Assessment

The prediction was that from mid‑2020 onward the U.S. would effectively behave like “an undeclared Sweden”: not seriously trying to fully stop COVID transmission, defaulting to a herd‑immunity‑style end state in which the virus becomes endemic.

1. COVID-19’s long‑term status in the U.S.
By 2023 the federal COVID-19 public health emergency was allowed to expire, and by 2025 major public‑health reporting and experts explicitly describe COVID-19 in the U.S. as having transitioned into an endemic respiratory disease, with ongoing but lower levels of severe illness and death rather than elimination. (en.wikipedia.org) This directly matches the prediction that the virus would not be stamped out but would become a permanent, background presence.

2. National strategy: elimination vs. “living with the virus”
The United States never adopted a zero‑COVID/elimination strategy; such approaches (mass testing, aggressive lockdowns to drive cases to zero) were associated with places like China, and are explicitly contrasted in global reporting with the “living with COVID” strategy followed by the U.S. and most Western countries. (en.wikipedia.org) Under both Trump and Biden there were substantial mitigation efforts—Operation Warp Speed for vaccines, and then Biden’s Executive Order 13987 to organize a more coordinated response—but these focused on reducing harm (through vaccination, treatment, and time‑limited NPIs), not on fully stopping transmission nationwide. (en.wikipedia.org) By early 2022, the administration’s public plans, outside expert roadmaps, and CDC’s relaxed masking guidance all framed the goal as “living with COVID” and keeping society open, not pursuing elimination. (insurancejournal.com) Senior advisers were publicly saying that eradication was unrealistic and that the U.S. would have to live with the virus long‑term. (pbs.org) That is effectively a managed herd‑immunity end state: population‑level protection via a mix of vaccination and widespread prior infection, with no expectation of stopping spread entirely.

3. Comparison to Sweden / “undeclared Sweden”
Sweden’s early strategy emphasized keeping much of society open, avoiding strict lockdowns, and letting significant community transmission occur, a choice their own inquiry later described as avoiding more “rigorous and intrusive” controls even though it produced high early death tolls. (en.wikipedia.org) The U.S. did use more formal restrictions than Sweden in 2020–21, but by 2022 most broad mask mandates and many other controls were lifted, shifting to personal responsibility and medical tools while accepting ongoing waves of infection—very similar in practical outcome to Sweden’s long‑run stance of tolerating endemic spread rather than striving for zero cases. (en.wikipedia.org)

4. Where the prediction was off, and why it still counts as right
What Sacks didn’t foresee was the scale of the vaccine‑driven response and the temporary intensity of federal and state‑level NPIs in late 2020–2021; there was in fact a large, sustained nationwide effort to mitigate COVID. But on the falsifiable core of his claim—(a) the U.S. would not mount or maintain an effective national drive to fully contain or eliminate transmission, and (b) the country would end up in a de facto herd‑immunity / “live with it” equilibrium with COVID becoming endemic—subsequent policy and epidemiological reality match his forecast. Given that, the prediction is best scored as right, with the caveat that he understated how aggressively the U.S. would pursue vaccines and temporary controls before settling into that endemic, Sweden‑like end state.