The pandemic was unprecedented. Where we succeeded, where we didn’t, and what we learned.
The event that would come to define the early 2020s first entered the public consciousness on the eve of the decade, in late 2019.
At first, though, the emergence of SARS-CoV-2, the coronavirus that causes COVID-19, wasn’t seen as a grave threat by much of the world.
By March 2020, however, the landscape had shifted.
As the highly contagious and deadly virus spread around the planet, it soon became apparent that drastic global action was necessary.
On March 11, 2020, World Health Organization Director-General Tedros Adhanom Ghebreyesus officially declared COVID-19 a pandemic and sweeping measures were quickly implemented across the United States and the world in an effort to contain the virus.
Now, three years later, the United States is in a better position.
Vaccines are widely available and while the virus and its variants still exist, they’re no longer as deadly as they once were. It’s now possible to see the light at the end of the tunnel.
While the outlook in 2023 is far more optimistic than that of 2020, the harsh lessons of COVID-19 — and the toll of
The average American likely wasn’t particularly concerned about the threat of COVID-19 in early 2020.
After all, the last major respiratory virus pandemic — the 1918 flu pandemic — had passed out of living memory. Other events such as the
But COVID-19 quickly proved that it was a different beast.
“This virus behaved very differently than its cousins SARS and MERS,” explained Dr. William Schaffner, a professor of preventive medicine and infectious diseases at the Vanderbilt School of Medicine in Nashville, Tennessee.
“This is one where it became very apparent that either asymptomatic or mildly symptomatic transmission could occur widely, with only a relatively small proportion of people,” Schaffner told Healthline. “That completely changed the entire public health and clinical perspective of this virus. And as soon as that became evident, we said at that time, ‘Oh dear, we’re in for something that looks like a pandemic. And this is going to be a very big deal.’”
Adding to the crisis was the fact that COVID-19 was a new virus. Data from similar viruses gave scientists some clue as to how it operated, but more data was necessary — data that didn’t yet exist.
Dr. Susan Cheng, an associate dean in the Public Health Practice & Diversity, Equity, and Inclusion department at the Tulane University School of Public Health and Tropical Medicine in Louisiana, told Healthline that COVID-19’s long incubation period and highly infectious nature, coupled with global travel, showed that the virus would be difficult to contain.
“Although it was first seen in late 2019, it took several more months to produce enough COVID-19-specific tests to start to get a better picture of the scope and breadth of the infection and for the U.S. to identify enough cases domestically to declare the disease a pandemic and respond effectively,” she said. “Until tests and data were available, it was difficult to establish accurate estimates of the level of disease transmission and prevalence in the country.”
By the end of March 2020, more than 100,000 cases had been reported in the United States with a death toll topping 1,500.
With humanity dealing with the kind of crisis that hadn’t been seen in a century, sweeping public health measures were introduced, all aimed at curbing the spread of the virus.
Masking guidelines and stay-at-home orders were introduced across the country and society adapted to what was often called “the new normal.”
The response to the COVID-19 pandemic had to come together quickly — and the results weren’t always optimal.
Cheng said that many of these rules had negative knock-on effects.
“For instance, while schools were kept remote and closed, several larger cities still allowed indoor gatherings for dining or entertainment without consistent mask policies,” she said. “Not providing opportunities for schools to operate under safer mitigation guidelines provided many challenges to working parents, which in turn impacted the workforce.”
Cheng says that COVID-19 response funds probably would have been better spent if there was a focus on providing better ventilation in buildings, more household tests, higher quality masks, and more protected workplace leave policies for quarantine and isolation, in order to provide more stability for workers.
Dr. Monica Gandhi, a professor of medicine and the associate division chief of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF/ San Francisco General Hospital, told Healthline, “I think the effects on learning loss and economic achievement from our prolonged school closures will have manifestations for our low-income children — as well as those from racial or ethnic minority groups — for a long time.”
Another challenge was messaging.
Schaffner points out that it’s tough for a large, diverse country like the United States to be consistent across its various states and territories.
“Think of it as an orchestra,” he said. “If you let the different instruments play on their own, you get a cacophony. Chaos. However, if they’re all playing from the same sheet of music — not necessarily playing the same note simultaneously — you have beautiful music.”
“We delegated a response to the pandemic to the states and what you got was cacophony when what we needed was strong central leadership,” he continued. “That communication should come from public health leadership and the CDC (U.S. Centers for Disease Control and Prevention), but then the politicians have to help for that be effective.”
The concepts of wearing a face mask and physical distancing may not have been familiar to many before the pandemic, but they quickly became common.
