> California and Florida

State policy only goes so far. Both CA and FL have a mix of communities full of careful people with okay-to-good leadership and places full of people fed a steady media diet of misinformation with mostly failed leadership. Florida had every possible advantage going into the pandemic, especially mild weather year around that lets people e.g. eat outside, but the state government completely flubbed the response. CA also had plenty of state failures: the policies about “reopening” were poorly timed, poorly targeted, and not responsive enough to changing circumstances.

What ultimately matters is people’s behavior at the individual level. Federal policy, state policy, and local policy can strongly influence this (e.g. by sharing good advice and accurate information, providing financial resources, supplying equipment and services, doing contact tracing, coordinating relief, ...) but in the USA there are plenty of individual people who have failed in their basic duty to society spread throughout the country.

> Florida was higher in summer 2021 wave - California is higher now

Florida was the literal initial epicenter of the 2021 delta wave in the US. It was seeded there (among other places) because Florida is a major travel hub, but got so bad because Florida is under-vaccinated and people didn’t take basic precautions compared to other initial seed sites. The Bay Area almost completely dodged Delta due to vaccinations and precautions while the under-vaccinated the CA central valley got hammered.

Now with omicron, people throughout the US have largely given up on non-vaccine interventions and the vaccine doesn’t perfectly protect against infection, so somewhere on the order of half of the population of both states (and every other) is going to get infected, but the number of hospitalizations and deaths in both states will almost entirely consist of unvaccinated people. Places in both states where people are vaccinated will be fine, while the FL panhandle and the CA central valley will get wrecked.

There are a bunch of US states with significantly lower population density than Vermont but significantly worse results. Or if you want somewhere to compare to the US that isn’t Vermont, the Bay Area, or Hawaii, look at most parts of Canada vs. most parts of the US. (Note, population density of Canada as a whole is not really relevant here, as most of the people live in a narrow urban band near the border.) Canada has generally had far fewer deaths than the US, even if we compare areas right across the border from each-other.

Sweden has had horrible results compared to its comparable neighbors (Finland, Norway, and Denmark). They backed off of their initial failed policy, but not before costing a lot of lives. Fortunately the Swedish public is generally more cautious than the leadership. And fortunately they ended up getting most people vaccinated (better than Finland which saw most of its pandemic deaths in 2021). Of course, the USA has done about 2.5x worse than Sweden.

> nothing humans have done has had much of an impact on the progress of the disease

This is empirically nonsense, and also a horrible attitude toward public health crises. What is true is that a public health intervention today that ends after 3 months won’t save someone in 6 months. Vaccination is much more permanent than social distancing.

Places where people universally wear masks (the higher quality the better) consistently have lower reproductive rate of the virus. Places where indoor dining was closed dramatically reduced the reproductive rate of the virus. Places where people started working from home, doing virtual school, closing public transit, etc. dramatically reduced the reproductive rate of the virus. Etc. There are hundreds of peer reviewed papers analyzing these trends; they aren’t a mystery.

Places where there was initial masking, quick mobilization of testing, a coordinated contact tracing effort, isolation for the sick, quarantine for travelers, support for the out of work, etc. did relatively very well (e.g. China, South Korea, Taiwan, New Zealand, Norway, Denmark, ...). We are talking about >10x fewer deaths than they might have had.

The problem in most of the US and most of Europe is that interventions came too slow, and when they were relaxed, in many places priorities have been wrong: useless interventions have sometimes been persisted (sanitizing surfaces, 6 feet of distance, masks outdoors) while the most important ones (esp. the closure of indoor bars/restaurants) were scrapped, and not enough was invested into getting people better masks, improving indoor ventilation, ensuring sick people stay home, etc. The criteria for re-instating social distancing and masking was based on the wrong metrics with thresholds set too high, and so lagged necessary response timing by weeks if not months. Political pressure and misinformation has overridden public health departments.