By the time you read to the bottom of this page, around four Americans will have died from COVID-19, but despite leading the world in infections and deaths for several months, things are still getting worse in the United States.

Everyday hundreds of thousands of new cases are being reported.

On multiple days this month alone the US has recorded more than 3000 deaths from coronavirus, passing the 2977 deaths in the September 11 terrorist attacks that changed that country forever.

On Wednesday last week the US reported a record 3611 deaths: one every 23 seconds.

Between Saturday December 12 and December 19 the US recorded 17,373 deaths: One every 34 seconds.

And things are still getting worse.

"We still are experiencing the outcome of the thanksgiving holiday and gatherings," the US government vaccine initiative's chief scientific officer Moncef Slaoui said on CNN's State of the Union Sunday, as the US approved the Moderna vaccine for distribution.

"And unfortunately, there may be more over the Christmas holiday. So there will be a continuing surge."

Around the country, with the exception of Kentucky, all states have more intensive care beds occupied than they did three months ago.

In California, the situation is rapidly deteriorating, with fears the state could become the next epicentre for the pandemic in America.

"I'm not going to sugar-coat this, we are getting crushed," Los Angeles County/University of Southern California Medical Centre chief medical officer Dr Brad Spellberg said at a media briefing on Friday.

Hospitalisations in California have doubled in the past three weeks. Last week the southern part of the state hit zero per cent capacity for patients needing intensive care.

On Thursday last week Providence St Mary Medical Centre in Apple Valley, California had 60 ICU level patients. The hospital has 20 ICU beds.

 

California has activated its "mass fatality" program: Stocking up on an additional 5000 bodybags and arranging for an additional sixty refrigerated storage units to support overflowing morgues.

"I don't want people to scare folks, but this is a deadly disease. And we need to be mindful of where we are in this current journey together, to the vaccine. We are not at the finish line," California governor Gavin Newsom said.

Thanksgiving travel and family gatherings are one factor as well as "COVID-fatigue" as people become complacent towards taking the same precautions they'd been employing to protect against the virus in the months previous.

According to Dr Emma Shortis, who follows the US as a research fellow at RMIT's Social Global Studies Centre, there are a number of other factors too.

First, there's been a "completely inept response from the Trump Administration basically from the start, a refusal to really address the problem and develop a co-ordinated response, and honestly a lack of care and a lack of interest in tackling the virus and the way it's spreading".

 

But the problems with rapidly filling hospitals and access to care go back further than Trump.

"The health system in the United States - if you can even call it a health system - is set up almost entirely on a for-profit basis and is just not equipped to deal with this sort of thing," Dr Shortis said.

Systemic factors such as people's health insurance being tied to their job also pose a problem when a pandemic puts millions of people out of their job.

"They also lose their health insurance, which makes getting healthcare extremely difficult when going to hospital can send you bankrupt in the United States."

The US is often touted as offering world class healthcare, and while that's true "for some people", there's a catch.

"If you're the President of the United States you get the best care in the world, but it's tied to money. Money buys you excellent healthcare in the United States, but if you don't have that kind of money you don't have access to that kind of healthcare."

 

Dr Shortis said part of the reason for this is the US' political culture but also because the federal government doesn't have overarching powers over the states that it would need to build a better healthcare system.

Money pouring into political parties from lobbyists representing insurance and pharmaceutical companies doesn't help either.

The US is built on ideologies centred on individualism and the free market, but according to Dr Shortis, "the markets aren't oriented to fixing global health crises".

Neither is the current administration.

"(Trump) isn't interested in addressing this problem," Dr Shortis said. "He's interested in prosecuting conspiracy theories around the election and holding on to power in any way that he can. The way the system is deadlocked between the House of Representatives and the Senate."

 

While Joe Biden will be inaugurated on January 20, it's not like he's going to flick a switch and solve all America's problems.

"Biden represents going back to 'normal'," Dr Shortis said. "The US can't go back to 'normal', for a lot of people that 'normality' was also not great. The deep systemic changes he needs to make, I'm not sure he has either the appetite nor the ability to make those changes.

"All of these crises in the US have been a long time in the making. Donald Trump has made these things worse but he didn't create them. I don't think Biden will be in a position to really address those systemic crises in the way they need to be addressed, I think the signs are pointing towards a continuation of this stalemate when it comes to US politics."

 

Mr Biden comes to the White House with a plan for his first 100 days in office that would involve a nationwide mask mandate (which the federal government doesn't have the power to enforce) and a goal to vaccinate an average of a million people every day.

Whether he can pull it off "will very much depend on the co-operation he can get from Congress and the Senate," Dr Shortis said.

"There is certainly some good will that comes from the first 100 days in office that Biden will be hoping to tap in to, but also, 70 million plus people voted for Donald Trump. They voluntarily came out and voted for Donald Trump, so I think Biden is going to encounter a significant amount of opposition."

Originally published as Death every 30 seconds crushing the US