Abstract
As the COVID-19 pandemic spread from the Far East throughout the world, while the inoculation was unavailable, countries introduced public health emergencies that engaged various non-pharmaceutical interventions (NPI). These restricted economic activity and private life. From the beginning, some countries at the source of the pandemic in the Far East implemented more comprehensive and restrictive NPI than Western countries. The former also experienced lower pandemic casualties.
The United States of America (the U.S.) faced the first wave of the pandemic in April 2020, and by the end of 2021 recorded the largest nominal mortality in the world, ranking in the top 20 countries on the mortality rate per population. The country had pandemic plans in place and a capable healthcare system. This capability-mortality contrast motivated our investigation. The problem of confronting the pandemic has been studied by focusing on singular NPI. We took a more comprehensive approach by relying on a new research instrument labeled Pandemic Containment Strategy Index (PCSI) which covers 10 areas of NPI. Our investigation covered the period from the start of 2020 until May 31, 2021. We used two samples of American states and publicly available data sources, and covered the first pandemic wave (n=26 states) and the post-first wave period (n=9 states).
We found that the U.S. restrictions on freedom of movement and business operations were in the mid-to-high range in the first wave, while the country underperformed in several NPI areas the PCSI addresses. Based on the PCSI classification of containment strategies, America's prevailing strategy was permissive. Central coordination was missing, tensions between medical and government authorities surfaced, and tests and protective equipment were lacking. In the post-first wave period, American states experienced additional and larger waves, while the strategic and operational problems continued. Our study contributes to understanding COVID-19 pandemic in the U.S. and the global context, and it has implications for the future study of the PCSI in particular and NPI in general.