Public Health School Researchers Document U.S. Government’s Failures to Slow Pandemic in New Study

Researchers at the Harvard School of Public Health documented points at which federal officials failed to take action to slow the COVID-19 pandemic’s spread in a study published Nov. 2.

The study — conducted by three teams of researchers led by William P. Hanage, Nancy J. Krieger ’80, and Mauricio Santillana, respectively — pointed out failures by the United States government to curtail the virus’s entrance into the U.S. via travel, protect essential employees from infection, and prevent excess mortality compared to other nations.

Krieger, a professor of social epidemiology at the School of Public Health, said she first conceived of the study in March, alarmed by a lack of any coordinated federal response to the virus.

Santillana, one of the study’s co-authors and an assistant professor at the School of Public Health, said he was also uneasy at the time.

“We were really well aware of the gravity of the situation back in February,” Santillana said. “It was very clear that this disease could have really disastrous consequences if it made it into our country.”

The researchers first examined the administration’s attempts to prevent COVID-19 from entering the United States. The study noted that at the time of the ban on travel from China, major outbreaks had already erupted in Italy and Iran.

“The federal administration proposed only measures to prevent people coming from China to the U.S.,” Santillana said. “There was a mandate definitely to look at symptomatic people coming from China, whereas there was nothing done for people coming from Europe.”

Krieger said that now, the United States can no longer remedy this mistake.

“It's well past the point of doing things at the borders,” Krieger said. “It matters in the U.S. internally, in terms of people moving around, because the virus moves because people move.”

Insufficient protection for essential employees formed another key failure of federal policy, according to the study. The U.S. saw early shortages of personal protective equipment such as masks, the distribution of which was delegated to state and local authorities rather than federal ones.

Additionally, the researchers pointed out that the federal Occupational Safety and Health Administration has to date issued no health standards specific to the coronavirus, and that high levels of OSHA complaints correlated with future outbreaks.

“What we found was a really strong trend between people complaining about occupational safety at their worksite, and then death following that, 15 days later, at least at the national level,” said Christian C. Testa, a statistical data analyst at HSPH who contributed to this portion of the study.

Santillana said Google searches like “What are the symptoms of COVID?” or “How long does it last?” are another possible marker his team is exploring to predict spikes in COVID-19 cases.

The study also examined excess mortality from COVID-19 in the United States. Though it comprises only four percent of the world population, the country makes up around 22 percent of global coronavirus deaths. Santillana referred to an October study by Columbia University researchers which estimated that up to 210,000 COVID-19 deaths in the U.S. were preventable.

But this excess mortality has not affected all Americans equally, according to the study.

“A persistent feature of the pandemic has been the existence of racial/ethnic inequities in cases, hospitalizations, and mortality,” the study states, “especially with regard to increased risk among U.S. Black, Latinx, and American Indian/Alaska Native populations compared to the U.S. white non-Hispanic population.”

Ultimately, while the study conceded that “all cases and deaths cannot be prevented,” the researchers concluded that “this country — and its political leaders, who bear responsibility — can and must do better.”

With a new administration entering the White House, federal accountability is paramount, according to Santillana.

“I think the biggest failure of the current administration is to treat this crisis, this pandemic, as a political thing, whereas it is a clear public health emergency, and needs to be addressed by experts who are public health officials,” Santillana said. “I would suggest that the new administration focuses on getting a uniform and coherent message.”