The COVID-19 pandemic has caused profound changes to our way of life, with significant differences in countries' policy responses leading to important disparate economic outcomes. The US Federal government's abdication of responsibility has left many in peril, both economically and healthwise, exacerbating long-standing racial and economic inequalities. Public policy and investment will largely determine rates of sickness, death, and economic pain. Comparing the current economic crisis with previous downturns shows that this crisis is categorically different, with attempts to return quickly to "business as usual" more likely to be marked by mass death than sustained economic inroads.