COVID-19: A Look Back at Where America Succeeded and Where We Failed

On the third anniversary of COVID-19 being declared a global pandemic, public health experts can point to clear cases where the United States succeeded in beating back the virus and others where it did not.

Even as the virus continues to spread, data from the Centers for Disease Control and Prevention show weekly cases, hospitalizations and deaths are declining, and the nation survived its first winter since the pandemic began without a true winter surge.

Public health experts said that while the US government and federal health agencies succeeded in many aspects — including the rollout of vaccines and home tests — there are also lessons to be learned from mixed messages.

“I think it’s important to remember that we lost millions and millions of lives and that we don’t forget all the things we’ve learned,” Dr. Priya Sampathkumar, professor of medicine and chief of infection control for the Mayo Clinic, told ABC News. “So learning is one thing, but keeping that memory and being ready to come together to prevent another pandemic is very important.”

Rapid rollout of the vaccines

Experts agree that the development and rollout of the covid-19 vaccines is one of the country’s greatest successes.

In April 2020, the Trump administration launched “Operation Warp Speed” to speed up the development and production of the COVID-19 vaccine, providing unlimited funding and other resources to pharmaceutical companies.

Most vaccines, from the initial stages of academic research to reaching the market, typically take 10 or more years to become available, experts said. However, researchers were able to perform several steps that are usually performed in a linear fashion simultaneously, allowing companies to obtain authorization from the US Food and Drug Administration and scale up production without reducing vaccine safety requirements.

“It really unlocked a new kind of vaccine era,” said Dr. John Brownstein, an epidemiologist and chief innovation officer at Boston Children’s Hospital and a contributor to ABC News. “We’ve recognized that we can develop and deploy a vaccine at a really reasonably fast pace from identification of a new virus to actual first prototype.”

“For the first time, we recognize that there are many places that can be parallel processes, so the process of production and regulatory approval can happen relatively simultaneously,” he added.

Sampathkumar said another reason the vaccines could be developed so quickly is because the genome sequence, or genetic makeup, of the virus was uploaded quickly to global databases.

“We very quickly sequenced the virus from the time the first case was reported in China at the end of December until about seven weeks later, we have the full sequence of the SARS-CoV-2 virus, which was a step towards making a vaccine,” she said . “For most previous virus epidemics, it took anywhere from six to 18 months to do that. So the very first step happened so quickly and set the stage for vaccine development.”

In addition, the relatively new technology of messenger RNA, or mRNA, was used. While most vaccines use a weakened or inactivated virus to stimulate an immune response, mRNA vaccines teach the body how to make proteins that can trigger an immune response and fight an infection.

Because scientists can design mRNA vaccines faster than they can produce the live or attenuated pathogens needed for a traditional vaccine, mRNA vaccines against COVID-19 were quickly developed, tested, mass-produced and delivered to the general population, preventing millions of hospitalizations and deaths. , according to analyses.

Home COVID tests available to everyone

Polymerase chain reaction (PCR) tests are considered the “gold standard” for COVID-19 testing. They look for genetic material from the virus and are considered to be very accurate.

However, in the early days of the pandemic, they had a very long processing time because samples must be sent to a laboratory and analyzed by a medical professional.

Companies quickly began scaling up production of rapid at-home antigen tests, which check for antigens, or proteins on the surface of the virus.

Although less accurate than PCR tests, these rapid tests are still considered fairly accurate when used in people with symptoms of infection and can provide results in 15 minutes or less.

Sampathkumar said the widespread use of home tests was “really amazing” because for many Americans, it was the first time they were able to test themselves at home for a virus, compared to flu tests and strep tests that are often performed at doctors’ offices, emergency departments or hospitals.

“When you think about it, when you feel sick or when you’re contagious to others, that’s the worst possible time to expect to go to an overcrowded clinic or hospital,” she said.

Last winter, the Biden administration launched a website where Americans could request free at-home rapid COVID tests delivered to their doorsteps.

“Making the tests available to anyone living in the US, you can order the tests and have them delivered to your home for free, was also a big step forward,” Sampathkumar said.

Mixed messages

Experts say public health officials erred by having mixed messages about preventive measures like masking.

In February and March 2020, officials including then-Surgeon General Dr. Jerome Adams and Dr. Anthony Fauci downplayed the need for the general public to wear masks.

However, the CDC changed its guidance in early April, recommending that everyone wear a mask or face covering.

While reports have suggested the CDC and other officials delayed recommending masking because they were concerned about causing a backlog of masks and other PPE supplies for healthcare workers, experts say it also means agencies didn’t give the clear messages the public needed.

“I think that kind of mixed messaging created enormous room for doubt, enormous room for skepticism in the public,” Dr. Richard Keller, a professor in the department of medical history and bioethics at the University of Wisconsin School of Medicine and Public Health, told ABC News. “It created levels of uncertainty that were really unnecessary and deep and ultimately harmful.”

The experts say it is normal for their understanding of a virus to evolve as more information is learned, but they noted that public health officials did not do a good job of communicating this process to the public.

“That was really made clear through the pandemic: our inability to communicate the nuance of the science as the science was developing,” Brownstein said. “That was really our Achilles’ heel because we weren’t able to explain to the public that a recommendation can change based on how the science evolves.”

People view COVID-19 deaths as the victims’ fault

Keller said that as the pandemic has progressed, many Americans have come to view COVID-19 deaths as the fault of the victims and have lost a sense of compassion.

Some of this may have been blamed on public health messages, including the Biden administration calling it a “pandemic of the unvaccinated” and emphasizing how much more likely people are to die from COVID if they are not vaccinated.

According to the CDC’s latest estimates, people who are up-to-date on their vaccines have a nearly ten times lower risk of dying compared to an unvaccinated person. Other risk factors include lower socioeconomic status and/or underlying medical conditions such as diabetes and hypertension.

“Labeling this a ‘pandemic of the unvaccinated’ suggests that the people who are dying are dying because it’s their own fault,” Keller said. “I think it’s a harmful message because it does a couple of things.”

“It suggests that people are to blame for their own unhappiness. It also mischaracterizes the true nature of mortality statistics such as where people die and what their circumstances are,” he added.