'An unmitigated disaster': America's year of Covid
At around 5pm on 20 January 2020, Dr George Diaz received a call from the federal health protection agency, the Centers for Disease Control and Prevention (CDC), bearing alarming news. They had just logged a positive test for a new strain of coronavirus in a 35-year-old man who had recently returned to Washington state from Wuhan, China. CDC officials wanted to bring the patient in to Diaz’s hospital, Providence Regional medical center in Everett, outside Seattle
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© Photograph: Patrick T Fallon/AFP/Getty Images A nurse supports a patient as they walk into a Covid-19 care site built in a parking garage at Renown Regional medical center in Reno, Nevada, on 16 December 2020.
Many people taking that call would have hit the panic button. The positive test was the first ever recorded in the US for this frightening new strain of disease. The virus was so novel it still had no name other than 2019-nCoV, and no one could say for sure how infectious it was, how it was transmitted and critically just how deadly it would prove to be.
Related: 'It’s like we didn’t count': when Covid deaths are omitted, families pay the price
But for Diaz, this was his moment. As an infectious diseases physician, dealing with highly-infectious airborne illnesses was his business. He’d trained for years to handle Ebola, and when the first news started trickling out of Wuhan about a novel coronavirus, he knew it was only a matter of time before it might reach America.
“The only surprise here was that we would be the first to receive a patient,” he said.
So thoroughly was his hospital prepared, that two weeks previously they had staged a table-top drill that ran through caring for a patient with the new coronavirus. So when reality struck and the anonymous patient really did arrive on the evening of 20 January, Diaz and team knew exactly what to do.
The man was brought into the hospital through a secret side entrance of the hospital. He was carried inside an isopod, and taken along designated corridors to an isolation room. Only nursing staff were allowed to enter, while Diaz communicated with his patient through an intercom
Many people taking that call would have hit the panic button. The positive test was the first ever recorded in the US for this frightening new strain of disease. The virus was so novel it still had no name other than 2019-nCoV, and no one could say for sure how infectious it was, how it was transmitted and critically just how deadly it would prove to be.
Related: 'It’s like we didn’t count': when Covid deaths are omitted, families pay the price
But for Diaz, this was his moment. As an infectious diseases physician, dealing with highly-infectious airborne illnesses was his business. He’d trained for years to handle Ebola, and when the first news started trickling out of Wuhan about a novel coronavirus, he knew it was only a matter of time before it might reach America.
“The only surprise here was that we would be the first to receive a patient,” he said.
So thoroughly was his hospital prepared, that two weeks previously they had staged a table-top drill that ran through caring for a patient with the new coronavirus. So when reality struck and the anonymous patient really did arrive on the evening of 20 January, Diaz and team knew exactly what to do.
The man was brought into the hospital through a secret side entrance of the hospital. He was carried inside an isopod, and taken along designated corridors to an isolation room. Only nursing staff were allowed to enter, while Diaz communicated with his patient through an intercom
.
© Provided by The Guardian Providence Regional medical center where the first known person infected with coronavirus was observed, in Everett, Washington. Photograph: Jason Redmond/AFP/Getty Images
Diaz told the Guardian that the man he was now treating at the frontlines of what would become the US pandemic “was a bright and educated person. He was obviously very concerned about this novel disease which really had no end in sight.”
On his fifth day in hospital, the patient developed pneumonia. That was a serious turn, as early indications from Wuhan suggested that people infected with the virus who went on to have pneumonia were dying in large proportions.
Diaz was ready for that too. He had been studying the promising results of a trial on animal models in North Carolina using a new antiviral medication, remdesivir, that appeared to speed recovery. It looked like it might be applicable to the coronavirus. So he scrambled to get emergency approval, and within a day of the patient developing pneumonia, Diaz was infusing him with remdesivir – the first such deployment of the drug in the world.
A day after that, the patient started to feel better. His pneumonia receded and breathing improved, and he was allowed to go home under supervision soon after.
