COVID-19 pandemic in the United States

COVID-19 pandemic in the United States
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COVID-19 cases per 100,000 people by state, as of January 17
Disease COVID-19
Virus strain SARS-CoV-2
Location United States
First outbreak Wuhan, Hubei, China[1]
Index case Chicago, Illinois (earliest known arrival)[2]
Everett, Washington (first case report)[3]
Arrival date January 13, 2020[4]
(2 years, 1 week and 1 day ago)
Confirmed cases 68,569,950[5]
Suspected cases 146,585,169 (CDC estimate in September 2021)[6]
  • 43,059,089[7]
  • 857,768[5] (reported)
  • 921,000 (CDC estimate in September 2021)[6]
  • 1,030,000 (The Economist estimate on December 12, 2021)[8]
Fatality rate
  • 1.3% (CDC)
  • 1.3% (JHU)
  • 249,702,939[5] (75.21%) (people with at least one dose)
  • 208,751,563[5] (62.88%) (fully vaccinated people)
Government website
Suspected cases have not been confirmed by laboratory tests as being due to this strain, although some other strains may have been ruled out.
COVID-19 cases in the United States
Covid cases per million

The COVID-19 pandemic in the United States is part of the worldwide pandemic of coronavirus disease 2019 (COVID-19). Since January 2020, 68,569,950[5] confirmed cases have been reported with 857,768[5] deaths, the most of any country, and the nineteenth-highest per capita worldwide.[9] As many infections have gone undetected, the Centers for Disease Control and Prevention (CDC) estimated that, as of May 2021, there could be a total 120.2 million infections in the United States, or more than a third of the total population.[10][6] COVID-19 is the deadliest pandemic in U.S. history;[11] it was the third-leading cause of death in the U.S. in 2020, behind heart disease and cancer.[12] From 2019 to 2020, U.S. life expectancy dropped by 3 years for Hispanic Americans, 2.9 years for African Americans, and 1.2 years for white Americans.[13] These effects have persisted as U.S. deaths due to COVID-19 in 2021 exceeded those in 2020.[14]

On December 31, 2019, China announced the discovery of a cluster of pneumonia cases in Wuhan. The first American case was reported on January 20, and President Donald Trump declared the U.S. outbreak a public health emergency on January 31. Restrictions were placed on flights arriving from China,[15][16] but the initial U.S. response to the pandemic was otherwise slow, in terms of preparing the healthcare system, stopping other travel, and testing.[17][18][19][a]

The first known American deaths occurred in February. On March 6, 2020, Trump allocated $8.3 billion to fight the outbreak and declared a national emergency on March 13. The government also purchased large quantities of medical equipment, invoking the Defense Production Act of 1950 to assist.[21] By mid-April, disaster declarations were made by all states and territories as they all had increasing cases. A second wave of infections began in June, following relaxed restrictions in several states, leading to daily cases surpassing 60,000. By mid-October, a third surge of cases began; there were over 200,000 new daily cases during parts of December 2020 and January 2021.[22][23]

COVID-19 vaccines became available in December 2020, under emergency use, beginning the national vaccination program, with the first vaccine officially approved by the Food and Drug Administration (FDA) on August 23, 2021.[24] Studies have shown them to be highly protective against severe illness, hospitalization, and death. In comparison with fully vaccinated people, the CDC found that those who were unvaccinated were from 5 to nearly 30 times more likely to become either infected or hospitalized. There has nonetheless been some vaccine hesitancy for various reasons, although side effects are rare.[25][26][27] There have also been numerous reports that unvaccinated COVID-19 patients have strained the capacity of hospitals throughout the country, forcing many to turn away patients with life-threatening diseases.

