To see the smiling faces of the children murdered at Robb elementary school in Uvalde, Texas, is unbearable. The killing of at least 19 pupils and two teachers is not, as it should be, unthinkable. It comes a decade after 20 children and six staff members were shot dead at Sandy Hook elementary school in Connecticut, and only 10 days after the racist murder of 10 mostly black shoppers at a supermarket in Buffalo, New York.

Gun sales have risen sharply since the pandemic began, although the US already had more guns than citizens, far ahead of any other country. The murder rate has soared by nearly 30%. Firearms are the leading cause of death for America’s children, claiming the lives of more than 1,500 under-18s last year. Mass shootings account for at most 3% of gun violence deaths; many occur in ones or twos, and largely in disadvantaged neighbourhoods of colour. Unlike Tuesday’s tragedy, these victims go mostly unremarked, even when they are school age. Yet they, too, are irreplaceable to those who loved them.

Attempts to curb mass shootings, for example through banning assault weapons, are therefore both necessary and wholly inadequate. Yet lawmakers have struggled to enact and defend even these. Many believed that Sandy Hook had to prove a turning point. The passionate efforts of bereaved parents, vilified and attacked as they grieved, have led to a gunmaker being found liable for a mass shooting in the US for the first time. But the most wide-reaching change resulting from school shootings has been that millions of children now go through drills – traumatising those who will, thankfully, never encounter a shooter.

On Tuesday, Joe Biden asked – as so many have – why the US is “willing to live with this carnage”. Support for tighter gun controls has dropped in recent years, though most still want them, and backing usually rises after mass shootings. Texan Republican leaders have prided themselves on expanding gun rights. Governor Greg Abbott, along with state senator Ted Cruz and Donald Trump, is due to speak at the NRA’s meeting in Houston this weekend. The Republican grip on the country’s institutions, skewing the executive, the legislature and the judiciary rightward, is another problem. A conservative, pro-gun supreme court will rule shortly on a New York law restricting who can carry guns in public, potentially imperilling restrictions elsewhere.

Local gun violence prevention programmes work: the Biden administration is right to have dramatically increased funding, but more must be done. It is also essential that misogyny is addressed: most mass shooters have a history of expressing hatred of women and attacking female family members, and most women shot by their partners have previously been abused by them.

It is hard to feel any optimism when persistent campaigning by survivors and bereaved families has failed to shift the nation. The question is not merely what might save children like those at Uvalde, but whether anything will be done to save Americans more broadly if even these deaths do not force the US to address gun violence seriously. These deaths were not unthinkable. Inaction, in the face of them, must be.