There comes a point in the unfolding of every epidemic when public-health officials acknowledge that despite their best efforts, an invisible microbial foe has managed to outwit them. That time has come. As cases of COVID-19 began to wane in early March in China, there was a surge in new infections around the globe, from Iran to Italy, South Korea to the U.S.
Deaths also rose—the U.S. recorded its first coronavirus-related mortalities—and health officials warned that the disease has “pandemic potential.” There are now more than 80,000 cases of COVID-19 infection in mainland China and nearly 13,000 outside the country, with the latter tally growing daily.
When the Chinese government took the unprecedented steps of quarantining first the city of Wuhan, where COVID-19 emerged, and then 60 million people living in the province of Hubei, where Wuhan is located, the hope was to contain the virus. If the people most likely to have been exposed to and infected by the virus couldn’t travel, then they couldn’t spread the disease very far.
That was also President Donald Trump’s public reasoning for the aggressive travel restrictions the U.S. government put in place in January, denying entry to many foreign nationals from China, and funneling passengers arriving in the U.S. who might have traveled to China through select airports where they had their temperature scanned and then, for those with a fever, on to further testing and monitoring.
But if COVID-19 has taught government and public-health leaders anything, it’s that containment, in an era when viruses are given wings through the ease of international travel, is increasingly only a short-term strategy for combatting infectious disease. And that’s especially true when it comes to the COVID-19 virus, which appears to jump covertly from person to person by piggybacking in some hosts without really making them sick.
Detecting these people is akin to capturing clouds, and public-health officials are now acknowledging that the time for containment has slipped through their fingers. But that reality is proving more difficult for political leaders to accept. At his first press conference directly addressing the COVID-19 outbreak, Trump downplayed its potential impact in the U.S., declaring that a widespread uptick is “not inevitable. The risk to the American people remains very low.” Chancellor Angela Merkel reassured the German public on her website that “the German health system is well prepared.” Prime Minister Shinzo Abe of Japan, along with the International Olympic Committee, maintains that the Summer Games will continue as planned in that country, but critics say the Health Ministry has held back on testing for the disease out of fear that it would expose an alarming number of infections.
Betting too heavily on containment’s succeeding almost certainly slowed preparations for dealing with the virus’ spread, including scaling up testing and medical-facility capacity to accommodate a possible surge in patients. “The cat is out of the bag. COVID-19 cannot be contained, and we know this is going to be a pandemic,” says Dr. Tom Frieden, former director of the U.S. Centers for Disease Control and president and CEO of Resolve to Save Lives.
What’s making the shift from containment to control especially difficult is COVID-19’s unknowns: its contagiousness, incubation period and deadliness. “It could be like an average flu year, or way worse, or not as bad—we just don’t know,” says Frieden. U.S. health officials anticipate that in order to minimize transmission of the disease, some communities will need to adopt policies like advising employees to work from home and canceling public gatherings.
That’s just a glimpse of what might be coming not just for Americans but for people worldwide, warn the residents of Wuhan. “There are so many things you can’t see with your eyes, like the emotional damage people suffer from, especially the survivors who have lost family members to this outbreak,” says Togo, a resident who anonymously volunteers online to connect COVID-19 patients with treatment. “But this is only on the outside. The way they were hurt, the scars they have, will never recover.”
—With reporting by Charlie Campbell/Beijing and Aria Chen/Hong Kong
This appears in the March 16, 2020 issue of TIME.