A fourth rise in infections began in March amidst the rise of the Alpha variant, a more easily transmissible variant first detected in the United Kingdom. That was followed by a rise of the Delta variant, an even more infectious mutation first detected in India, leading to increased efforts to ensure safety. The January 2022 emergence of the omicron variant, which was first discovered in South Africa, has led to record highs in hospitalizations and cases, with as many as 1.5 million new infections reported in a single day.[28]

State and local responses to the pandemic have included mask mandates, prohibition and cancellation of large-scale gatherings (including festivals and sporting events), stay-at-home orders, and school closures.[29] Disproportionate numbers of cases have been observed among Black and Latino populations,[30][31][32] as well as elevated levels of vaccine hesitancy,[33][34] and there has been a sharp increase in reported incidents of xenophobia and racism against Asian Americans.[35][36] Clusters of infections and deaths have occurred in many areas.[b] The COVID-19 pandemic has also led to misinformation and conspiracy theories.[39]


December 2019 to April 2020

In November 2019, COVID-19 infections had first broken out in Wuhan, China.[40][41] China publicly reported the cluster on December 31, 2019.[3] After China confirmed that the cluster of infections was caused by a novel infectious coronavirus[3] on January 7, 2020, the CDC issued an official health advisory the following day.[42] On January 20, the World Health Organization (WHO) and China both confirmed that human-to-human transmission had occurred.[43] The CDC immediately activated its Emergency Operations Center (EOC) to respond to the outbreak in China.[44] Also, the first report of a COVID-19 case in the U.S. was publicly reported,[3] though the All of Us study (released in 2021) showed five states already had cases weeks earlier.[45] After other cases were reported, on January 30, the WHO declared a Public Health Emergency of International Concern (PHEIC) – its highest level of alarm[46] – warning that "all countries should be prepared for containment."[47][48][d] The same day, the CDC confirmed the first person-to-person case in the U.S.[50] The next day, the country declared a public health emergency.[51] Although by that date there were only seven known cases in the U.S., the HHS and CDC reported that there was a likelihood of further cases appearing in the country.[51]

The Trump administration evacuated American nationals from Wuhan in January.[52] On February 2, the U.S. enacted travel restrictions to and from China.[16] On February 6, the earliest confirmed American death with COVID-19 (that of a 57-year-old woman) occurred in Santa Clara County, California. The CDC did not report its confirmation until April 21,[53] by which point nine other COVID-19 deaths had occurred in Santa Clara County.[54] The virus had been circulating undetected at least since early January and possibly as early as November.[55] On February 25, the CDC warned the American public for the first time to prepare for a local outbreak.[56][57] The next day, New York City saw the sickening of its "patient zero", Manhattan attorney Lawrence Garbuz, then thought to be the first community-acquired case.[58][59][60] Another case known as "patient zero" in Los Angeles is a man named Gregg Garfield, a man who spent 64 days in the Burbank Hospital, on a ventilator for 30 days, with a 1% chance to live. Contracting the virus from a ski trip, Garfield is back on the slopes, although with fingers and toes amputated.[61] In February, Vice President Mike Pence took over for Secretary Alex Azar as chair of the White House Coronavirus Task Force.[62]

March 6: President Trump and Alex Azar at the signing of Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 into law

By March 11, the virus had spread to 110 countries, and the WHO officially declared a pandemic.[29] The CDC had already warned that large numbers of people needing hospital care could overload the healthcare system, which would lead to otherwise preventable deaths.[63][64] Dr. Anthony Fauci said the mortality from COVID-19 was ten times higher than the common flu.[65] By March 12, diagnosed cases of COVID-19 in the U.S. exceeded a thousand.[66] On March 16, the White House advised against any gatherings of more than ten people.[67] Three days later, the United States Department of State advised U.S. citizens to avoid all international travel.[68]

By the middle of March, all fifty states were able to perform tests with a doctor's approval, either from the CDC or from commercial labs. However, the number of available test kits remained limited.[69] As cases began spreading throughout the nation, federal and state agencies began taking urgent steps to prepare for a surge of hospital patients. Among the actions was establishing additional places for patients in case hospitals became overwhelmed.[70]