While proponents of masks said wearing them generally curbed the spread of aerosolized droplets that cause infection, mask mandates did not work as well as expected.
This isn’t because masking can’t work. It has more to do with the highly contagious nature of COVID-19 and its variants as well as inconsistent application of masks that, more often than not, are not medical grade.
In addition, there’s the human nature factor where some people won’t wear them as well as the practical aspects such as children not always being able to properly wear the coverings.
“Since the Omicron variant was so transmissible, universal contact tracing was
“Basically, mask mandates by themselves don’t seem to work. Although that may seem counterintuitive, this is likely because people wear different kinds of masks and wear them in different ways, like below the nose. A large Cochrane review — considered our gold standard in summarizing evidence-based medicine — recently showed that population-level masking did not have a significant effect by the current studies on COVID-19 spread.”
While the masking issue has been heavily politicized, it’s worth re-emphasizing that one-way masking can protect at-risk individuals, even if widespread masking mandates proved to be largely ineffective.
While it’s impossible to put a positive spin on the virus itself, it’s still worth noting that the response to this virus showed many success stories.
“When we opened our textbooks, figuratively speaking, to COVID, what we found was blank pages,” said Schaffner. “So we all started from scratch.”
An early success story, said Schaffner, was the quick development of rapid tests — first at testing centers, and then through the dissemination of take-at-home tests.
From there, the larger job of developing a vaccine as quickly as possible loomed large. But by building on data from similar viruses, scientists were able to start working on a COVID-19 vaccine almost immediately.
“It was applied very quickly — I mean, within hours of the molecular biologist letting us know what the genome of this virus was,” Schaffner said. “People at the National Institutes of Health immediately went to work.”
Cheng echoes Schaffner’s sentiment that the rapid development of the vaccine was a major success story.
“In previous pandemic preparedness analyses, the rough estimate to produce and disseminate enough vaccines would have been in the 18- to 36-month span,” she said. “However, the mRNA vaccines were able to capitalize on advances made in mRNA technology in general, and years of research on SARS and MERS more specifically.”
“There were also more local success stories here in the U.S., such as the rapid and high rates of vaccination uptake in Navajo Nation after the high levels of infection that were reported early on,” Cheng added.
While it’s understandable to be feeling a sense of acute pandemic fatigue — after all, it’s been three years — it’s also worth looking at how much has changed between 2020 and 2023.
Thanks in large part to vaccinations, along with natural immunity that’s developed among the population, COVID-19 is now more manageable. Cases are generally less severe, and more than 80% of Americans have received at least one dose of the vaccine.
There’s also the fact that, in 2020, COVID-19 was running rampant through a population with no natural immunity. In 2023, despite the periodic emergence of new variants, the population is better equipped to weather the storm.
Although COVID-19 is still officially a pandemic, there’s light at the end of the tunnel.
Nonetheless, while the pandemic will eventually be downgraded to endemic, the virus itself remains.
“Unfortunately, a knowledge of the history of infectious diseases has shown us that COVID-19 does not have the features of an eradicable virus,” said Gandhi.
“Smallpox was successfully
She notes that SARS-CoV-2 — the coronavirus that causes COVID-19 — has none of these features.
“With ongoing circulation, we will likely continue to see new subvariants, but COVID-19 is becoming more predictable like influenza and not mutating as much,” she added.
Because COVID-19 cannot be wiped out entirely, Gandhi says it’s important to continue to get booster shots, particularly for older and vulnerable people.
The pandemic also shone new light on public health systems. When it comes to the interface between health professionals, politicians, and the general public, Schaffner says — revisiting his orchestra analogy — the band still isn’t back together.
“We’re still not at the place where the whole orchestra is playing from the same sheet of music under one conductor and we need to move toward that,” he said. “In order to get us to a place where we can handle things should there be another pandemic, we would need to be more secure in order to initiate a coherent, comprehensive, and accepted response.”
Cheng says the response to the pandemic laid bare the many gaps in public health and social infrastructure that still exist.
“The devastating health inequities faced by many sectors of our communities, our Black and brown folks, our folks living in assisted living facilities or in prisons, our folks working in manufacturing, our indigenous folks, highlighted the social determinants of health impact on individuals and communities differently,” she explained.
“The ability of governments, healthcare systems, public health, and communities to respond to COVID-19 was impressive and saved millions of lives,” Cheng continued. “However, there are still many areas of improvement to be ready to respond more effectively to the next pandemic — and the next pandemic is a matter of when, and not if.”