue at least until a vaccine is ready.

Native Americans were similarly vulnerable. A third of the people in the Navajo Nation can’t easily wash their hands, because they’ve been embroiled in long-running negotiations over the rights to the water on their own lands. Those with water must contend with runoff from uranium mines. Most live in cramped multigenerational homes, far from the few hospitals that service a 17-million-acre reservation. As of mid-May, the Navajo Nation had higher rates of COVID‑19 infections than any U.S. state.

Americans often misperceive historical inequities as personal failures

the largely unregulated, social-media-based communications infrastructure of the 21st century almost ensures that misinformation will proliferate fast. “In every outbreak throughout the existence of social media, from Zika to Ebola, conspiratorial communities immediately spread their content about how it’s all caused by some government or pharmaceutical company or Bill Gates,”

Rumors coursed through online platforms that are designed to keep users engaged, even if that means feeding them content that is polarizing or untrue. In a national crisis, when people need to act in concert, this is calamitous. “The social internet as a system is broken,” DiResta told me, and its faults are readily abused.

Like pandemics, infodemics quickly become uncontrollable unless caught early.

In 2016, when DiResta spoke with a CDC team about the threat of misinformation, “their response was: ‘ That’s interesting, but that’s just stuff that happens on the internet.’ ”

The WHO, the CDC, and the U.S. surgeon general urged people not to wear masks, hoping to preserve the limited stocks for health-care workers. These messages were offered without nuance or acknowledgement of uncertainty, so when they were reversed—the virus is worse than the flu; wear masks—the changes seemed like befuddling flip-flops.

Drawn to novelty, journalists gave oxygen to fringe anti-lockdown protests while most Americans quietly stayed home. They wrote up every incremental scientific claim, even those that hadn’t been verified or peer-reviewed.

By tying career advancement to the publishing of papers, academia already creates incentives for scientists to do attention-grabbing but irreproducible work. The pandemic strengthened those incentives by prompting a rush of panicked research and promising ambitious scientists global attention.

In March, a small and severely flawed French study suggested that the antimalarial drug hydroxychloroquine could treat COVID‑19. Published in a minor journal, it likely would have been ignored a decade ago. But in 2020, it wended its way to Donald Trump via a chain of credulity that included Fox News, Elon Musk, and Dr. Oz. Trump spent months touting the drug as a miracle cure despite mounting evidence to the contrary, causing shortages for people who actually needed it to treat lupus and rheumatoid arthritis. The hydroxychloroquine story was muddied even further by a study published in a top medical journal, The Lancet, that claimed the drug was not effective and was potentially harmful. The paper relied on suspect data from a small analytics company called Surgisphere, and was retracted in June.**

Science famously self-corrects. But during the pandemic, the same urgent pace that has produced valuable knowledge at record speed has also sent sloppy claims around the world before anyone could even raise a skeptical eyebrow.

No one should be shocked that a liar who has made almost 20,000 false or misleading claims during his presidency would lie about whether the U.S. had the pandemic under control; that a racist who gave birth to birtherism would do little to stop a virus that was disproportionately killing Black people; that a xenophobe who presided over the creation of new immigrant-detention centers would order meatpacking plants with a substantial immigrant workforce to remain open; that a cruel man devoid of empathy would fail to calm fearful citizens; that a narcissist who cannot stand to be upstaged would refuse to tap the deep well of experts at his disposal; that a scion of nepotism would hand control of a shadow coronavirus task force to his unqualified son-in-law; that an armchair polymath would claim to have a “natural ability” at medicine and display it by wondering out loud about the curative potential of injecting disinfectant; that an egotist incapable of admitting failure would try to distract from his greatest one by blaming China, defunding the WHO, and promoting miracle drugs; or that a president who has been shielded by his party from any shred of accountability would say, when asked about the lack of testing, “I don’t take any responsibility at all.”

