COVID-19 pandemic in the United States

• 1. Introduction

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  On the 20th of January, 2020, the COVID-19 pandemic arrived in the United States with a single reported case. By the 6th of February, a 57-year-old woman in Santa Clara County, California had already died from the virus. The CDC would not confirm her death until the 21st of April. Long before any official alarm sounded, the pathogen had been spreading undetected, possibly since November 2019.

  COVID-19 became the third-leading cause of death in the United States in 2020, behind only heart disease and cancer. According to the Global Health Security Index, the country had been ranked the most prepared nation on earth for a pandemic. How a seemingly prepared nation came to record more deaths than any country in the world, which communities bore the heaviest cost, and why those losses were not evenly shared: those questions run through every chapter of what follows.

• 2. A Slow Start

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  On the 31st of January, 2020, Health and Human Services Secretary Alex Azar declared a public health emergency. Only seven known cases existed in the country at that point. Travel restrictions on flights from China followed, but broader preparations lagged significantly. Testing kits remained scarce, and efforts to slow arrivals from other parts of the world were slow to materialize.

  In September 2019, the Trump administration had terminated the PREDICT program, a $200 million epidemiological research initiative that the United States Agency for International Development had funded since 2009. The program trained scientists in sixty foreign laboratories to detect viruses with pandemic potential. One of those laboratories was in Wuhan, the city where the novel coronavirus was first identified.

  In late February, Trump proposed allocating $2.5 billion to fight the outbreak. Congress approved more than three times that amount: $8.3 billion, with only Senator Rand Paul and Representatives Andy Biggs and Ken Buck voting against. Trump signed the bill on the 6th of March. One week later, on the 13th of March, he declared a national emergency.

  By March 26, data from The New York Times showed the United States had more known COVID-19 cases than any other country. The country reported over 100,000 cases by March 27. On the 11th of April, the American death toll crossed 20,000, surpassing Italy to become the highest in the world. By the 28th of April, confirmed cases had exceeded one million.

• 3. Waves and Variants

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  Daily COVID-19 case counts surpassed 60,000 in June 2020, as a second wave of infections swept through states that had relaxed restrictions. The 80th Sturgis Motorcycle Rally in Sturgis, South Dakota, that August drew over 400,000 attendees. Public health officials traced at least 300 infections across more than 20 states back to the event.

  On the 2nd of October, Trump announced on Twitter that both he and the First Lady had tested positive for COVID-19. He was given an experimental Regeneron product containing two monoclonal antibodies and transferred to Walter Reed National Military Medical Center, where he received remdesivir and dexamethasone. By mid-October, a third surge was underway nationwide.

  Over 200,000 new daily COVID-19 cases were recorded during parts of December 2020 and January 2021. By the 1st of January, 2021, the country had passed 20 million total cases, an increase of more than one million in a single week.

  The Alpha variant, first detected in the United Kingdom, arrived in the United States on the 29th of December, 2020, with a confirmed case in Colorado. By the 7th of April, 2021, Alpha had become the dominant strain in the country. The Delta variant, first detected in India, was reported in the U.S. for the first time on the 12th of April, 2021, in California. By the 7th of July, Delta had surpassed Alpha as the dominant strain. By August 2021, Delta accounted for 99 percent of all cases. It was also found to double the risk of hospitalization for those who had not yet been vaccinated.

  The Omicron variant, first discovered in South Africa, drove case counts to levels never previously seen when it emerged in January 2022. As many as 1.5 million new infections were reported in a single day. By the end of 2022, the CDC estimated that roughly 77.5 percent of Americans had contracted COVID-19 at least once.

• 4. The Vaccination Campaign

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  On the 14th of December, 2020, the first COVID-19 vaccine doses were administered in the United States. The Pfizer-BioNTech vaccine received FDA emergency use authorization on the 11th of December, followed by Moderna on the 18th. The first vaccine to receive full FDA approval did so on the 23rd of August, 2021.

  The CDC found unvaccinated Americans were between five and nearly thirty times more likely to be infected or hospitalized than the fully vaccinated. Hospitals in states with low vaccination rates began exceeding capacity by mid-August 2021. Eight states held one-quarter of the U.S. population: Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Nevada, and Texas. By mid-August, those eight states together accounted for half of all COVID-19 hospitalizations in the country. The intensive care units in five of them were over 90 percent full by the end of the month.

  On the 4th of May 2021, Biden announced a goal of having 70 percent of all American adults receive at least one vaccine shot by July 4. The country fell short: only 67 percent of the adult population had done so by the deadline. By August 2021, more than 800 colleges and universities and over 200 healthcare companies had implemented some form of vaccination requirement. Companies outside healthcare followed, including United Airlines, Tyson Foods, and Walmart.

  In May 2025, Health and Human Services Secretary Robert F. Kennedy Jr. removed the COVID-19 vaccine from the CDC's recommended immunization schedule for healthy children and pregnant women. Kennedy bypassed the normal scientific review process to do so. In August 2025, he announced the termination of 22 mRNA vaccine development projects worth nearly $500 million through the Biomedical Advanced Research and Development Authority.

• 5. An Unequal Burden

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  Stop AAPI Hate, an organization formed in response to the pandemic, received 3,795 reports of racism against Asian Americans and Pacific Islanders in just the first year. The surge in xenophobia and racism was among the earliest social consequences of the outbreak's arrival in the United States.