Throughout March and early April, several state, city, and county governments imposed "stay at home" quarantines on their populations to stem the spread of the virus.[71] By March 27, the country had reported over 100,000 cases.[72] On April 2, at President Trump's direction, the Centers for Medicare & Medicaid Services (CMS) and CDC ordered additional preventive guidelines to the long-term care facility industry.[73] On April 11, the U.S. death toll became the highest in the world when the number of deaths reached 20,000, surpassing that of Italy.[74] On April 19, the CMS added new regulations requiring nursing homes to inform residents, their families and representatives, of COVID-19 cases in their facilities.[75] On April 28, the total number of confirmed cases across the country surpassed 1 million.[76]

May to August 2020

By May 27, less than four months after the pandemic reached the U.S., 100,000 Americans had died with COVID-19.[77] State economic reopenings and lack of widespread mask orders resulted in a sharp rise in cases across most of the continental U.S. outside of the Northeast.[78] A study conducted in May 2020 indicated that the true number of COVID-19 cases in the United States was much higher than the number of confirmed cases with some locations having 6–24 times higher infections, which was further confirmed by a later population-wide serosurvey.[79][80][81]

On July 6, the United States Department of State announced the country's withdrawal from WHO effective July 6, 2021.[82] On July 10, the CDC adopted the Infection Fatality Ratio (IFR), "the number of individuals who die of the disease among all infected individuals (symptomatic and asymptomatic)", as a new metric for disease severity.[83] In July, US PIRG and 150 health professionals sent a letter asking the federal government to "shut it down now, and start over".[84] In July and early August, requests multiplied, with a number of experts asking for lockdowns of "six to eight weeks"[85] that they believed would restore the country by October 1, in time to reopen schools and have an in-person election.[86]

In August, over 400,000 people attended the 80th Sturgis Motorcycle Rally in Sturgis, South Dakota, and from there, at least 300 people in more than 20 states were infected.[87] The CDC followed up with a report on the associated 51 confirmed primary event-associated cases, 21 secondary cases, and five tertiary cases in the neighboring state of Minnesota, where one attendee died of COVID-19.[88] The U.S. passed five million COVID-19 cases by August 8.[89]

September to December 2020

On September 22, the U.S. passed 200,000 deaths, according to data from Johns Hopkins University.[90] In early October, an unprecedented series of high-profile U.S. political figures and staffers announced they had tested positive for COVID-19.[91][92] On October 2, Trump announced on Twitter that both he and the First Lady had tested positive for COVID-19 and would immediately quarantine.[93][92] Trump was given an experimental Regeneron product with two monoclonal antibodies[94][e] and taken to Walter Reed National Military Medical Center,[96] where he was given remdesivir and dexamethasone.[97]

USA Today studied the aftermath of presidential election campaigning, recognizing that causation was impossible to determine. Among their findings, cases increased 35 percent compared to 14 percent for the state after a Trump rally in Beltrami County, Minnesota. One case was traced to a Joe Biden rally in Duluth, Minnesota.[98]

On November 9, President-elect Biden's transition team announced his COVID-19 Advisory Board.[99] On the same day, the total number of cases had surpassed ten million[100] while the total had risen by over a million in the ten days prior, averaging 102,300 new cases per day.[101] Pfizer also announced that its COVID-19 vaccine may be up to ninety percent effective.[102][103] In November, the Trump administration reached an agreement with a number of retail outlets, including pharmacies and supermarkets, to make the COVID-19 vaccine free once available.[104]

In spite of recommendations by the government not to travel, more than 2 million people flew on airlines during the Thanksgiving period.[105] On December 8, the U.S. passed 15 million cases, with about one out of every 22 Americans having tested positive since the pandemic began.[106] On December 14, the U.S. passed 300,000 deaths, representing an average of more than 961 deaths per day since the first known death on February 6. More than 50,000 deaths were reported in the past month, with an average of 2,403 daily deaths occurring in the past week.[107]

On December 24, following concerns over a probably more easily transmissible new SARS-CoV-2 variant from the United Kingdom, later called Alpha, the CDC announced testing requirements for American passengers traveling from the UK, to be administered within 72 hours, starting on December 28.[108][109] On December 29, the U.S. reported the first case of this variant in Colorado. The patient had no travel history, leading the CDC to say, "Given the small fraction of US infections that have been sequenced, the variant could already be in the United States without having been detected."[110]

January to April 2021

President Joe Biden visits a COVID-19 vaccination site at Walter Reed Medical Center.

