Abstract
The rapid spread, and relentless mutations of SARS2, are a reminder of how quickly upper respiratory viruses that do not cause acute, debilitating disease in all infected persons can spread, and that continuing mutation is an adaptive hallmark of viruses. The global response to the SARS2/COVID19 pandemic varied widely, country to country, and state to state in the United States of America (U.S.). To better prepare for the next pandemic, the U.S. Government Accounting Office recommends that health agencies “…identify, document and share all challenges and lessons learned … to improve the response to ongoing and future public health emergencies…” Some countries continually published SARS2/ COVID19 reviews and adjusted recommendations throughout the pandemic, but an objective review of the U.S. SARS2/COVID19 public health response is lacking. This knowledge gap can be at least partially filled by taking advantage of publicly-available databases. As an example, this is a report of the spread of SARS2/COVID19 in diverse communities in Middlesex County, Massachusetts. Neither mask mandates nor vaccinations halted the surge of SARS2/COVID19 in January, 2022; communities with the highest infection incidence were statistically significantly lowest in per capita income and highest in population density. If these findings apply globally, the development of a library of effective medications should be the first-line defense against the next pandemic, with a plan for effective distribution to the most vulnerable persons.