That first confirmed case of Covid-19 in the US had turned out to be a triumph of medical science. Everyone – from Diaz down – had been operating in the dark. They were dealing with a terrifying unknown, yet responded with discipline, logic and imagination and achieved an outcome that was astonishingly successful. That the first patient is with us still is testament to that achievement.
“It did go well, it actually did all go well,” Diaz said demurely.
That was day one, patient one. If only the same could be said about the rest of America’s year of Covid.
Diaz told the Guardian that the man he was now treating at the frontlines of what would become the US pandemic “was a bright and educated person. He was obviously very concerned about this novel disease which really had no end in sight.”
On his fifth day in hospital, the patient developed pneumonia. That was a serious turn, as early indications from Wuhan suggested that people infected with the virus who went on to have pneumonia were dying in large proportions.
Diaz was ready for that too. He had been studying the promising results of a trial on animal models in North Carolina using a new antiviral medication, remdesivir, that appeared to speed recovery. It looked like it might be applicable to the coronavirus. So he scrambled to get emergency approval, and within a day of the patient developing pneumonia, Diaz was infusing him with remdesivir – the first such deployment of the drug in the world.
A day after that, the patient started to feel better. His pneumonia receded and breathing improved, and he was allowed to go home under supervision soon after.
That first confirmed case of Covid-19 in the US had turned out to be a triumph of medical science. Everyone – from Diaz down – had been operating in the dark. They were dealing with a terrifying unknown, yet responded with discipline, logic and imagination and achieved an outcome that was astonishingly successful. That the first patient is with us still is testament to that achievement.
“It did go well, it actually did all go well,” Diaz said demurely.
That was day one, patient one. If only the same could be said about the rest of America’s year of Covid.
One of the striking coincidences of the US pandemic year is that the first anniversary, 20 January 2021, falls on the day of Joe Biden’s presidential inauguration. That sets a sharp frame through which to view the year: the devastation that has befallen America as a result of the political mishandling of the crisis must wholly be owned, down to the day, by Donald Trump.
The numbers crudely tell the story. Nobody knew it then, but that initial confirmed case in Washington state was the opening drop in what was to become a tsunami of infection – more than 23,896,221 cases, and rising now at the tear-away rate of up to 300,000 new cases a day.
The death statistics are similarly brutal. That first patient may have survived and is doing well. But he was followed by 396,935 people who were not so fortunate. In another striking coincidence of this year of contagion, the death toll from Covid in the US is now within a hair’s breadth of surpassing the 405,000 Americans who lost their lives in the second world war.
The numbers crudely tell the story. Nobody knew it then, but that initial confirmed case in Washington state was the opening drop in what was to become a tsunami of infection – more than 23,896,221 cases, and rising now at the tear-away rate of up to 300,000 new cases a day.
The death statistics are similarly brutal. That first patient may have survived and is doing well. But he was followed by 396,935 people who were not so fortunate. In another striking coincidence of this year of contagion, the death toll from Covid in the US is now within a hair’s breadth of surpassing the 405,000 Americans who lost their lives in the second world war.
There’s another resonant lens through which the year can be seen. Last week, at least 4,400 Americans died from Covid on a single day – more than the total loss of life on 9/11.
Across the country, from coast to coast and through every nook and cranny of the heartlands, the virus is wreaking havoc, upturning lives as it shreds the global reputation of this once revered nation. More than one in 10 members of Congress have tested positive. The new highly contagious variant of the virus has landed in New York City and other cities, including Los Angeles where hospitals are once again on the edge of meltdown with patients parked on gurneys in crowded hallways.
Across the country, from coast to coast and through every nook and cranny of the heartlands, the virus is wreaking havoc, upturning lives as it shreds the global reputation of this once revered nation. More than one in 10 members of Congress have tested positive. The new highly contagious variant of the virus has landed in New York City and other cities, including Los Angeles where hospitals are once again on the edge of meltdown with patients parked on gurneys in crowded hallways.
