On Wednesday, it was like Tedros was reading from Ryan’s old script. “If countries wait until their hospitals start to fill up, it’s too late,” he said. “Don’t wait. Act now. We are running out of ways to say this. But we will keep saying it. All of us — every government and every individual — must use all the tools we have right now.”

But what would that mean? What are those tools? At its press conference, the WHO applauded the removal of travel restrictions and declined to reverse its guidance on booster shots, which advises that nations should prioritize first and second doses instead. A number of WHO scientists emphasized the value of a “wait-and-see approach” despite the urgency expressed by Tedros, Ryan, and others. “What we really need now is a coordinated research effort and not jumping to conclusions” said WHO chief scientist Soumya Swaminathan. “I think it’s premature to conclude that this reduction in neutralizing activity would result in a significant reduction in vaccine effectiveness.” Just a few days later, there are signs that vaccine effectiveness against transmission has fallen dramatically with Omicron — perhaps to as low as 30 percent for those who have been fully vaccinated with the Pfizer vaccine, and perhaps all the way to zero for those fully vaccinated with AstraZeneca. Zero is a number you do not want to see in contexts like these, though those estimates only refer to transmission, not severe illness, and it appears efficacy could be largely restored by boosters…

As shambolic and ineffectual as the initial pandemic response was, not just in the United States but all across the West, in retrospect it appears to be a scale of intervention we are unlikely to ever repeat, or even approach, through the remainder of the pandemic, no matter how bad it gets. Even amid a grim wave, lesser measures — work-from-home, school closures, social distancing — are likely to be imposed more weakly and tentatively, if they are imposed at all. Mask-wearing can and will be encouraged, but even the celebrated studies of mask efficacy have found relatively modest effects. And caseloads of the scale we already have today, before Omicron, are already well beyond our capacity for contact tracing. These various tools can still play a useful mitigating role, but it is also the case that for many Americans, pandemic burnout has set the standard for such measures so high that even staggering daily case counts and death totals may not meet it.