On January 1, 2021, the U.S. passed 20 million cases, representing an increase of more than a million over the past week and 10 million in less than two months.[111][112] On January 6, the CDC announced that it had found at least 52 confirmed cases of the Alpha variant, and it also stressed that there could already be more cases in the country.[113] In the following days, more cases of the variant were reported in other states, leading former CDC director Tom Frieden to express his concerns that the U.S. will soon face "close to a worst-case scenario".[114] It was believed the variant had been present in the U.S. since October.[115]

On January 19, the U.S. passed 400,000 deaths, just five weeks after the country passed 300,000 deaths.[116] On January 22, the U.S. passed 25 million cases, with one of every 13 Americans testing positive for COVID-19.[117] By March 5, more than 2,750 cases of COVID-19 variants were detected in 47 states; Washington, D.C.; and Puerto Rico.[118] On February 22, the U.S. passed 500,000 deaths, just five weeks after the country passed 400,000 deaths.[119] In the first prime time address of his presidency on March 11, Biden announced his plan to push states to make vaccines available to all adults by May 1, with the aim of making small gatherings possible by July 4.[120] On March 24, the U.S. passed 30 million cases, just as a number of states began to expand the eligibility age for COVID-19 vaccines.[121] Experts began warning against public relaxation of COVID-19 mitigation measures as vaccines continue to be administered, with one, CDC director Rochelle Walensky, warning of a new rise in cases.[122]

By April 7, the Alpha variant had become the dominant COVID-19 strain in the U.S.[123] On April 12, the U.S. reported its first cases of a new "double mutant" SARS-CoV-2 variant from India, later called Delta, in California.[124] By April 25, the country's seven-day average of new infections was reported to be decreasing, but concerns were raised about drops in vaccine demand in certain parts of the U.S., which were attributed to vaccine hesitancy.[125][126][127] On April 29, the CDC estimated that roughly 35% of the U.S. population had been infected with the virus as of March 2021, about four times higher than the official reported numbers.[10]

May to August 2021

On May 4, Biden announced a new goal of having 70 percent of all adults in the U.S. receive at least one COVID-19 vaccine shot by July 4, along with steps to vaccinate teenagers and more inaccessible populations.[128] The country ultimately did not reach that goal, with only 67 percent of the overall adult population having done so by July 4.[129] On May 6, a study by the Institute for Health Metrics and Evaluation estimated that the true COVID-19 death toll in the U.S. was more than 900,000 people.[130] On May 9, Dr. Fauci confirmed that the U.S. death toll was likely undercounted.[131]

On May 13, the CDC changed its guidance and said that fully vaccinated individuals do not need to wear masks in most situations.[132] Some states ended their mask mandates shortly after, while others maintained the mandate. The CDC was criticized for the confusion resulting from the announcement, as it did not remove existing state and local mandates. The guidance also did not remove the federal mask mandate on public transportation.[133] On June 15, the U.S. passed 600,000 deaths, though the number of daily deaths had decreased due to vaccination efforts.[134]

By June, COVID-19 cases rose again, especially in Arkansas, Nevada, Missouri, and Wyoming. The rising numbers were believed to be attributable to the Delta variant.[135] By July 7, the Delta variant had surpassed the Alpha variant to become the dominant COVID-19 strain in the U.S., according to CDC data.[136] By August the Delta variant accounted for 99 percent of all cases and was found to double the risk of hospitalization for those not yet vaccinated.[137]

