Five years ago, on March 11, 2020, the World Health Organization declared COVID-19 a pandemic, a moment that irrevocably altered the course of global history. Tuesday, March 11th, 2025, marked the fifth anniversary. Since then, millions of Americans have been hospitalized, and more than 1.2 million people have died. While the acute public health emergency has subsided, the virus, SARS-CoV-2, continues to evolve and circulate, raising a critical question: are we truly prepared for the next pandemic?
The debate over whether the COVID-19 pandemic has officially ended is largely academic, as clinical epidemiologist Ziyad Al-Aly of Washington University in St. Louis points out. “For the family that lost a loved one a week ago in the ICU, that threat is real. That pain is real. That loss is real.”
Current Numbers: Hospitalizations, Deaths, and Long COVID
In the last 28 days ending about Feb. 16, 2025, roughly 3,800 Americans were hospitalized due to COVID-19, according to World Health Organization (WHO) data. Centers for Disease Control (CDC) data shows that during the week ending March 1, the rate of COVID-19-associated hospitalizations was 1.4 per 100,000 people, significantly lower than the peak of 35.6 per 100,000 people during the 2021-22 season.
Since the pandemic began, more than 1.22 million Americans have died from COVID-19, as of March 6, 2025. During the week ending March 1, 2025, there were 274 deaths recorded, the lowest number since the pandemic began. The current age-adjusted death rate is 0.1 per 100,000 people, significantly lower than the 6.5 per 100,000 recorded in January 2021.
Millions also grapple with long COVID. As of August 2024, a federal survey indicated that 17.9 percent of adults have experienced long COVID, equivalent to approximately 47.6 million Americans. Currently, about 14.1 million Americans are experiencing long COVID symptoms, with nearly a quarter reporting significant activity limitations. Recent data also indicates that around 1.01 million children have experienced long COVID.
Vaccination remains a critical tool. The CDC recommends everyone six months and older receive the updated 2024-2025 COVID-19 vaccine. However, as of Feb. 22, 2025, vaccination coverage remains low, with only 23.2 percent of adults and 11.9 percent of children vaccinated with the updated vaccine, despite evidence that it is safe, and effective.
From Pandemic to Endemic: What We’ve Learned and What We Haven’t
The shift from emergency response to endemic management has brought both progress and challenges. We’ve gained invaluable insights into the virus: its airborne transmission, its potential for severe illness and long-term complications like long COVID, which affects millions globally. We’ve also witnessed the rapid development of mRNA vaccines, a testament to scientific innovation.
However, the pandemic exposed critical vulnerabilities. Health inequities, strained healthcare systems, and the rapid spread of misinformation hampered effective responses. As Peter Chin-Hong, an infectious disease physician at the University of California, San Francisco Health, notes, “Some of the biggest threats are people being fatigued with COVID [news] and the amount of misinformation and disinformation.”
Tracking the Virus: A New Era of Surveillance
Monitoring the virus has also shifted. Genomic surveillance and wastewater analysis now play crucial roles in tracking variants and infection levels. Yet, the reduction in centralized data reporting and access to free resources raises concerns about our ability to detect and respond to future surges.
The Unfinished Fight Against Long COVID
Long COVID remains a significant challenge. Al-Aly highlights its widespread impact, affecting multiple organ systems and causing significant economic losses. “Unfortunately, we haven’t really cracked the code for treating long COVID. There are still no established treatments approved by the FDA.”
Black America and COVID-19: A Crisis of Inequity Exposed
Dr. Uché Blackstock’s experiences in a Brooklyn urgent care center during the pandemic’s early days revealed a stark reality: systemic racism amplified the virus’s impact on Black communities. By early April 2020, data showed Black people in nearly every state had higher COVID-19 infection and death rates. This disparity wasn’t due to biological differences, but rather systemic inequities shaping factors like:
- Essential Worker Status: Many Black Americans worked in essential roles, increasing their exposure.
- Living Conditions: Overcrowded housing and limited access to safe spaces contributed to higher transmission.
- Healthcare Access: Existing disparities in access to quality healthcare exacerbated the severity of the virus.
- Mask-Wearing Disparities: Early in the pandemic, Black Americans were more likely to wear masks than white Americans, but studies showed white Americans were less likely to follow safety precautions when they understood the racial disparities of the virus.
- Lack of Empathy: Studies showed white Americans were less empathetic when they learned of the disproportionate impact on Black communities.
“It was the chronic conditions, the lack of access to health care, the unsafe working environments — all exacerbated by years of neglect and inequality — that turned a containable virus into a death sentence for so many,” Dr. Blackstock emphasizes.
Are We Ready for the Next Pandemic?
Concerns about preparedness for future pandemics are prevalent. Al-Aly expresses worry that the politicization of COVID-19 responses, including vaccines and masks, has weakened our collective ability to act effectively. “If a pandemic breaks out in March 2025, I predict that vaccine uptake would be way less than it was for COVID-19, and there would be less enthusiasm for masking and a lot of the public health measures that protected millions of people in the U.S.”
Lessons Learned and Hope for the Future
Yet, there are glimmers of hope. Operation Warp Speed demonstrated the potential for rapid scientific mobilization. The global scientific community’s focus on long COVID and the crucial role of patient advocacy also provide examples of collaborative efforts. And as Bill Hanage of Harvard T.H. Chan School of Public Health reminds us, the collective efforts of individuals to limit contact and prioritize public health were also a huge help.
Ultimately, while significant strides have been made, the future of pandemic preparedness remains uncertain. We have enhanced our scientific understanding and developed crucial tools, but societal factors, political divisions, and the persistent threat of misinformation pose ongoing challenges. To be truly prepared for what’s next, we must foster scientific collaboration, promote public trust in science, prioritize equitable access to healthcare, and directly address systemic racism.
