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A Different Future Was Possible: Reflections on the US Pandemic Response

By Justin Feldman

The inadequacies of the early U.S. pandemic response are well-rehearsed at this point — the failure to develop tests, distribute personal protective equipment, recommend masks for the general public, protect essential workers, and take swift action to stop the spread.

But to focus on these failures risks forgetting the collective framing and collective policy response that dominated the first few months of the COVID-19 pandemic. And forgetting that makes it seem as though our current, enormous death toll was inevitable. This dangerously obscures what went wrong and limits our political imagination for the future of the COVID-19 pandemic and other emerging crises.


When the pandemic first hit the U.S., there was a widely shared understanding of the virus as a collective problem: We all had to do our part to flatten the curve and protect our local health care systems. We clapped for essential workers to show gratitude, if we were not essential workers ourselves. The promise of herd immunity, where we would protect each other by protecting ourselves through vaccination, was on the distant horizon.

A collective policy response complemented this rhetorical and ideological framing. In March 2020, Congress expanded unemployment benefits at unprecedented levels, subsidized businesses, guaranteed paid sick leave for many workers, and broadened Medicaid eligibility. The Trump administration used executive powers to ban evictions and pause student loan payments.

These policies were far from perfect, but they led to a reduction of poverty and uninsurance rates. They allowed furloughed workers to, in most cases, earn more on unemployment than they had on the job. They allowed people to stay home when sick, protecting their coworkers. Most crucially, the federal policy response created conditions in which states could implement universal SARS-CoV-2 mitigation measures (e.g., closing or restricting non-essential businesses), while minimizing their adverse consequences on the populace. Nearly all states initially adopted such measures, even those with uniformly Republican leadership.

What followed was a concerted campaign to dismantle collective protections and assimilate COVID-19 into the model used to treat most social problems: individuals are responsible for themselves, and minimal tools of state intervention will protect (however inadequately) only those deemed to be high-risk and worthy.

The U.S. conservative movement, convened by the Council for National Policy, organized a campaign to fight against public health measures nearly a year before vaccines or outpatient treatments were available to the general population. The main motivation behind this campaign was to ensure that the capitalist class would not incur the cost of the pandemic via government intervention.

For their part, liberal institutions acquiesced to removing most collective health protections as well, albeit on a slower timeline. In early January 2021, amid the country’s largest wave of deaths during the pandemic, only five U.S. states had fully banned indoor dining. During the winter of 2020 to 2021, the only consistent partisan policy difference remaining for COVID-19 was mask mandates. But the Biden administration would soon push states to eliminate mask mandates, and later to nudge people to unmask even amid high SARS-CoV-2 transmission.

By August 2022, the position of Biden’s CDC was essentially to eschew collective public health measures, with the exception of particularly high-risk people and places, which is not all that different from the right-wing position of two years prior. The availability of vaccines and antivirals certainly helps, but the ongoing toll of disability and death under this strategy remains unacceptably high. During the second year of the pandemic, U.S. life expectancy fell a staggering 6.6 years below 2019 levels, largely due to COVID-19 deaths.

This is but one example of the immense costs the virus has imposed on society. These costs could be borne, at least in part, by business and government, which could foot the bill for regulatory measures that would reduce transmission in workplaces and other indoor environments, as well as expand the social safety net.

Instead, the costs are almost entirely imposed on the people, especially working-class people, disabled people, and people of color, who pay with their lives and livelihoods. The social allocation of COVID-19’s costs should therefore be seen as a dramatic upward wealth redistribution.


Early in the COVID-19 pandemic, the Indian author and activist Arundhati Roy explained what was at stake in the historical moment. In April 2020, she wrote:

Historically, pandemics have forced humans to break with the past and imagine their world anew. This one is no different. It is a portal, a gateway between one world and the next. We can choose to walk through it, dragging the carcasses of our prejudice and hatred, our avarice, our data banks and dead ideas, our dead rivers and smoky skies behind us. Or we can walk through lightly, with little luggage, ready to imagine another world. And ready to fight for it.

In most countries, and particularly in the United States, I’m afraid that “our dead ideas” have won — at least for the time being. If we have in fact passed through the portal to another world, it is certainly not better than the one we inhabited in 2019.

But it is important to remember that a different future was still possible in early 2020. And there are elements of this early time-period of the pandemic response — a regulatory, redistributive, and collective response — that can help us remember that the limits of what is possible are perhaps wider than we think.

Justin Feldman

Justin Feldman, ScD is a social epidemiologist and a research fellow at the Harvard FXB Center for Health and Human Rights. His research focuses on police violence as well as economic and racial health inequities.

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