COVID-19: A look back at what the US succeeded and what we failed to do

On the third anniversary of COVID-19’s declaration as a global pandemic, public health experts can point to clear cases where the United States succeeded in containing the virus and others where it failed.

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

Public health experts said that while the U.S. government and federal health agencies have succeeded in many ways — including the rollout of vaccines and home testing — lessons can also be learned from mixed coverage.

“I think it’s important to remember that we’ve lost millions and millions of lives and that we don’t forget all the things we’ve learned,” Dr. Priya Sampathkumar, a professor of medicine and the chief of infection control for 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 really 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 achievements.

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

The majority of vaccines, from the first steps of academic research to reaching the market, generally take 10 years or more to become available, experts say. However, researchers were able to perform several steps that are usually linear at the same time, allowing companies to obtain approval from the US Food and Drug Administration and scale production without reducing vaccine safety requirements.

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

“For the first time, we recognize that there can be a parallel process in many places, so the manufacturing process and regulatory approval can happen relatively simultaneously,” he added.

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

“We sequenced the virus very quickly from the first case reported in China at the end of December to about seven weeks later, we have the complete sequence of the SARS-CoV-2 virus, which was a step towards making of a vaccine,” she said. . “For most previous viral epidemics, it took six to 18 months to do that. So that 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 mount an immune response and fight an infection.

Because researchers 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 rapidly developed, tested, mass-produced and delivered to the general population, helping millions hospitalizations and deaths were prevented, according to analyses.

Home COVID testing available for everyone

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

However, in the early days of the pandemic, they had a very long lead time as samples had to be sent to a lab and analyzed by a medical professional.

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

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

Sampathkumar said the widespread use of home testing was “very astonishing” because it was the first time for many Americans to test themselves for a virus at home, compared to flu tests and strep tests often performed at doctors’ offices, emergency centers or hospitals.

“If you think about it, if you feel sick or if you are contagious to others, it’s the worst possible time to expect to go to a crowded clinic or hospital,” she said.

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

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

Mixed coverage

Experts say public health officials have made missteps by having mixed messages about preventive measures such as 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, in early April, the CDC changed its guidelines and advised everyone to wear a mask or face covering.

While reports have suggested that the CDC and other officials have delayed recommending masks for fear of sparking a run on masks and other PPE supplies for healthcare workers, experts say this also means agencies haven’t delivered the clear message it public needed.

“I think that kind of mixed coverage created a huge space for doubt, a huge space for public skepticism,” 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 ended up being damaging.”

The experts say it’s normal for their understanding of a virus to evolve as more information is learned, but they noted that public health officials have not properly communicated that process to the public.

“That was really highlighted by the pandemic: our inability to convey the nuance of science as science evolved,” Brownstein said. “That was really our Achilles’ heel because we couldn’t explain to the public that a recommendation might change based on how the science evolves.”

People who view deaths from COVID-19 as the fault of the victims

Keller said that as the pandemic continues, many Americans have come to blame the COVID-19 deaths on the victims and have lost a sense of compassion.

Part of this may have been to blame for public health reports, including the Biden administration calling it a “pandemic of the unvaccinated” and highlighting how much more likely people are to die from COVID if they are not vaccinated.

According to the CDC’s most recent estimates, people who are up to date on their vaccines have an almost 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.

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

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