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More than 800,000 Americans have died of COVID-19, more than all U.S. deaths in both world wars, the Korean War and the Vietnam War combined.JEFF KOWALSKY/AFP/Getty Images

Willie Greene has lost friends to COVID-19. He and his wife both contracted the virus, “and it was really bad,” he said. Mr. Greene is mayor of Galax City, a Virginia town of 6,300 in the foothills of the Blue Ridge Mountains that ranks among the worst-hit places in the United States.

In Galax, COVID-19 has killed more than one person in 100. That is more than six times the average U.S. annual rate of people killed by cancer.

Now, Mr. Greene and officials in other hard-hit communities are looking with fear to the hyperspeed spread of the Omicron variant. “I’m worried. I’m very worried,” he said.

But Mr. Greene feels helpless to do anything in a community where the pandemic has polarized people in a way he can’t remember since the days of segregation.

“There’s not a whole lot I can do about it,” he said. “It’s so political.”

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Around the world, public-health experts are staggered by Omicron’s extraordinary proliferation, with case counts doubling every three days, driving record numbers of infections in the U.K., where experts say it is spreading two to three times faster than the Delta variant.

Canada is battening the hatches against Omicron with provinces reimposing restrictions on gatherings.

But in the United States, where the pandemic has landed in the midst of a political paroxysm, the spectre of an even-more infectious virus has done little to motivate action. In fact, in places that have proven the most vulnerable to COVID-19, political leaders and epidemiologists say hostility toward public-health measures has rendered impracticable the most basic tools to fight the virus, even as Omicron bears down.

U.S. President Joe Biden delivered stark warnings about the rise of Omicron this week, but did not announce additional measures.

“Due to the steps we’ve taken, Omicron has not yet spread as fast as it would’ve otherwise done and as is happening in Europe. But it’s here now, and it’s spreading, and it’s going to increase,” he said at the White House after meeting with his pandemic-response team on Thursday.

Mr. Biden warned that unvaccinated people will “soon overwhelm” hospitals, and urged Americans to “move now” to get their booster shots.

The White House on Friday warned that Omicron would lead to a further rise in cases, including a wave of deaths among unvaccinated people. Officials told Americans to get vaccinated and boosted, and to wear masks in indoor public places. They did not announce new actions to make people get their shots or wear masks.

On Friday, Jeffrey Zients, Mr. Biden’s COVID-19 czar, said that because of vaccines, this wave will not be the same as last winter’s. “This is not a moment to panic, because we know how to protect people and we have the tools to do it,” he said.

But, he warned, “for the unvaccinated, you’re looking at a winter of severe illness and death for yourselves, your families and the hospitals you may soon overwhelm.”

More than 800,000 Americans have died of COVID-19, more than all U.S. deaths in both world wars, the Korean War and the Vietnam War combined.

And while Prime Minister Justin Trudeau this week pleaded with Canadians not to travel abroad, two chief executive officers of major U.S. airlines pushed for a relaxation of COVID-19 safety measures. Gary Kelly of Southwest Airlines said it was not necessary to wear masks on airplanes, a rule Mr. Biden put in place on the first day of his presidency.

“I think the case is very strong that masks don’t add much, if anything, to the air cabin environment,” Mr. Kelly told a congressional hearing this week. “It is very safe and very high-quality compared to any other indoor setting.” Added Doug Parker, head of American Airlines: “I concur. An aircraft is the safest place you can be.”

The men spoke unmasked. On Friday, Southwest said Mr. Kelly had tested positive for COVID-19.

On Farragut Square in downtown Washington, about 50 people queued up at a mass testing site on Friday morning. Yvette Liu, 25, was there because a co-worker had tested positive. She said she was “not really” concerned about Omicron.

“I’m just here because we’re supposed to,” said Ms. Liu, an architect.

Michael Kinch, a public-health professor at Washington University in St. Louis, said hubris among the unvaccinated and exhaustion among others from living with constraints help explain why the United States is behind other countries in taking action.

“People are going to die that don’t need to die in the U.S. because we’re not taking it seriously enough,” he said. “The two things we know will slow or stop this virus altogether are vaccines and masks. Should vaccine mandates be instituted? Yes. Those who are unvaccinated are ensuring that we’re going to have, after Omicron, every other letter in the Greek alphabet.”

But resistance to reinstating pandemic measures is widespread.

Take Alabama, where the mask mandate expired in April. “I’d be shocked” if it was brought back, said Suzanne Judd, a public-health scholar at the University of Alabama. She said she expects Omicron to bring record case numbers to the state by January.

“We don’t really have a lot of the social measures in place to stop it. It’s going to lead to huge amounts of absenteeism,” she said.

Her modelling late this summer suggested 20 per cent of teachers could be out of school at any time in the Delta variant wave. With Omicron, “it could be even higher,” she said. Worse, the flu has also returned to Alabama this winter.

With little prospect for state-level intervention, lower levels of government will have to act, Prof. Judd said, pointing to some Alabama school districts that have had success with mask mandates.

Some local leaders say they no longer feel able to act. James Young, the mayor of Philadelphia, Miss., was called a “dictator” for ordering mask-wearing last year. Although businesses and government buildings can demand masks, they haven’t been broadly required in Mississippi since Governor Tate Reeves relaxed a statewide mandate in March. The Governor has since called national guidance on masks foolish.

Mississippi, the poorest U.S. state, has the country’s highest COVID-19 death rate, and Neshoba County, where Philadelphia is located, is the worst in the state. Just 37 per cent of people in Neshoba, which has a large Indigenous population, are fully vaccinated. “Sadly for many, it has cost them their lives,” Mr. Young says.

In his community and others, the factors that have led to high death rates largely remain in place, leaving them particularly vulnerable to new outbreaks.

In Arizona’s Navajo County, with a COVID-19 death rate nearly three times the national average, life has returned to normal. At high-school football games, “the whole town comes out,” said Daryl Seymore, who chairs the county’s board of supervisors. After nearly two years in the pandemic, “it’s not going away, and we’re not going to change how we want to live,” he said.

In Galax City, the high death toll has prompted action. Nearly three quarters of adults have now received at least one dose of the vaccine. Still, positivity rates are already at 15 per cent amid a post-Thanksgiving return of the Delta variant, and Breanne Forbes Hubbard, the local state population health manager, worries about what Omicron will bring.

“Our community is over this. We’re over it, too,” she said. “I’m afraid that’s going to lead to folks kind of ignoring this and not taking any mitigation steps – and we’re going to see the potential for some poor outcomes.”

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