COVID cases continue to escalate and the death toll for the U.S. has exceeded a quarter of a million. Yet, as this FiveThirtyEight poll shows, over 30% of Americans are “not very” or “not at all” concerned about infection. Obviously, as we head into the holiday season, this is incredibly problematic.

The division between those who believe in science and the anti-maskers can be attributed in particular to one’s political affiliation and primary source of information. These factors are mitigated by geography, as local and state authorities set the tone for the regional public response early in the pandemic, often paralleled in local news coverage. Moreover, experience with COVID’s effects, either personally or through friends and family, also shapes the extent to which people view the disease as a threat.

We also can’t dismiss the toll of “pandemic fatigue” on public behavior, as individuals stop caring about precautions that they would have taken months ago because it feels like we’ve been doing this forever. Why are we in this spot? Unlike past outbreaks, our global access to information enabled countries around the world to learn about COVID early on and (to different extents) take action. In short, we feel like we should be past this pandemic because we’ve been in it so long. Except we haven’t.

Last spring, we pretended that the first wave had a conclusion, a denouement. It did — if you live in New York City or other places that experienced the surge and the dwindling of cases. The rest of the U.S. was really in a waiting period. In this calm before the storm, many people took the precautions needed to carry us through the pandemic. However, collectively, we acted like that was it, that we had made it through the wave. In reality, most of the U.S. has only just begun its red zone.

Let’s compare where we are to this moment in past outbreaks/epidemics/pandemics. From my study of 200 years of epidemic history, I can tell you that both small and large-scale outbreaks follow specific patterns in their construction in media messages and in public perception. For this comparison, ignore the amount of time we’ve known about COVID., focusing instead on the severity of the crisis itself.

Placed in the midst of other epidemics, we are approximately at the same timeline point as . . .

• August 1721, Boston smallpox epidemic
• October 1793, Philadelphia yellow fever epidemic
• October 1918, “Spanish Flu” across U.S., “Spanish Flu”
• Late January 1925, diphtheria in Nome, Alaska
• September/October 1952, polio in the Midwest
• December 1968, “Hong Kong” flu in New York and many other places

These critical points not only mark escalating cases within different outbreaks/epidemics/pandemics, they also share collective public emotions: sadness, scarcity, panic, and loss. While there are certainly variations in responses, shared characteristics define the severity of the situation. Listed above are the peaks of despair, when hospital ran short of staff, beds, and equipment. Gravediggers and coffins became in demand. Images of this moment captured rows of the ill in makeshift hospitals, stacks of wrapped bodies, and quarantine signs. Towns and local media became solely focused on the sick, dying, and deceased, seeking supplies and care providers, while banning public gatherings and funeral bell tolling. Ministers ceased holding services for fear that they were spreading disease among parishioners.

This is where we are in our COVID-19 pandemic. If you are not feeling this moment yet, it is not due to the case numbers. Rather, it is the cultural climate that is imaging a reality that is not this one. Many local news outlets have opted not to publish cause of death as COVID-19 or showcase the experiences of survivors, blocking communities from the devastation from this disease. We have convinced ourselves that we did the work last summer so we must be fine now. NOPE. Even if you are not personally seeing it, the U.S. (and most of the world) is in crisis mode.

We are at a crossroads for what will happen next. Changing the course of the pandemic needs to occur at all levels, including our individual choices. It might feel like we’ve been in this pandemic state forever. Unfortunately, though, we are deeply in the midst of the crisis — a reason to stay home, not to give up.