On August 1, the U.S. passed 35 million cases.[138] By early and mid-August, hospitals in some states with low vaccination rates began to exceed capacity.[139] One-quarter of the U.S. population resides in eight states—Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, Nevada, and Texas—but, by mid-August, these states together had a half of COVID-19 hospitalizations in the nation.[140] By the end of the month, the ICUs of five of those—Alabama, Arkansas, Florida, Georgia, and Texas—were over 90% full.[141]

September to November 2021

On September 8, the U.S. passed 40 million cases.[142] By September 15, one in every 500 Americans had died from COVID-19.[143] By September 20, COVID-19 had killed over 675,000 Americans, the estimated number of American deaths from the Spanish flu in 1918. As a result, COVID-19 became the deadliest respiratory pandemic in recent American history.[144] The Associated Press called the new numbers a "colossal tragedy" because, despite a century of advances in science, the country failed to take full advantage of vaccines.[145] On October 1, the U.S. passed 700,000 deaths.[146] On October 18, the U.S. passed 45 million cases.[147] On November 26, Biden announced that the U.S. will restrict travel from South Africa and seven other African countries due to concerns over a new variant from the area, called Omicron.[148]


On January 28, 2020, the CDC updated its China travel recommendations to level 3, its highest alert.[149] On February 8, the WHO's director-general announced that a team of international experts had been assembled to travel to China and he hoped officials from the CDC would also be part of that mission.[150][151] In January, Boeing announced a donation of 250,000 medical masks to help address China's supply shortages.[152] On February 7, the State Department said it had facilitated the transportation of nearly eighteen tons of medical supplies to China, including masks, gowns, gauze, respirators, and other vital materials.[153] On the same day, U.S. Secretary of State Pompeo announced a $100 million pledge to China and other countries to assist with their fights against the virus.[154]

Contact tracing is a tool to control transmission rates during the reopening process. Some states like Texas and Arizona opted to proceed with reopening without adequate contact tracing programs in place. Health experts have expressed concerns about training and hiring enough personnel to reduce transmission. Privacy concerns have prevented measures such as those imposed in South Korea where authorities used cellphone tracking and credit card details to locate and test thousands of nightclub patrons when new cases began emerging.[155] Funding for contact tracing is thought to be insufficient, and even better-funded states have faced challenges getting in touch with contacts. Congress has allocated $631 million for state and local health surveillance programs, but the Johns Hopkins Center for Health Security estimates that $3.6 billion will be needed. The cost rises with the number of infections, and contact tracing is easier to implement when the infection count is lower. Health officials are also worried that low-income communities will fall further behind in contact tracing efforts which "may also be hobbled by long-standing distrust among minorities of public health officials".[156] As of July 1, only four states are using contact tracing apps as part of their state-level strategies to control transmission. The apps document digital encounters between smartphones, so the users will automatically be notified if someone they had contact with has tested positive. Public health officials in California claim that most of the functionality could be duplicated by using text, chat, email, and phone communications.[157]

In the United States, remdesivir is indicated for use in adults and adolescents (aged twelve years and older with body weight at least 40 kilograms (88 lb)) for the treatment of COVID‑19 requiring hospitalization.[158] The FDA issued an emergency use authorization (EUA) for the combination of baricitinib with remdesivir, for the treatment of suspected or laboratory confirmed COVID-19 in hospitalized people two years of age or older requiring supplemental oxygen, invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO).[159] In early March, President Trump directed the FDA to test certain medications to discover if they had the potential to treat COVID-19 patients.[160] Among those were chloroquine and hydroxychloroquine, which have been successfully used to treat malaria for over fifty years. A small test in France by researcher Didier Raoult had given positive results, although the study was criticized for design flaws, small sample size, and the fact that it was published before peer review.[161] On March 28, the FDA issued an Emergency Use Authorization (EUA) which allowed certain hospitalized COVID-19 patients to be treated with hydroxychloroquine or chloroquine.[162][160][163][164] On June 15, the FDA revoked the EUA for hydroxychloroquine and chloroquine as potential treatments for COVID-19, saying the available evidence showed "no benefit for decreasing the likelihood of death or speeding recovery".[165] However, Trump continued to promote the use of hydroxychloroquine for COVID-19 through July.[166]

