In September 2020, just before COVID-19 began its wintry surge through the United States, I wrote that the country was trapped in a pandemic spiral, seemingly destined to repeat the same mistakes. But after vaccines arrived in midwinter, cases in the U.S. declined and, by summer’s edge, had reached their lowest levels since the pandemic’s start. Many Americans began to hope that the country had enough escape velocity to exit its cycle of missteps and sickness. And though experts looked anxiously to the fall, few predicted that the Delta variant would begin its ascent at the start of July. Now the fourth surge is under way and the U.S. is once again looping through the pandemic spiral. Arguably, it never stopped.
This new surge brings a jarring sense of déjà vu. America has fallen prey to many of the same self-destructive but alluring instincts that I identified last year. It went all in on one countermeasure—vaccines—and traded it off against masks and other protective measures. It succumbed to magical thinking by acting as if a variant that had ravaged India would spare a country where half the population still hadn’t been vaccinated. It stumbled into the normality trap, craving a return to the carefree days of 2019; in May, after the CDC ended indoor masking for vaccinated people, President Joe Biden gave a speech that felt like a declaration of victory. Three months later, cases and hospitalizations are rising, indoor masking is back, and schools and universities are opening uneasily—again. “It’s the eighth month of 2021, and I can’t believe we’re still having these conversations,” Jessica Malaty Rivera, an epidemiologist at Boston Children’s Hospital, told me.
But something is different now—the virus. “The models in late spring were pretty consistent that we were going to have a ‘normal’ summer,” Samuel Scarpino of the Rockefeller Foundation, who studies infectious-disease dynamics, told me. “Obviously, that’s not where we are.” In part, he says, people underestimated how transmissible Delta is, or what that would mean. The original SARS-CoV-2 virus had a basic reproduction number, or R0, of 2 to 3, meaning that each infected person spreads it to two or three people. Those are average figures: In practice, the virus spread in uneven bursts, with relatively few people infecting large clusters in super-spreading events. But the CDC estimates that Delta’s R0 lies between 5 and 9, which “is shockingly high,” Eleanor Murray, an epidemiologist at Boston University, told me. At that level, “its reliance on super-spreading events basically goes away,” Scarpino said.
As of May, the CDC stopped monitoring all breakthrough infections and focused only on those that led to hospitalization and death. It also recommended that vaccinated people who were exposed to the virus didn’t need to get tested unless they were symptomatic. That policy has since been reversed, but it “allowed people to get lax,” said Jessica Malaty Rivera, who was also a volunteer for the COVID Tracking Project at The Atlantic. “We’ve never tested enough, and we’re still not testing enough.” With Floridians once again facing hours-long lines for tests, “it’s a recap of spring 2020,” Samuel Scarpino, the infectious-disease expert, told me. “We continue to operate in an information vacuum, which gives us a biased and arguably unusable understanding of COVID-19 in many parts of the U.S. That makes us susceptible to this kind of thing happening again.”
What we need, Scarpino argues, is a nimble, comprehensive system that might include regular testing, wastewater monitoring, genetic sequencing, Google-search analyses, and more. It could track outbreaks and epidemics in the same way that weather forecasts offer warnings about storms and hurricanes. Such a system could also monitor other respiratory illnesses, including whatever the next pandemic virus turns out to be. “My phone can tell me if I need to carry an umbrella, and I want it to tell me if I should put a mask on,” Scarpino said. “I’d like to have that for the rest of my life.”