  As of the 15th of September, 2020, Black Americans had COVID-19 mortality rates more than twice as high as those of White and Asian Americans. In May 2020, CNN reported that the Navajo Nation had the highest rate of infection in the entire country. In June 2021, the CDC confirmed that American Indian and Alaska Native people showed the highest hospitalization and death rates of any racial group. Hispanic and Latino persons suffered the highest COVID-19 infection rates compared with White persons.

  From 2019 to 2020, life expectancy for Hispanic Americans fell by three years and for African Americans by 2.9 years. For White Americans, the drop was 1.2 years. An NPR analysis of COVID Tracking Project data found Black Americans' share of COVID-19 deaths was 1.5 times their share of the total population. In some states, that proportion reached 2.5 times. Hispanics and Latinos faced disproportionate infection rates in 45 states and a disproportionate share of deaths in 19 states. Native American and Alaskan Native deaths were disproportionately high in at least 21 states, in some reaching five times the average.

  A survey of booster shot uptake found that 19 percent of White non-Hispanic people had received an updated booster. That compared with about 11 percent of Hispanic people and about 7 percent of non-Hispanic American Indian, Alaska Native, and Black people. The CDC noted that only 61 percent of COVID-19 case reports included race and ethnicity data. That gap means the documented disparities may still undercount the true scale of unequal exposure.

• 6. Political Fractures

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  In February 2020, the partisan gap over COVID-19 was nearly invisible. Roughly 70 percent of Democrats and 72 percent of Republicans believed the virus represented a real threat. By mid-March 2020, that consensus had fractured. Seventy-six percent of Democrats still viewed COVID-19 as a genuine danger, while only 40 percent of Republicans agreed.

  The CDC was the most trusted source of COVID-19 information overall, at 85 percent. The WHO followed at 77 percent, and state and local government officials at 70 to 71 percent. The news media was trusted by 47 percent of respondents, with Trump rated at 46 percent. A May 2020 poll found that 54 percent of Americans felt the federal government was doing a poor job stopping the spread of the virus.

  Responding to Democratic proposals to expand mail-in voting in COVID-19 relief legislation, Trump said "you'd never have a Republican elected in this country again." He called the practice corrupt and insisted voters show up in person, even while he himself had voted by mail in a recent Florida primary. A study published in Science Advances compared opinions in January-February 2020 with those in June 2020. It found that high COVID-19 fatality rates at the county level correlated with declining support for Trump's reelection.

  In April 2025, federal government websites including Covid.gov were updated to emphasize the theory that the virus originated in a Wuhan laboratory. The new material replaced practical guidance such as how to order free COVID tests. It also included criticism of mask mandates, social distancing, the World Health Organization, and pandemic-era figures including Anthony Fauci and Andrew Cuomo.

• 7. Economic Collapse

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  The economic peak of February 2020 gave way to a recession almost immediately. By April, the unemployment rate had surged to 14.7 percent, with more than 23 million Americans out of work. The U.S. economy contracted 4.8 percent in the first quarter of 2020. During the second quarter, GDP fell at an annualized rate of 32.9 percent, the largest such drop on record. By June 2020, the country's economy was more than ten percent smaller than it had been in December 2019.

  OpenTable estimated in May 2020 that 25 percent of American restaurants would close permanently. A Yelp report found that about 60 percent of U.S. businesses that closed during the pandemic would not reopen. The Aspen Institute indicated that as many as 30 to 40 million people were at risk of eviction by the end of 2020. Total healthcare costs for treating the epidemic ranged from $34 billion to $251 billion, according to analysis presented by The New York Times.

  In the largest individual case of pandemic fraud, dozens conspired to claim nearly $250 million in USDA child nutrition funds. The scheme was called Feeding Our Future, and no meals were ever provided to children. As of 2025, more than 4,200 Americans had been federally charged with pandemic fraud. Those charges resulted in more than 2,400 convictions and $2 billion in recovered funds and forfeitures.

• 8. Living With the Virus

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  On the 26th of April, 2022, Anthony Fauci declared that the United States was "out of the pandemic phase." The following day, he qualified that statement, saying the country was moving toward endemicity but clarifying that "the world is still in a pandemic." On the 18th of September, 2022, Biden declared in a 60 Minutes interview that the COVID-19 pandemic was "over" in the United States. The medical community contested that view: roughly 400 Americans were still dying from the disease each day at that time.

  On the 10th of April, 2023, Biden signed into law a resolution terminating the national emergency, effective immediately. The separate public health emergency remained in effect until the 11th of May.

  Hospitalizations rose 24 percent in the first two weeks of August 2023, the first major surge after the public health emergency had formally ended. Film studio Lionsgate briefly reinstated a mask mandate following an outbreak. Morris Brown College reinstated temperature checks and restricted large events for two weeks at the start of its fall semester. Three school districts in Texas and Tennessee suspended in-person learning temporarily due to high positivity rates among students.

  When hospitalizations first exceeded 20,000 after the public health emergency ended, the federal government acted. On the 25th of September, 2023, it restarted the free COVID test delivery program. Health Secretary Xavier Becerra stated that replenished stockpiles would allow the program to continue through the holiday season. In January 2024, wastewater data showed U.S. COVID-19 infections had reached their second-highest recorded level, surpassed only by the initial Omicron wave of January 2022. On the 1st of March, 2024, the CDC shortened its COVID-19 isolation guidance to align with its rules for influenza and RSV. The new threshold was one day after becoming fever-free without medication, the same bar already set for those two diseases.