From early 2020, more than 70 companies worldwide (with five or six operating primarily in the U.S.) began vaccine research.[167][168] In preparation for large-scale production, Congress set aside more than $3.5 billion for this purpose as part of the CARES Act.[169][168] On November 20, 2020, the Pfizer–BioNTech partnership submitted a request for emergency use authorization for its vaccine to the Food and Drug Administration (FDA),[170][171] which was granted on December 11.[172][173] On December 18, 2020, the FDA granted the Moderna vaccine emergency use authorization,[174][175] which Moderna had requested on November 30, 2020.[176][177] Starting on December 14, 2020, the first doses of COVID-19 vaccine were administered.[178]

Polling showed a significant partisan divide regarding the outbreak.[179] In February 2020, similar numbers of Democrats and Republicans believed COVID-19 was "a real threat": 70% and 72%, respectively. By mid-March 2020, 76% of Democrats viewed COVID-19 as "a real threat", while only 40% of Republicans agreed.[180] In mid-March, various polls found Democrats were more likely than Republicans to believe "the worst was yet to come" (79–40%), to believe their lives would change in a major way due to the outbreak (56–26%),[181] and to take certain precautions against the virus (83–53%).[182] The CDC was the most trusted source of information about the outbreak (85%), followed by the WHO (77%), state and local government officials (70–71%), the news media (47%), and Trump (46%).[182] A May 2020 poll concluded that 54% of people in the U.S. felt the federal government was doing a poor job in stopping the spread of COVID-19 in the country. 57% felt the federal government was not doing enough to address the limited availability of COVID-19 testing. 58% felt the federal government was not doing enough to prevent a second wave of COVID-19 cases later in 2020.[183] In September 2020, Pew Research Center found that the global image of the United States had suffered in many foreign nations. In some nations, the United States' favorability rating had reached a record low since Pew began collecting this data nearly twenty years earlier. Across thirteen different nations, a median of fifteen percent of respondents rated the U.S. response to the pandemic positively.[184]



Sign reading "we'll get thru this"
Marquee at a closed music venue in Washington, D.C.

The pandemic, along with the resultant stock market crash and other impacts, led a recession in the United States following the economic cycle peak in February 2020.[185] The economy contracted 4.8 percent from January through March 2020,[186] and the unemployment rate rose to 14.7 percent in April.[187] The total healthcare costs of treating the epidemic could be anywhere from $34 billion to $251 billion according to analysis presented by The New York Times.[188] A study by economists Austan Goolsbee and Chad Syverson indicated that most economic impact due to consumer behavior changes was prior to mandated lockdowns.[189] During the second quarter of 2020, the U.S. economy suffered its largest drop on record, with GDP falling at an annualized rate of 32.9 percent. As of June 2020, the U.S. economy was over ten percent smaller than it was in December 2019.[190]

President Trump and Airline CEOs discuss COVID-19's impact on the travel industry on March 4, 2020.

