Percentage wise, most who catch this new coronavirus will develop mild or manageable symptoms. But it is so contagious, that the small fraction of those who need critical care can be massive in sheer number. And dying from COVID-19, the respiratory disease caused by the novel coronavirus (SARS-CoV-2), is horrific: a raging flu, energy-sapping soreness, and body-quaking coughing are common, but the telltale sign are the white patches in CT scans from fluid that fills lungs, like pneumonia, so that you effectively drown from the inside. Patients, hyperventilating from lack of breath and delirious with fever, often have to be restrained, lest they rip out the breathing tube which feels like it is choking them.
On Thursday, America's COVID-19 death toll shot up past 1,000-even as they are underreported. An "apocalyptic" surge hit one New York hospital, where inside some died in the emergency room waiting for a bed, and outside a refrigerated truck was stationed for the expected dead. At another, nurses wore trash bags after gowns ran out-right here, in the wealthiest city in the world, where 84 billionaires park exult in a combined net worth more than the GDP of Australia.
On a divergent path from our own is South Korea, which also discovered its first coronavirus case on the very same day as the U.S: January 20. Just one week after that critical day, South Korean government officials met with medical companies asking them to develop testing kits for mass production, promising to cut red tape and fast track approval. Their innovation of drive-through testing centers launched on February 26. Their response was everything ours was not: acting immediately, early widespread testing, contact tracing, and a serious message to the public. Daily new cases have fallen from 1,000 to 100 -there are only more than 9,000 cases total for a country with a population of 51 million-and the country has lifted some of its more stringent measures, opening restaurants and schools with some social-distancing requirements.
The U.S. response was a study in contrasts. But it didn't have to be so. "What's infuriating is, none of this is surprising," Jeremy Konyndyk, an expert on global outbreak preparedness and senior policy fellow at the Center for Global Development, tells me over the phone. "All of this was predictable as soon as we saw what was happening in Wuhan in mid-January."
Six years ago, when the Ebola epidemic broke out in Africa, Konyndyk was working-with Ebola czar Ron Klain -as the director of U.S. Agency for International Development's Office of Foreign Disaster Assistance, helping to coordinate the response with the Centers for Disease Control, the military, and West African governments. "You came away from that experience just absolutely horrified at how unprepared we were for something worse."
"One of the things that we were clearly lacking was a standing unit at the White House that had a visibility over all the different pieces of this," said Konyndyk of the initially disjointed response to Ebola due to the siloing of various experts. "Pandemic response is really...an interdisciplinary effort." In addition to public health issues, there are security, transit, and financial issues, as well as diplomatic and global security issues. For example, at the outset of the Ebola outbreak, governors attempted to screen travelers from affected countries, filling the void of the federal government not providing actionable guidance, which turned out to be counterproductive and chaotic. When Klain came on, he pulled together the FAA, the CDC, Customs and Border Patrol, other parts of DHS and HHS, and state and local authorities for a coordinated response. By contrast, when hospitals and local and state officials begged Donald Trump to use the Defense Production Act to ramp up production of emergency medical provisions, he advocated for a splintered, localized response instead: "Governors are supposed to be doing a lot of this work...We're not a shipping clerk." Without the federal government kickstarting manufacturing, states are now competing against one another in a bidding war for critical supplies as nurses and doctors start to fall sick, and the death toll builds exponentially.
After the lessons of Ebola, the Obama White House created a global health security team set up exactly for the kind of threat now posed by the novel coronavirus sweeping the globe. In 2018, as is now widely reported, the Trump White House dissolved that team, and attempted to cut pandemic preparedness funds. "The decision to dismantle that, which was one of the first things John Bolton did when he arrived as the national security advisor, that left the White House without that capacity," said Konyndyk. "That unit could not overcome the chaotic leadership of this president. [But] I think it would have tightened and clarified and made more effective the coordination and planning process that that was underway."
