Six months and 200,000 deaths later, the U.S. is right back where it started, staring down the barrel of mass fatalities, widespread infection and crippling economic loss from COVID-19.

This once-in-a-generation crisis has not been met with a unified response, or a common will to fight. Instead, the nation keeps going around in circles, dooming itself to the grim promise of more dark days ahead.

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“We will be at 300,000 deaths by Dec. 1,” warns Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College, “and maybe even 400,000 deaths by the time of the next presidential inauguration.”

A projection from the Institute for Health Metrics and Evaluation at the University of Washington predicts 415,000 deaths as early as Jan. 1, 2021.

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Of the approximately 31 million cases and nearly one million COVID-19 deaths worldwide, the United States has suffered at a disproportionately high rate. On the same day the U.S. reached 200,000 deaths, it edged closer to its seven millionth case.

“We need a national response,” says Dr. Ali Mokdad, who developed the IHME model. “If we do so, like other countries, we can control this virus.”

There seems to be little chance of that happening in the current climate.

Former member of White House coronavirus task force blasts Trump over response

Former member of White House coronavirus task force blasts Trump over response

The use of facemasks is still an open debate, fueled by a president who has oscillated between mocking masks, wearing one himself, and mocking them again. During an ABC News town hall this week, Trump even blamed Joe Biden, who is not currently president, for failing to implement a national mask mandate.

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Trump has also returned to holding indoor campaign rallies without masks or physical distancing, despite his admission to Bob Woodward in February that he understood the virus to be airborne. Typically, the only person socially distanced at these events is Trump, who is consistently kept at a good distance from everyone else.

At the same time, President Trump is still promising a magical end to the pandemic; proclaiming the virus “will just disappear;” promoting unproven cures like hydroxychloroquine or convalescent plasma; and promising a vaccine will be ready this fall, without acknowledging it could take another year or more to immunize the public on a wide scale.

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All the while, state and local decision-makers — and everyday Americans — go through the same circular arguments themselves.

In one America, the virus is treated as a serious threat, reopening is cautious and phased, masks are widely used and virus cases are low.

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In the other America, there’s a rush to act as though everything is normal, with precautions ignored, and masks shunned, even as case numbers surge.

“How can we pretend like everything’s normal?” asks Dayna James, an emergency room nurse in Miami. “Have one 12-hour shift alongside me, and maybe you’ll change your mind.”

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James says the situation at her hospital in Florida has improved since the peak of cases in early August, but she’s worried that people will assume the worst is over.

“I’m really expecting a second wave,” she says. “Decisions were made on some level to open up everything, and I don’t think that we have a good enough handle on it.”

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In the absence of a strategy, the pandemic has adopted a rhythm of its own.

Case numbers spike, then drop, only to spike to a higher level, and never drop down as low as they were before. It’s not so much a wave, as a continuously rising tide, where the number of daily infections remains “unacceptably high,” according to experts like Dr. Anthony Fauci.

Coronavirus: U.S. needs ‘to be doing much better’ amid pandemic, Fauci says

Coronavirus: U.S. needs ‘to be doing much better’ amid pandemic, Fauci says

That has jeopardized the viability of reopening schools and colleges, and made it all but impossible that businesses like restaurants will be able to resume normal operations for the long term.

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Every aspect of daily life is now subject to the whims of something that can’t be seen — what Trump has called “the invisible enemy.”

“It’s beyond frustrating knowing that the sort of simple pleasures in life have evaporated,” Dr. Hotez says. “The quality of life in the United States is not very good right now.”

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Still, almost everything to do with the pandemic is viewed through a political lens — though the virus does not care whether its hosts are Democrats or Republicans.

Dr. Hotez blames a lack of federal strategy for both a failure to respond and the political weaponization of the pandemic, accusing the president of running a “disinformation campaign.”

As a result, Hotez says, “the American public never really fully understood or appreciated the gravity of the COVID-19 pandemic, until they started seeing family members and friends get sick or hospitalized.”

Coronavirus: Biden questions Trump’s comments on COVID-19 pandemic response, compares U.S. deaths to Canada

Coronavirus: Biden questions Trump’s comments on COVID-19 pandemic response, compares U.S. deaths to Canada

Americans who haven’t seen that first-hand, have the privilege of ignoring the virus altogether or decrying it as a hoax.

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Those who face the real consequences have been disproportionately Black or Hispanic, had lower incomes, and at risk of greatest exposure through front-line work.

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I would love for Americans to maintain their focus and [not] let down their guard in order to control this virus,” Dr. Mokdad says.

All these months later, few experts are optimistic that will happen.

There are no domestic travel restrictions within the United States, and state-level quarantine requirements are not enforced with the kind of rigor that countries like Canada and Australia have adopted.

The crude, and often used analogy, is that the U.S. has tried to build a no-peeing section in a swimming pool — there’s nothing to stop the virus from spreading from high-risk areas to low-risk ones.

An analysis of a large-scale motorcycle rally in Sturgis, South Dakota estimated that the event led to 260,000 COVID-19 cases, and $12.2 billion in public health costs nationwide, after nearly half a million people gathered for the event and then disbursed around the country.

Trump giving misleading information about potential COVID-19 vaccine

Trump giving misleading information about potential COVID-19 vaccine

The way out requires Americans everywhere to be on the same page about how to respond.

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“You want to open schools, you want to open up colleges, you want to have sporting events?,” asks Dr. Hotez. “We can do all those things, but we’ve got to bring the entire nation down to some agreed-upon low level of containment.”

In a recent interview with Global News, Fauci, the top infectious disease expert in the United States, expressed his fear that Americans will simply give up, and stop taking precautions out of sheer frustration.

Coronavirus: Dr. Fauci warns of ‘COVID-19 fatigue’

Coronavirus: Dr. Fauci warns of ‘COVID-19 fatigue’

“I’m concerned that people are going to get so discouraged, they’re going to loosen up the kinds of attention to public health measures which we need to continue to focus on if we’re going to keep this under control,” Fauci said.

Continue to be careful,” Fauci pleaded. “It will end. We will get back to normal.”

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Hotez cautioned it will be a slow road back. “Sorry to be so sombre,” he said, adding there are no quick fixes. “I think a year from now, life will be better than it is now. And I think a year after that, it will be even better, but it may not be completely normal by then.”

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