© Provided by The Guardian Bodies wrapped in plastic line the walls inside a refrigerated trailer used as a mobile morgue in El Paso, Texas on 13 November 2020. Photograph: Justin Hamel/AFP/Getty Images
John Holdren has spent much of the year investigating what lies behind these horrifying features of the American pandemic and the human catastrophe they denote. He was Barack Obama’s senior White House science adviser through both terms in office and in that role he and a council of top scientists and public health experts prepared six reports seeking to prepare the country for a future pandemic.
When the real pandemic struck home a year ago, Holdren reassembled 10 members of that Obama-era council to carry out a series of inquiries into specific aspects of the national Covid response. What went wrong, and how could it be put right? The idea was to come up with practical tips that could help the US government extract itself from the current disaster, as well as provide advice for tackling any future pandemic.
Their findings give a wealth of detail on the failings of the Trump administration’s response. Their first inquiry, released in May, looked at how the national stockpile of emergency medical supplies had been allowed to wither under Trump.
When the real pandemic struck home a year ago, Holdren reassembled 10 members of that Obama-era council to carry out a series of inquiries into specific aspects of the national Covid response. What went wrong, and how could it be put right? The idea was to come up with practical tips that could help the US government extract itself from the current disaster, as well as provide advice for tackling any future pandemic.
Their findings give a wealth of detail on the failings of the Trump administration’s response. Their first inquiry, released in May, looked at how the national stockpile of emergency medical supplies had been allowed to wither under Trump.
© Provided by The Guardian Healthcare workers treat a patient suffering from Covid-19 in Houston, Texas. Photograph: Go Nakamura/Getty Images
They warned that urgent action was needed to replenish the reserves to avoid drastic shortages of masks, ventilators and other PPE come the winter, but Trump ignored that advice too. Just as they predicted, an alarming dearth of masks and other equipment is once again putting frontline health workers in mortal danger.
Later studies by Holdren’s group looked at the disastrously slow roll out of testing and contact tracing and how public health data could be better used to control spread of the disease. As he looks back on their work, Holdren is struck that one factor kept cropping up in all their studies that more than anything else explains the calamity.
They warned that urgent action was needed to replenish the reserves to avoid drastic shortages of masks, ventilators and other PPE come the winter, but Trump ignored that advice too. Just as they predicted, an alarming dearth of masks and other equipment is once again putting frontline health workers in mortal danger.
Later studies by Holdren’s group looked at the disastrously slow roll out of testing and contact tracing and how public health data could be better used to control spread of the disease. As he looks back on their work, Holdren is struck that one factor kept cropping up in all their studies that more than anything else explains the calamity.
President Trump and his minions ignored the science and, worse, actively disputed it
John Holdren
“The federal government has to take leadership in the response to a national and global pandemic. Trump refused to do that, and that stance was an unmitigated disaster.”
At the start of the pandemic, Holdren watched with dismay as Trump disbanded the White House team responsible for pandemic preparedness and ignored the plethora of detailed plans that had been bequeathed to him by the Obama administration. The president even ignored his own top scientific advisers such as Dr Anthony Fauci, the leading US infectious diseases official.
But the most damaging aspect of Trump’s response, in Holdren’s opinion, was the alternative universe he created around the virus.
“President Trump and his minions ignored the science and, worse, actively disputed it. They created misunderstanding and confusion among the public, and made not wearing masks a political statement which was a catastrophe,” Holdren said.
On the anniversary of America’s pandemic, the results are still glaringly visible. Republican-controlled states like Oklahoma, where new cases have soared to record-breaking heights, still have no mask ordinance in place.
At least three Democratic Congress members have tested positive after they were forced to shelter from the insurrection at the Capitol building incited by Trump. As they cowered in a room, several Republican peers also taking cover sneeringly refused to wear a mask. The refuseniks included Marjorie Taylor Greene, the first open advocate of the QAnon conspiracy theory to gain a congressional seat.
The cumulative impact of such willful disregard for public safety has been that the early successes of George Diaz and other doctors and scientists like him have been dissipated in the winds of cynical political discord. Diaz himself has seen the fallout with his own eyes.
