By RICHARD SKOLNIKLos AlamosThe US is falling further and further behind in its fight against COVID-19. The number of new cases has been at an all-time high. The number of deaths has been climbing. We have the tenth highest number of deaths per million population in the world and Florida has almost as many cases in a week as China has had during its entire outbreak. In addition, many hospitals are becoming overwhelmed with COVID-19 patients, health workers continue to face PPE shortages, and test results are taking so long in some places that they are of no value in managing the epidemic.In fact, when it comes to COVID-19, the US is a shockingly bad outlier. Many other countries, from all income groups, have effectively used traditional public health measures, plus varying degrees of “lockdowns” to suppress the outbreak. Vietnam has had fewer than 1,000 cases and Thailand fewer than 3,500. Rwanda can return COVID-19 test results faster than many places in the US. Although the virus arrived in South Korea and the US on the same day, an American has a 70 times greater risk of dying of COVID-19 than a South Korean.Moreover, our COVID-19 trajectory puts us on course to have more than 200,000 deaths by the early fall. This will be about the same number who died in the 20-year Vietnam War. It will be about half the number of military casualties in World War II. We are also at risk of a long-lasting pandemic-related economic depression and the outbreak has profound psychological, social, and educational costs.Our failures to address COVID-19 effectively are overwhelmingly self-inflicted. Our federal government and many state governments have failed to implement well-known public health strategies effectively:Leaders in successful countries identified clear national goals, created a national consensus around those goals, and organized their institutions to achieve them as if their country’s life depended on it.Leaders in the successful countries provided clear and consistent messaging to their people about the nature of the problem, what it would take to address it, and the role of different members of society if they were to tame the outbreak.Countries that have done well against the outbreak have taken policy measures in line with emerging evidence about the disease. They worked continuously to ensure that their people overwhelmingly supported such measures.The countries that have kept new cases and deaths low effectively implemented public health measures at an early stage, including testing, isolation of the infected, contract tracing, and quarantine of their contacts.If we don’t want COVID-19 to get much worse, we need to stop making excuses for American failures. We also need to act in a number of areas with extreme urgency:We must recommit to suppressing the virus.While continuing to promote the development of a vaccine, we must not wait for it, unless we want millions of additional people to get infected and tens of thousands more to die.We must dramatically revise the approach to COVID-19 in states that are seeing major rises in infections.Some or all states will have to work together, even without the federal government, if necessary, to create a coordinated approach to testing and the procurement of needed equipment.We must encourage innovation and social action, such as the Rockefeller Foundation plan to take testing to 30 million a week.States must push national leadership to empower and support CDC, rather than to work around it.We must ensure that appropriate data is consistently collected, available to all, and used in scientific and not political ways as a basis for decision making.We must promote personal responsibility for wearing masks and social distancing whenever we are near other people.We also need to reject thoroughly the idea that “only deaths matter”. Each person who gets COVID-19 needs to be isolated. Each infected person is at risk of infecting others, and could be hospitalized, wind up in an ICU, or die. Many of those who get infected will survive but could face potentially long-lasting neurological, vascular, or pulmonary complications and disabilities. We have no idea yet about the extent to which people with infection and only limited symptoms might wind up later with complications of the infection. Each case also raises a host of social and economic consequences. Thus, completely contrary to what some of our leaders tell us – each case has enormous costs and consequences and we must beat back the virus now.Some governors, both Democrats and Republicans have shown how to lead. Some states, like Connecticut, are winning against the virus. However, if we continue as a nation on our present route, we are headed over the cliff. Let’s hope that we can be exceptional enough to realize this, wake up, and take the urgent actions needed to correct our course.Editor’s note: Richard Skolnik is the former regional director for health for South Asia at the World Bank. He was the director of an AIDS treatment program for Harvard and taught Global Health at the George Washington University and Yale. He is the author of Global Health 101 and the instructor for Yale/Coursera’s Essentials of Global Health.