The U.S. is heading into Labor Day weekend with just over four times as many Covid-19 cases and more than twice as many hospitalizations as at this time last year — despite having vaccinated 62% of the American population with at least one dose.

The U.S. and the world are nowhere near where health officials hoped, and thought, we would be 20 months into the pandemic — and more than eight months after vaccines that boasted efficacy rates around 95% were rolled out.

Though the outbreak is significantly worse by most measures than 2020, setting the U.S. up for a tough fall season, the delta variant, vaccines and open schools make it hard to predict how the pandemic will unfold, doctors and scientists say.