COVID-19 is on the run in much of the U.S. How we got here.

Cases, hospitalizations, and deaths from COVID-19 have all plummeted since mass distribution and administration of the vaccines began. A look back at a challenging year and how we got to this point. 


Matt Wellington

Former Director, Public Health Campaigns, PIRG

One year and six months. That’s how long it was between hugs with my mom. Thanks to safe and effective vaccines, we and so many other people across the country are now reuniting with friends and loved ones. Cases, hospitalizations, and deaths from COVID-19 have all plummeted since mass distribution and administration of the vaccines began. Physicians who have treated countless patients sick with the disease are reporting with relief and joy their first consecutive days without seeing any COVID-19 patients in their ICUs. 

How did we turn the tide from the dark days of January 2021 (earlier this year!), when 125,000 people were hospitalized with the disease, with thousands dying every day? 

As the numbers of cases and deaths finally head in the right direction, let’s look back at how PIRG responded to help save lives during the greatest health threat in a century. 

Winter 2019-2020

In late February 2020, I went to a dinner party with some public health colleagues in Boston. There were 53 new cases of COVID-19 identified that day in the U.S., mostly on the West Coast. People furiously sanitized their hands and tried, with limited success, to not touch their faces. A little more than a month later, the 7-day moving average of new cases hit 20,000. We hunkered down, wondering when and how this would end.

Spring 2020

After we abandoned our office buildings in March, PIRG staff huddled together, virtually, to figure out a plan of action to help. Both federal and state response efforts had gaping holes. Fixing them required sifting through misinformation and conflicting opinions, finding effective solutions, and then communicating clearly with decision makers and the public. We hit the ground running.

No one knew how widespread the virus was because of a serious lack in tests and testing infrastructure. (A report out this week suggests the virus already was spreading through a handful of states in December 2019.) Health professionals wore garbage bags and reused single use masks for days to try to stay safe amidst a critical shortage of personal protective equipment (PPE.) The federal government passed responsibility to states and local governments to procure their own supplies, which resulted in a chaotic marketplace riddled with price gouging and counterfeit merchandise. 

We consulted with health professionals, supply chain experts and other stakeholders to formulate the right approach— a transparent, centrally coordinated effort from the federal government that would streamline PPE sourcing and testing infrastructure. We raised awareness for that approach and rallied public support, eventually sending thousands of public comments to Adm. Brett Giroir, the person in charge of testing efforts, advocating that everyone who needs a test should be able to get a test. 

In letters to the Trump Administration signed by mayors and hundreds of doctors we emphasized that the current system did not adequately address the crisis. The letters requested that the federal government centralize the supply chains and increase funding. In a series of national media stories and press conferences we spotlighted stakeholders including the mayor of Denver and emergency medicine physician Val Griffith from Get Us PPE. We also held a highly attended national webinar with health professionals and Rep. Andy Kim (NJ) from the House Select Committee on the Coronavirus Crisis to emphasize the continued need for PPE and draw a roadmap to fix the broken supply chain by using the Defense Production Act. 

In May, the Trump administration started a new initiative to combat the pandemic: Operation Warp Speed, which was devoted to developing and purchasing COVID-19 vaccines. 

Summer 2020

Throughout the summer, the Trump Administration continued to downplay the threat of the virus. The administration considered winding down its response efforts, and attempted to block more federal funding for testing. People dealing with the pandemic across the country were telling a very different story. 

As the virus raged on, local officials were still struggling to find supplies, so health professionals still didn’t have enough PPE to protect themselves or enough testing to track its spread. We launched a social media campaign to amplify their experiences and show that the crisis was far from over. Mayor Chris Mehl of Bozeman, Mont., told us, “I can’t give the people who are risking their lives the equipment they need so they can go home to their families.” 

Jacob Oldefest, a paramedic in Denver, said, “We don’t need to be running to our deaths with… inadequate PPE. I don’t need to be reusing the same paper PPE. Why do I need to be sacrificed?”

Reshma Ramachandran, MD, a family medicine physician in Los Angeles, said, “I get really worried that our rationing of tests has led to an underappreciation for how bad this virus really is, and an overconfidence in reopening parts of the state and going back to normal.”

In early summer, defying public health recommendations and responding to the complaints of a pandemic-fatigued public, many states eased or repealed restrictions meant to curb the spread of COVID-19. However, most states that rolled back restrictions had not lowered their case counts enough to contain the virus through aggressive testing. (Most states also lacked the kind of testing infrastructure they’d need to do that anyway.) COVID-19 cases skyrocketed, hitting new records in July, with the worst outbreaks concentrated in the South and Southwest.  