And it has been chaotic, routinely so. In late January, well after the first confirmed U.S. case, the president said "we have it totally under control," repeating this mantra again and again. In late February, six days after Italy went on lockdown, he claimed: "the risk to the American people remains very low...the 15 within a couple of days is going to be down to close to zero," and that it would "disappear" like a "miracle." He compared it to the common flu. He said the Democratic reaction to it was " their new hoax." In mid-March, Trump announced a surprise Europe travel ban, failing to mention that citizens would be able to return, flooding airports with last-minute travelers, who rushed back to America, crammed together waiting for hours to get through security in Petri-dish hallway-Illinois governor JB Pritzker told Trump to " get his shit together." As the seriousness of the pandemic became more apparent, Trump turned to a favored political hatchet, racism, calling it " the Chinese virus," berating reporters ("fake news") for asking softball questions, and travel bans well after the virus was established in the U.S. ("worse than useless at this point" says Konyndyk). To lead the response to the worst pandemic since the Spanish flu, Trump appointed a remarkably unfit bunch: vice president Mike Pence, who as governor of Indiana mishandled and exacerbated an HIV outbreak; his son-in-law Jared Kushner, who confused agencies with his " shadow task force;" along with a CDC director, Robert Redfield, who had exactly zero experience leading a public health agency.
Of course, it is not just Trump and his team of loyalist buffoons. Our political leadership is failing us on nearly every level. Two Republican senators-North Carolina's Richard Burr and Georgia's Kelly Loeffler-after getting briefed on the threat of coronavirus in February, reassured the public that everything would be fine, and promptly sold off millions of their stock portfolios. In mid-March, after the WHO officially declared the outbreak a " a pandemic," Mitch McConnell left the capital for a three-day weekend to hang out with Brett Kavanaugh at a judicial event in Kentucky-and then threw a tantrum on the Senate floor when Democrats refused to sign onto a stimulus bill with a $500 billion slush fund to corporations with no oversight, and paltry sums to hospitals, individuals, and local and state governments. Four Republicans-including Florida's Rick Scott, whose former hospital company committed massive Medicare fraud-tried to block the legislation reasoning in typical conservative illogic that the four-month unemployment benefits were too generous, as if masses of people would quit their jobs during a pandemic for a few months of more slightly higher pay. And instead of offering the American people an alternative of transparency and bold vision, the Democratic leadership has effectively surrendered messaging the president, whose daily press briefings offer a lineup of supplicant officials praising him instead of straightforward public health messaging. While America still struggled with shortages of healthcare professionals, beds, equipment, and unified messaging on staying home, Arkansas senator Tom Cotton snarled that China needed to be held " accountable" for what it "inflicted" on the world. Towards the end of March, talks with G7 foreign ministers about releasing a joint statement broke down, according to Der Spiegel, because Secretary of State Mike Pompeo insisted on calling it the "Wuhan virus."
While Italy's overwhelmed hospitals made choices about who they could save and who they had to let die, and messages about staying home ricocheted across social media, California congressman Devin Nunes encouraged Americans to eat out, and Oklahoma governor Kevin Stitt tweeted a (now deleted) photo of himself and his kids grinning in a "packed" restaurant. As spring breakers mobbed Florida beaches, governor Ron DeSantis shrugged his shoulders, scoffing at the idea of closing them. (One young reveler, who was shamed for saying "if I get corona, I get corona" on video, later apologized, saying he didn't realize the severity of the outbreak and had elderly people he "adored"-if only our political leaders had gotten out a coherent, responsible message earlier.) And New York mayor Bill de Blasio was so resistant to taking action that his top health advisors threatened to resign if he didn't close schools and businesses; when library heads closed the city libraries he made veiled threats about cutting their funding. What a difference a couple weeks make after pre-symptomatic carriers spread the virus like an unseen wildfire. After de Blasio's foot-dragging on social distancing, deaths are clocking in every 17 minutes and the city is now setting up makeshift morgues.
In Italy, politicians and revelers also filled bars and restaurants weeks before their hospitals reached capacity, laughing at pandemic Cassandras suggesting they alter their way of life. The difference is: While Italy has an older population, it is one of the world's healthiest nations and has one of the best public health systems. Chillingly, it also has more doctors and hospital beds per capita than America. We are now left to wait for loved ones to die with no one by their side and funerals conducted over videoconferencing.
Two weeks after I spoke with Konyndyk, who told me then he was operating in a state of barely suppressed rage, the U.S. became the world leader in coronavirus cases ( even with its still-limited testing), with more hot spots flaring up across a country with no universal healthcare. "Someday, we'll need the 9/11-style commission to understand how this was screwed up so badly. The fact that the disease arrives here was not avoidable. The fact that it would kill Americans was not avoidable. But how many? That was under our control. How severe the outbreak? That was under our control," he told me.
But "first, we need to get through it."
How one young doctor at a Seattle lab tried to get out in front of the coronavirus crisis by inventing his own test. And why the absurdity of his struggle should make us all afraid.