In September, Bain & Company reported on the tumultuous changes in consumer behavior before and during the pandemic. Potentially permanently, they found acceleration towards e-commerce, online primary healthcare, livestreamed gym workouts, and moviegoing via subscription television. Concurrent searches for both low-cost and premium products, and a shift to safety over sustainability, occurred alongside rescinded bans and taxes on single-use plastics, and losses of three to seven years of gains in out-of-home foodservice.[191] OpenTable estimated in May that 25 percent of American restaurants would close their doors permanently.[192]

The economic impact and mass unemployment caused by the COVID-19 pandemic has raised fears of a mass eviction crisis,[193][194][195][196] with an analysis by the Aspen Institute indicating 30–40 million are at risk for eviction by the end of 2020.[197][198] According to a report by Yelp, about sixty percent of U.S. businesses that have closed since the start of the pandemic will stay shut permanently.[199]

Impact of the pandemic on various economic variables [year missing]
Variable Feb Mar Apr May June July Aug Sep Oct Nov
Jobs, level (000s)[200] 152,463 151,090 130,303 133,002 137,802 139,582 140,914 141,720 142,373 142,629
Jobs, monthly change (000s)[200] 251 −1,373 −20,787 2,699 4,800 1,780 1,371 661 653 256
Unemployment rate %[201] 3.5% 4.4% 14.7% 13.3% 11.1% 10.2% 8.4% 7.9% 6.9% 6.7%
Number unemployed (millions)[202] 5.8 7.1 23.1 21.0 17.8 16.3 13.6 12.6 11.1 10.7
Employment to population ratio %, age 25–54[203] 80.5% 79.6% 69.7% 71.4% 73.5% 73.8% 75.3% 75.0% 76.0% 76.0%
Inflation rate % (CPI-All)[204] 2.3% 1.5% 0.4% 0.2% 0.7% 1.0% TBD TBD TBD TBD
Stock market S&P 500 (avg. level)[205] 3,277 2,652 2,762 2,920 3,105 3,230 3,392 3,380 3,270 3,694
Debt held by public ($ trillion)[206] 17.4 17.7 19.1 19.9 20.5 20.6 20.8 21.0 21.2 21.3


The pandemic has had far-reaching consequences beyond the disease itself and efforts to contain it, including political, cultural, and social implications.

From the earliest days of the pandemic, there were reported incidents of xenophobia and racism against Asian Americans.[36] During the first year, an ad-hoc organization called Stop AAPI Hate received 3,795 reports of racism against Asian Americans and Pacific Islanders.[207]

Disproportionate numbers of cases have been observed among Black and Latino populations.[30][31][32] Of four studies published in September 2020, three found clear disparities due to race and the fourth found slightly better survival rates for Hispanics and Blacks.[208] As of September 15, 2020, Blacks had COVID-19 mortality rates more than twice as high as the rate for Whites and Asians, who have the lowest rates.[209] CNN reported in May 2020 that the Navajo Nation had the highest rate of infection in the United States.[210] In June 2021, the CDC confirmed these numbers, reporting that American Indian or Alaska Native, Non-Hispanic persons had the highest rates of both hospitalizations and deaths, while Hispanic and Latino persons suffered the highest rates of COVID compared to White persons. However the CDC noted that only 61% of case reports included race and ethnicity data, which could result in inaccurate estimates of the relative risk among groups.[211] Additionally, a study published by the New England Journal of Medicine in July 2020 revealed that the effect of stress and weathering on minority groups decreases their stamina against COVID.[212]

From 2019 to 2020, in the United States, the life expectancy of a Hispanic American decreased 3 years, for an African American 2.9 years, and for a White American 1.2 years.[13] The COVID Tracking Project[213] published data revealing that people of color were contracting and dying from COVID-19 at higher rates than Whites. An NPR analysis of April–September 2020 data from the COVID Tracking Project found that Black people's share of COVID-19 deaths across the United States was 1.5 times greater (in some states 2.5 times greater) than their share of the U.S. population. Similarly, Hispanics and Latinos were disproportionately infected in 45 states and had a disproportionate share of the deaths in 19 states. Native American and Alaskan Native cases and deaths were disproportionally high in at least 21 states and, in some, as much as five times more than average. White non-Hispanics died at a lower rate than their share of the population in 36 states and D.C.[214]

By April 2020, closed schools affected more than 55 million students.[215]