Even though hospitals in some areas threatened to overflow with COVID-19 patients, at first, few health professionals were willing to support governors extending stay-at-home orders. It was a politically unpopular opinion and many Americans were fed up with restrictions. But with no other readily available options to slow the spread of the virus and deaths mounting, we crafted an open letter to decision-makers calling for another temporary stay-at-home order; closure of non-essential businesses; and a renewed COVID-19 response effort. We asked some of the top experts in their fields to lend their names—virologists, epidemiologists, emergency medicine physicians and more. 

The “Shut down, start over, do it right” letter struck a chord. From a handful of signatures and news stories to nearly 1,500 health professionals signing from nearly every state and national news coverage from outlets such as CNN, MSNBC and NBC Nightly News, millions of people heard the message. Reporters who knew about the letter asked governors if they would consider another shutdown. We got our health professional signers in front of the TV cameras and on the airwaves, so the message came from credible science-based sources. Although we received criticism, and even some death threats, we kept going, because it was the right thing to do. 

While few states followed all of our recommendations, several did take important steps in the right direction. At least six states established or expanded their mask mandates, and at least 10 states paused or even rolled back their reopening plans in the weeks following our letter. Hawaii was the only state to follow all the recommendations, and it paid off. Unlike most other states, which experienced massive spikes in the winter that dwarfed summer records, Hawaii’s case counts dropped and never rebounded to that level.

Fall 2020 

By the fall of 2020, the Brown University School of Public Health had established targets for how many people needed to be tested regularly in order to suppress the virus. When it became clear that the federal government would not deliver on adequate testing, some states devised their own testing plans to track the virus’ spread. We then shifted our approach from calling on the federal government to highlighting state success stories and urging governors to follow best practices. We released a series of scorecards grading states on their performance versus Brown’s testing targets. The scorecards generated local media attention and led to positive engagement with governors’ offices about how to improve testing infrastructure.

As the holidays approached, we also launched the ”Home Safe for the Holidays” initiative with infectious disease expert Dr. Syra Madad. The effort advised people how to minimize risk during the holiday season, emphasized the importance of testing and other safety measures, and gave people an opportunity to urge their governors to adopt best practices on testing. 

Winter 2020-2021

As cases and deaths skyrocketed during and after the holidays, the first vaccines rolled out, some with the help of Operation Warp Speed, others developed without federal funding. Medical professionals and high-risk Americans received precedence for initial vaccination.

As fall turned into winter, Congress debated another coronavirus relief package. We partnered with small businesses across several states to emphasize to lawmakers that to jump-start the economy, they needed to allocate significant money toward testing infrastructure and vaccine distribution. 

In February, Business Insider published an op-ed we co-authored with a physician-led group, Get Us PPE, noting that the change in the White House elicited a “collective sigh of relief from health professionals and local officials across the country as the president signed executive orders to combat COVID-19.” In President Joe Biden’s first months in office, his administration implemented several of the measures we and other health groups had been screaming from the rooftops for, including full utilization of the Defense Production Act to procure PPE, providing robust funding for testing and vaccine distribution and central coordination of the COVID-19 response effort. 

Spring/Summer 2021 

After large-scale vaccine production began, our role shifted to demystifying distribution and informing the public about the hows and whys of vaccination to the public. We organized a series of national webinars with health experts to give reliable information about the vaccines to reporters, local officials and policy-makers. Recordings can be found here:

November 2020: “Preparing to vaccinate the country against COVID-19”

January 2021: “Reaching marginalized communities with the COVID-19 vaccines”  

January 2021: “Communicating effectively about the COVID-19 vaccines”

March 2021: “The pandemic at one year: A race between vaccines and variants”

What’s next?

Large swaths of the American public are now fully vaccinated against COVID-19. But we still need to ensure as many people as possible get vaccinated to protect themselves and their communities. Some people need to hear about vaccine safety and efficacy from trusted messengers such as physicians to feel confident getting it. Others simply need help getting to and from a vaccination site. We’re working with community partners, health professionals and other stakeholders to make it happen.

As we get together with loved ones again, we can’t forget that more than 600,000 people from our families, friend groups and neighborhoods weren’t so lucky. We’ll take lessons learned from COVID-19 to prevent the next pandemic. And if another crisis comes, we’ll meet it head on. 


Matt Wellington

Former Director, Public Health Campaigns, PIRG