A new study finds poor leadership is the reason for America's unrivaled coronavirus death toll

• In the spring, many countries had high death rates, as the coronavirus circulated around the world unchecked.
• But in the months since then, most countries took simple steps to prevent disease transmission, and death rates fell dramatically.
• Except the US: the country has been a consistent outlier in coronavirus deaths.
• A new study shows just how bad the US lagged behind other rich countries over the summer, in disease control and prevention.
• "We lacked federal leadership and coordination that we needed," one expert said.

A fresh fall wave of coronavirus infections is beginning to bubble up, as the top half of the world begins its annual tilt into chillier months, and people retreat inside.

"We're seeing cases accelerate – particularly in Europe and North America," World Health Organization Director General Tedros Adhanom Ghebreyesus said during a news conference on Monday. "I know there's fatigue, but the virus has shown that when we let our guard down, it can surge back at breakneck speed."

But there is one rich country in the Northern Hemisphere which never really caught a break from the devastation of widespread coronavirus deaths over the summer.

The US did not ever sufficiently put its guard up against this virus at the federal level. And that decision has now made America the world leader in pandemic death.

The US is the only rich country where people keep dying from the virus in droves

A study out in the medical journal JAMA this month shows just how consistently and continually bad the US has been at stamping out deadly coronavirus infections during this pandemic, when compared to other rich countries around the globe.

In March and April, "people were dying because they didn't know what to do," study co-author Ezekiel Emanuel, a health policy expert at the University of Pennsylvania, told Insider, as his study was released.

But since June, no other big, industrialized, rich country has fared as bad as the US. Each other previously hard-hit virus hotspot, in countries with more than 5 million people, where the per capita GDP is also greater than $25,000, has fared far better than the US, when it comes to protecting its most vulnerable citizens.

Just take a look at the COVID-19 death rate in the US, from June 7 to October 14. At 32.4 dead per 100,000 people, the American death rate from the summer into the fall this year was roughly eight times Italy's (4.1 per 100,000), more than five times that of France (5.7 per 100,000), and more than four times Belgium's toll (7.2 per 100,000). The US even far surpassed hard-hit Spain (10.9 per 100,000), and Sweden (11 per 100,000).

In fact, the only countries where the death rate appears to have consistently rivaled that of the US over the summer, according to worldwide estimates from the European Centre for Disease Prevention and Control collected by Our World In Data, are Mexico and Brazil.

The Presidents of both of those countries also downplayed the severity of this virus. Brazil's Jair Bolsonaro (who himself had COVID-19, the disease caused by the virus) called it a "little flu," while Mexico's Andrés Manuel López Obrador shunned masks and encouraged people in his country to "go out on to the streets."

The reason for such a deadly American summer is now clear.

The US lacks leadership to control the virus

"We lacked federal leadership and coordination that we needed," Emanuel (who formerly worked on health policy in the Obama Administration) told Insider. "It's quite clear that compared to all the other countries, we have much higher mortality rates after May, after the first bulge. We're just doing much worse."

Part of the problem, Emanuel said, is proper pandemic etiquette hasn't been modeled from above, as seen recently during the large coronavirus outbreak at the White House.

"There's this battle between freedom and face mask wearing," he said. "Wrong! Wear face masks, you can have a lot more freedom."

The best solution we have to defeat the pandemic virus — for which there are still no great treatments or approved vaccines — Emanuel and other public health experts agree, would be a better coordinated public health response from state to state, and better nationwide disease surveillance too.

"We've got to get a testing regime and a contact tracing regime in place," he said. "We've got to get the PPE available and widespread. And we did none of that. And that's the problem."

Maria van Kerkhove, an American disease expert and coronavirus technical lead at the World Health Organization, agreed.

"All of us remain humble to this virus, and the fact that we don't know everything," she said last week during a WHO press conference. "But we know a heckuva lot more than we did a few months ago."

Many countries have seen how, as disease transmission rates get very, very low, it can become safe for schools and businesses to reopen.

Cinemas in Italy have done it. Beer gardens in China have, too.

But none of this reopening can happen safely, until the virus ceases to transmit from person to person, through widespread adoption of measures including distancing, testing, quarantining of contacts and isolation of cases, as well as simple, everyday prevention efforts like masks and good ventilation.

"If the leader of our country and every cabinet member would be wearing masks, and very publicly, they would galvanize and organize all the influencers, the celebrities, the sports stars, the business leaders to do the same and to model the good behavior so that public gets the message, norming happens and you get a consistent approach," Emanuel said. "That's what's needed."