Body count has long been the yardstick by which we measure calamity. There were the 58,000 U.S. lives lives lost in the Vietnam war; the 1,496 souls who perished on the Titanic. In the hours after the September 11 attacks, when the death toll was not known, then-New York Mayor Rudy Giuliani famously said, “The number of casualties will be more than any of us can bear, ultimately.”
We are, once again, trying to bear the unbearable as the U.S. today surpassed 200,000 deaths caused in the still-rampaging COVID-19 pandemic. We remain, as we have long been, the world’s hardest-hit country, with just 4% of the global population but roughy 21% of both deaths and overall cases; it’s a dubious distinction that was fast in coming.
It was not long ago, on Feb. 29, that the U.S.’s first COVID-19 death was recorded, in Washington state. By March 29, the death count had exceeded the 2,977 people who ultimately did die in the 9/11 attacks. At that time, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, predicted that total deaths would be between 100,000 and 200,000, and the disease promptly set out to prove that prediction a tragic low-ball. On April 29, the Vietnam death toll was surpassed. On May 23 we had reached 100,000 deaths. On July 29 it was 150,000. With the 200,000 threshold now having been crossed, the outlook for the rest of the year remains grim. The Institute for Health Metrics (IMHE) at the University of Washington School of medicine now predicts a likely scenario of 410,000 deaths by the end of the year.
The fact that we find ourselves here was a result of serial failures in our politics, our culture and in our ability to imagine that the world’s most powerful nation could fail to rise to a health challenge many people had long predicted was inevitable. As TIME’s Elijah Wolfson and Alex Fitzpatrick have reported, 45 days before the first COVID-19 case was diagnosed, the Global Health Security Index was published, assessing 195 countries on their perceived ability to handle a major disease outbreak, and ranking the U.S. first.
“It’s clear the report was wildly overconfident in the U.S.,” Wolfson and Fitzpatrick write, “failing to account for social ills that had accumulated in the country over the past few years, rendering it unprepared for what was about to hit.”
Exceedingly unprepared, as the families of the 200,000 dead could sorrowfully attest. Still, there are glimmers of good news obscured by the bad. A handful of states, including Maine, Vermont, New York and Massachusetts, have new-infection rates below 1% of all people tested. But 27 states exceed the 5% positivity line the World Health Organization sets as a standard that must be maintained for at least two weeks before a country or region should consider reopening its economy. Only 14 states have seen daily case counts hold steady or fall over the past 14 days.
Battling the pandemic remains difficult, especially with mixed messages continuing to come out of the White House and Washington. President Donald Trump continues to downplay the significance of mask-wearing, publicly breaking with CDC Director Robert Redfield, and calling him “confused,” after he testified before Congress that a simple face mask could be as effective in stopping disease spread as a vaccine. The President continues to hold public rallies with little social distancing or mask use, and claims that the 200,000 death toll is, in some ways, a success story since the numbers could have been much worse.
“If we didn’t do our job, it would be three and a half, two and a half, maybe 3 million people,” he said on Friday. “We have done a phenomenal job with respect to COVID-19.”
History will be the ultimate judge of what kind of job the Administration and the nation as a whole have done in responding to the pandemic. But with a vaccine still months away and the coming winter forcing people back indoors—and into close, infectious quarters—the 400,000-plus figure is almost certain to be reached before the end of the year, with numbers equally certain to keep climbing after that. The final number of lives lost will, once again, be more than any of us can bear.