The pandemic prompted calls from voting rights groups and some Democratic Party leaders to expand mail-in voting, while Republican leaders generally opposed the change. Some states were unable to agree on changes, resulting in lawsuits. Responding to Democratic proposals for nationwide mail-in voting as part of a COVID-19 relief law, President Trump said "you'd never have a Republican elected in this country again" despite evidence the change would not favor any particular group.[216] Trump called mail-in voting "corrupt" and said voters should be required to show up in person, even though, as reporters pointed out, he had himself voted by mail in the last Florida primary.[217] Though mail-in vote fraud is slightly higher than in-person voter fraud, both instances are rare, and mail-in voting can be made more secure by disallowing third parties to collect ballots and providing free drop-off locations or prepaid postage.[218]

High COVID-19 fatalities at the state and county level correlated with a drop in expressed support for the election of Republicans, including the reelection of Trump, according to a study published in Science Advances that compared opinions in January–February 2020 with opinions in June 2020.[219]

Hospital care crisis

Vaccination campaign

Effectiveness of COVID-19 vaccines

Timeline graph of doses administered

Timeline of daily COVID-19 vaccine doses administered in the US.[229]
Timeline of daily COVID-19 vaccine doses administered in the US.svg
See the latest date on the timeline at the bottom.
COVID-19 vaccination campaign in the United States
USA. Percent of people receiving at least one COVID-19 dose reported to the CDC by state or territory for the total population.png
United States. Percentage with at least one vaccination dose. See Commons source for date of last upload. US territories: GU = Guam. AS = American Samoa. RP = Republic of Palau. FM = Federated States of Micronesia. MP = Northern Mariana Islands. MH = Marshall Islands. VI = Virgin Islands.[230]
Date December 14, 2020 (2020-12-14) – present
Location  United States
Compact of Free Association:[231][232]
 Marshall Islands
Cause COVID-19 pandemic in the United States
Organized by Center for Disease Control and Prevention
Participants 182,896,080 people have received at least one dose administered of PfizerBioNTech, Moderna and Janssen
(July 7, 2021)
157,908,171 people have been fully vaccinated (both doses of Pfizer–BioNTech or Moderna, or one dose of Johnson & Johnson)[233]
Outcome 55% of the United States population has received at least one dose of a vaccine
48% of the United States population is fully vaccinated
Website COVID-19 Vaccine: CDC

Background to various vaccines

Vaccine mandates

By August 2021, more than 800 colleges and universities, over 200 health care companies and dozens of states, local governments and school districts, had some type of vaccination requirements.[246] President Biden has appealed to public organizations and private companies to require employees to be vaccinated, which companies are now legally allowed to do.[247]

Until August to September 2021, many companies were giving bonuses for getting vaccinated.[248] Nonetheless, nearly 2,000 private hospitals and health systems had previously issued vaccine mandates. Many companies outside health care did the same, such as United Airlines, Tyson Foods, and Walmart among them. Washington state had already required vaccines for all state employees and contractors.[248] With the new Delta variant spreading infections more quickly due to its higher transmissibility, companies including Facebook, Google, and Salesforce, have already issued employee vaccine mandates.[249]

According to a USA Today poll from August 2021, 68% supported a business's right to refuse service to unvaccinated customers, and 62% supported employer's right to mandate vaccinations to its employees. In the same poll, 72% also felt that mandating masks was "a matter of health and safety" and should not be considered an infringement of personal liberty.[250]

Preparations made after previous outbreaks

The United States has experienced pandemics and epidemics throughout its history, including the 1918 Spanish flu, the 1957 Asian flu, and the 1968 Hong Kong flu pandemics.[251][252][253] In the most recent pandemic prior to COVID-19, the 2009 swine flu pandemic took the lives of more than 12,000 Americans and hospitalized another 270,000 over the course of approximately a year.[251]

According to the Global Health Security Index, an American-British assessment which ranks the health security capabilities in 195 countries, the U.S. was the "most prepared" nation in 2020.[254][255]


See also