(1) Awful demographics, many underlying conditions--unhealthy population, (2) numerous international airports and international traffic, (3) multiple administrative missteps in early response,(4) continued, almost incomprehensible, failure to declare Covid airborne and respond accordingly (this continues), (5) awful messaging on masking early, (6) US has a bad health care system (30th in world) focusing almost completely on expensive treatment and medication but not on prevention (7) a culture of individuality that prevents effective long term population-based responses (8) rampant misinformation and politicization of the issue (9) effective recordkeeping that makes the US look worse comparatively.