Having worked so effectively with hospital colleagues and health partners at local, state and even federal level, he has observed their collective efforts undermined by lies. “We live in an era in the US of disinformation where many people believe things that are simply untrue. That’s been a major hindrance for us,” he said.
Patients in life-threatening condition have been flown into his hospital over the mountains from Idaho, where mask wearing is still widely frowned upon. He sees the pattern as a direct result of disinformation. “That’s been a massive problem. It directly harms our people, and it makes our job harder in saving lives.”
© Provided by The Guardian A patient rests in a corridor waiting for a room at Providence Cedars-Sinai Tarzana medical center in Tarzana, California.
Photograph: Apu Gomes/AFP/Getty Images
As historians look back on the first year of America’s pandemic, they might single out Scott Atlas, who joined the White House in August as a senior adviser on coronavirus. As Trump’s attention drifted away from the pandemic to more exciting prospect – such as overturning the results of a presidential election – Atlas provided the intellectual cover he needed for federal inaction.
A senior fellow at Stanford’s Hoover Institute, Atlas insisted that the risk of the virus had been “grossly overblown”. If vulnerable groups such as older people could be protected from the virus, then the rest of the population could be exposed and left to acquire “herd immunity”.
Tell that to Jessica Beltran. Most of her relatives were fit and healthy and could not be categorized as anything like vulnerable. Yet when the virus swept through their community in Phoenix, Arizona, it ripped her family apart.
Beltran, 39, was the first to fall sick. She developed a fever on 1 July, having probably contracted the virus from her job as a TSA employee at Phoenix airport. She became severely ill and took days to recover. By the time she was back on her feet, her brother Gil and mother Irene had fallen sick.
Gil, 44, was in a vulnerable category. He was 450lb, obese and diabetic. He too probably caught the virus from his job, driving rental car buses at the airport. “He had the biggest heart, he would help anybody in need,” Beltran said.
He entered hospital on 16 July. The institution was overrun in the midst of a surging pandemic, and had run out of the breathing apparatus Gil desperately needed. His condition declined so rapidly that he was put on a ventilator, and died on 21 July.
“It hit us hard. I have no words for all the love we felt for Gil,” Beltran said.
The family had little time to mourn. Two days after Gil’s death, Beltran’s mother Irene, a healthy and strong 66-year-old, was hospitalized with Covid. She fought hard for a full month, dying on 20 August after developing a brain bleed.
Six days later Beltran’s father Gilberto, 75, who had been contracted the virus separately while visiting his brother in Douglas, Arizona, became the next to die. His body had been ravaged by a blood infection unleashed by Covid-19.
The last to go was Beltran’s brother Pablo, 42. He struggled for more than 50 days in an induced coma before the family had to let him go and switch off his machine on 10 September.
Jessica Beltran lost both her parents and both her brothers. She can’t get the picture out of her head of her loved ones entangled in tubes and wires, unable to say goodbye. She has waves of depression, finds it hard to function. “It’s a very big void,” she said. “I’m trying to mourn four people and I don’t know how to do that.”
A month after her second brother died, Beltran turned on the TV to hear Trump brag about how quickly he had recovered from his own bout with Covid-19. He’d received a cocktail of state-of-the-art drugs including remdesivir, the antiviral medication Diaz had prescribed for the very first confirmed patient. Beltran had tried to secure that same medication for her parents and brothers, but had been told it wasn’t available.
As Trump returned from hospital to the White House, he said: “Don’t be afraid of Covid, don’t let it dominate your life.”
“That was hurtful,” Beltran said. “It’s not fair. It’s not fair to the people.”
LIKE THE PHANTOM OF THE OPERA REMOVING HIS MASK
© Provided by The Guardian Donald Trump removes his protective mask on the Truman Balcony of the White House on 5 October 2020. Photograph: Ken Cedeno/Bloomberg/Getty Images
Andi Egbert, senior researcher with APM Research Lab, has thought a lot about fairness during America’s year of Covid. Her team has been looking at the racial disparities of the pandemic’s impact in a project named The Color of Coronavirus.