Trump is a comorbidity of the COVID‑19 pandemic. He isn’t solely responsible for America’s fiasco, but he is central to it. A pandemic demands the coordinated efforts of dozens of agencies. “In the best circumstances, it’s hard to make the bureaucracy move quickly,” Ron Klain said. “It moves if the president stands on a table and says, ‘Move quickly.’ But it really doesn’t move if he’s sitting at his desk saying it’s not a big deal.”

everyday Americans did more than the White House. By voluntarily agreeing to months of social distancing, they bought the country time, at substantial cost to their financial and mental well-being. Their sacrifice came with an implicit social contract—that the government would use the valuable time to mobilize an extraordinary, energetic effort to suppress the virus, as did the likes of Germany and Singapore. But the government did not, to the bafflement of health experts. “There are instances in history where humanity has really moved mountains to defeat infectious diseases,” says Caitlin Rivers, an epidemiologist at the Johns Hopkins Center for Health Security. “It’s appalling that we in the U.S. have not summoned that energy around COVID‑19.”

People suffered all the debilitating effects of a lockdown with few of the benefits. Most states felt compelled to reopen without accruing enough tests or contact tracers. In April and May, the nation was stuck on a terrible plateau, averaging 20,000 to 30,000 new cases every day. In June, the plateau again became an upward slope, soaring to record-breaking heights.

It is no coincidence that other powerful nations that elected populist leaders—Brazil, Russia, India, and the United Kingdom—also fumbled their response to COVID‑19. “When you have people elected based on undermining trust in the government, what happens when trust is what you need the most?”

the United States underperformed across the board, and its errors compounded. The dearth of tests allowed unconfirmed cases to create still more cases, which flooded the hospitals, which ran out of masks, which are necessary to limit the virus’s spread. Twitter amplified Trump’s misleading messages, which raised fear and anxiety among people, which led them to spend more time scouring for information on Twitter.

The virus was never beaten in the spring, but many people, including Trump, pretended that it was. Every state reopened to varying degrees, and many subsequently saw record numbers of cases. After Arizona’s cases started climbing sharply at the end of May, Cara Christ, the director of the state’s health-services department, said, “We are not going to be able to stop the spread. And so we can’t stop living as well.” The virus may beg to differ.

The long wait for a vaccine will likely culminate in a predictable way: Many Americans will refuse to get it, and among those who want it, the most vulnerable will be last in line.

It is almost unheard-of for a public-health measure to go from zero to majority acceptance in less than half a year. But pandemics are rare situations when “people are desperate for guidelines and rules,” says Zoë McLaren, a health-policy professor at the University of Maryland at Baltimore County. The closest analogy is pregnancy, she says, which is “a time when women’s lives are changing, and they can absorb a ton of information. A pandemic is similar: People are actually paying attention, and learning.”

As the economy nose-dived, the health-care system ailed, and the government fumbled, belief in American exceptionalism declined. “Times of big social disruption call into question things we thought were normal and standard,” Redbird told me. “If our institutions fail us here, in what ways are they failing elsewhere?” And whom are they failing the most?

It is hard to stare directly at the biggest problems of our age. Pandemics, climate change, the sixth extinction of wildlife, food and water shortages—their scope is planetary, and their stakes are overwhelming. We have no choice, though, but to grapple with them. It is now abundantly clear what happens when global disasters collide with historical negligence.

America would be wise to help reverse the ruination of the natural world, a process that continues to shunt animal diseases into human bodies. It should strive to prevent sickness instead of profiting from it. It should build a health-care system that prizes resilience over brittle efficiency, and an information system that favors light over heat. It should rebuild its international alliances, its social safety net, and its trust in empiricism. It should address the health inequities that flow from its history. Not least, it should elect leaders with sound judgment, high character, and respect for science, logic, and reason.

“The correlation between influenza mortality and the vote share won by right-wing extremists is stronger in regions that had historically blamed minorities, particularly Jews, for Medieval plagues,”

authoritarian regimes, such as those in Hungary, Turkmenistan and Rwanda, have used the pandemic to crack down on opposition voices and critics