And what it lost in the process
1.
In fall of 2019, exactly zero scientists were studying COVID‑19, because no one knew the disease existed. The coronavirus that causes it, SARS‑CoV‑2, had only recently jumped into humans and had been neither identified nor named. But by the end of March 2020, it had spread to more than 170 countries, sickened more than 750,000 people, and triggered the biggest pivot in the history of modern science. Thousands of researchers dropped whatever intellectual puzzles had previously consumed their curiosity and began working on the pandemic instead. In mere months, science became thoroughly COVID-ized.
As of this writing, the biomedical library PubMed lists more than 74,000 COVID-related scientific papers — more than twice as many as there are about polio, measles, cholera, dengue, or other diseases that have plagued humanity for centuries. Only 9,700 Ebola-related papers have been published since its discovery in 1976; last year, at least one journal received more COVID‑19 papers than that for consideration. By September, the prestigious New England Journal of Medicine had received 30,000 submissions — 16,000 more than in all of 2019. “All that difference is COVID‑19,” Eric Rubin, NEJM’s editor in chief, says. Francis Collins, the director of the National Institutes of Health, told me, “The way this has resulted in a shift in scientific priorities has been unprecedented.” …
‘We are on an absolutely catastrophic path,’ said a COVID-19 doctor at America’s best-prepared hospital.
Perhaps no hospital in the United States was better prepared for a pandemic than the University of Nebraska Medical Center in Omaha.
After the SARS outbreak of 2003, its staff began specifically preparing for emerging infections. The center has the nation’s only federal quarantine facility and its largest biocontainment unit, which cared for airlifted Ebola patients in 2014. The people on staff had detailed pandemic plans. They ran drills. Ron Klain, who was President Barack Obama’s “Ebola czar” and will be Joe Biden’s chief of staff in the White House, once told me that UNMC is “arguably the best in the country” at handling dangerous and unusual diseases. …
More people than ever are hospitalized with COVID-19. Health-care workers can’t go on like this.
On Saturday morning, Megan Ranney was about to put on her scrubs when she heard that Joe Biden had won the presidential election. That day, she treated people with COVID-19 while street parties erupted around the country. She was still in the ER in the late evening when Biden and Vice President–elect Kamala Harris made their victory speeches. These days, her shifts at Rhode Island Hospital are long, and they “are not going to change in the next 73 days,” before Biden becomes president, she told me on Monday. …
The metaphors that Trump and others use when talking about COVID-19 are making the pandemic worse.
On Monday, as President Donald Trump left Walter Reed National Military Medical Center, Senator Kelly Loeffler of Georgia tweeted a doctored clip of the president tackling and punching the wrestler and WWE CEO Vince McMahon. In the edited version, McMahon’s face has been replaced with a picture of a virus. “COVID stood NO chance against @realDonaldTrump!” Loeffler wrote.
Similar sentiments, trumpeting Trump’s strength and fighting spirit, have poured forth since he tested positive for COVID-19. “#TrumpStrong,” Twitter users wrote. “Our president is strong and will beat the virus,” said House Minority Leader Kevin McCarthy. “He’s a fighter,” said former press secretary Sarah Huckabee Sanders. …
The new coronavirus seems so strange because it has our full attention in a way most viruses don’t.
Last Monday, when I called the cardiologist Amy Kontorovich in the late morning, she apologized for sounding tired. “I’ve been in my lab infecting heart cells with SARS-CoV-2 since 6 a.m. this morning,” she said.
That might seem like an odd experiment for a virus that spreads through the air, and primarily infects the lungs and airways. But SARS-CoV-2, the new coronavirus behind the COVID-19 pandemic, can also damage the heart. That much was clear in the early months of the pandemic, when some COVID-19 patients would be hospitalized with respiratory problems and die from heart failure. “Cardiologists have been thinking about this since March,” said Kontorovich, who is based at Mount Sinai. …
As the U.S. heads toward the winter, the country is going round in circles, making the same conceptual errors that have plagued it since spring.
Army ants will sometimes walk in circles until they die. The workers navigate by smelling the pheromone trails of workers in front of them, while laying down pheromones for others to follow. If these trails accidentally loop back on themselves, the ants are trapped. They become a thick, swirling vortex of bodies that resembles a hurricane as viewed from space. They march endlessly until they’re felled by exhaustion or dehydration. The ants can sense no picture bigger than what’s immediately ahead. They have no coordinating force to guide them to safety. They are imprisoned by a wall of their own instincts. This phenomenon is called the death spiral. …
Without understanding the lingering illness that some patients experience, we can’t understand the pandemic
Lauren Nichols has been sick with COVID-19 since March 10, shortly before Tom Hanks announced his diagnosis and the NBA temporarily canceled its season. She has lived through one month of hand tremors, three of fever, and four of night sweats. When we spoke on day 150, she was on her fifth month of gastrointestinal problems and severe morning nausea. She still has extreme fatigue, bulging veins, excessive bruising, an erratic heartbeat, short-term memory loss, gynecological problems, sensitivity to light and sounds, and brain fog. Even writing an email can be hard, she told me, “because the words I think I’m writing are not the words coming out.” She wakes up gasping for air twice a month. …
The coronavirus is hitting different parts of America in different ways, making the crisis harder to predict, control, or understand
There was supposed to be a peak. But the stark turning point, when the number of daily COVID-19 cases in the U.S. finally crested and began descending sharply, never happened. Instead, America spent much of April on a disquieting plateau, with every day bringing about 30,000 new cases and about 2,000 new deaths. The graphs were more mesa than Matterhorn — flat-topped, not sharp-peaked. Only this month has the slope started gently heading downward.
This pattern exists because different states have experienced the coronavirus pandemic in very different ways. In the most severely pummeled places, like New York and New Jersey, COVID-19 is waning. In Texas and North Carolina, it is still taking off. In Oregon and South Carolina, it is holding steady. These trends average into a national plateau, but each state’s pattern is distinct. Currently, Hawaii’s looks like a child’s drawing of a mountain. Minnesota’s looks like the tip of a hockey stick. Maine’s looks like a (two-humped) camel. The U.S. …
A guide to making sense of a problem that is now too big for any one person to fully comprehend
On March 27, as the U.S. topped 100,000 confirmed cases of COVID-19, Donald Trump stood at the lectern of the White House press-briefing room and was asked what he’d say about the pandemic to a child. Amid a meandering answer, Trump remarked, “You can call it a germ, you can call it a flu, you can call it a virus. You know, you can call it many different names. I’m not sure anybody even knows what it is.”
That was neither the most consequential statement from the White House, nor the most egregious. But it was perhaps the most ironic. In a pandemic characterized by extreme uncertainty, one of the few things experts know for sure is the identity of the pathogen responsible: a virus called SARS-CoV-2 that is closely related to the original SARS virus. Both are members of the coronavirus family, which is entirely distinct from the family that includes influenza viruses. Scientists know the shape of proteins on the new coronavirus’s surface down to the position of individual atoms. …
The fight against the coronavirus won’t be over when the U.S. reopens. Here’s how the nation must prepare itself.
What a difference a few months can make.
In January, the United States watched as the new coronavirus blazed through China and reached American shores. In February, hindered by an unexpected failure to roll out diagnostic tests and an administration that had denuded itself of scientific expertise, the nation sat largely idle while the pandemic spread within its borders. In March, as the virus launched several simultaneous assaults on a perilously stretched-thin health-care system, America finally sputtered into action, frantically closing offices, schools, and public spaces in a bid to cut off chains of transmission. Now, in April, as viral fevers surge through American hospitals and cabin fever grows in American homes, the U.S. …
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