The project’s latest figures for the year, brought up to 5 January, show that one in 735 black Americans have died from the disease, substantially more than the 1 in 1,030 white Americans.
When you adjust the data for age, the contrast is even starker. Black Americans are 2.3 times more likely to die than white Americans.
When Egbert reflects on those statistics, she thinks of each of the 56,000 African Americans who have lost their lives. She thinks too about the wider trauma inflicted on entire communities, where the prevalence of death has become so great, she says, that “it must feel like your world has come unmoored”.
And then she thinks about the booming lack of urgency that has ensued in the pandemic response. “We knew very early on how cruel and unequal the damage would be, and yet what? Where was the action that this country needed to stop the virus steamrolling over communities of color?”
Where was the action that this country needed to stop the virus steamrolling over communities of color? Andi Egbert
You can see what she means in a historic black community like Lowndes county, Alabama. This is the crucible of the civil rights movement, the area through which Martin Luther King and thousands of others marched in 1965, from Selma to Montgomery.
Lowndes county has suffered the highest per capita incidence of Covid in Alabama, among the highest in the country. On either side of Highway 80, the route of the legendary voting rights march, families have been left devastated by the contagion.
Families like those of Dizzie Maull, who died in May aged 81. He was active during the 1965 marches, which renders his passing not just personal, but epochal. “We’ve lost a lot of history,” said Catherine Flowers, an environmental justice campaigner whose group CREEJ has its roots in Lowndes county.
For Flowers, it is no coincidence that the pandemic has struck so hard in this resonant community. Lowndes county was dubbed “Bloody Lowndes” on the back of its long exposure to lynching and other forms of racial terrorism.
Today’s wounds are more of the same. “Covid – it’s the continuation of a trauma that has always been.”
© Provided by The Guardian A man walks past Sogho Express African Hair Braiding salon in the Bedford-Stuyvesant neighborhood of Brooklyn, New York, on 7 April 2020.
Photograph: Mark Lennihan/AP
•••
As America’s year of Covid comes to an end, and a new year begins, there’s hope of a fresh start. Biden’s proposed $1.9tn stimulus plan includes $160bn to fight the virus, including provision for a national vaccination program.
The battle now is to move beyond Trump’s fumbling and get a grip. But in the longer term there will need to be a reckoning with what has transpired.
Holdren’s group of scientists are among those who want to see a formal commission established to review Trump’s year of Covid so that the monumental mistakes that were made can be avoided down the line.
“We need to do better next time,” he said.
George Diaz looks back on the year that began so promisingly with his first patient, and thinks of South Korea, which through another startling coincidence recorded its first case on exactly the same day, 20 January 2020. South Korea’s death toll for the totality of the pandemic stands at 1,217 – fewer than a third of those who have died in the US on a single day.
“It shows you what happens when an entire nation is on the same page about the collective good,” Diaz said.
Jessica Beltran can do nothing else but review the year through the lens of loss. “My family was taken from me,” she said. “It was stolen. We had so much ahead of us together. We had a lot to live.”
•••
As America’s year of Covid comes to an end, and a new year begins, there’s hope of a fresh start. Biden’s proposed $1.9tn stimulus plan includes $160bn to fight the virus, including provision for a national vaccination program.
The battle now is to move beyond Trump’s fumbling and get a grip. But in the longer term there will need to be a reckoning with what has transpired.
Holdren’s group of scientists are among those who want to see a formal commission established to review Trump’s year of Covid so that the monumental mistakes that were made can be avoided down the line.
“We need to do better next time,” he said.
George Diaz looks back on the year that began so promisingly with his first patient, and thinks of South Korea, which through another startling coincidence recorded its first case on exactly the same day, 20 January 2020. South Korea’s death toll for the totality of the pandemic stands at 1,217 – fewer than a third of those who have died in the US on a single day.
“It shows you what happens when an entire nation is on the same page about the collective good,” Diaz said.
Jessica Beltran can do nothing else but review the year through the lens of loss. “My family was taken from me,” she said. “It was stolen. We had so much ahead of us together. We had a lot to live.”
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