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Tracing The Course Of The U.S. Pandemic


About nine months ago, January 19, a 35-year-old man walks into an urgent care clinic north of Seattle. He complains of four days of coughing and fever and says he's just visited family in Wuhan, China. The doctor takes a few swabs. A few days later...


UNIDENTIFIED REPORTER: The alarming new development of that deadly mystery virus outbreak, the first case in the U.S. confirmed.

CORNISH: Three weeks later, the disease caused by that virus is given a name by the World Health Organization.


UNIDENTIFIED PERSON #1: COVID-19 - CO for corona, VI for virus, D for disease and 19 because it started last year.

CORNISH: NPR's Will Stone has been tracing the course of the U.S. pandemic from its earliest days in Washington state.

Hey there, Will.


CORNISH: So we're going to talk through five key moments from this year that got us to where we are today. And we just told a story of the first known case in Washington. The next big story of the pandemic clearly was New York - right? - the Northeast.

STONE: Yeah. When it hit New York City, the rest of the country realizes this isn't just a Washington problem.


DAVID LIN: Every single person that rolled in - tubed, unstable, respiratory failure...

STONE: People like David Lin see the ERs in New York start filling up. He's a medical resident at the Mount Sinai Hospital.


LIN: COVID - next one, same. Next one, same. And they were anyone - young, old.

CORNISH: And the city's standing up these makeshift hospitals. I mean, the Navy hospital ship arrives.


UNIDENTIFIED PERSON #2: Yeah, the Comfort now is just pulling into dock here in Midtown Manhattan.

STONE: And by early April...


ANDREW CUOMO: And we talk about numbers.

STONE: ...Gov. Cuomo is reporting these huge death tolls every day.


CUOMO: We got 731 people who we lost. Behind every one of those numbers is an individual, is a family.

STONE: And it becomes clear that health care workers are getting sick, too. They're burning out. They're worried about their health.


SACHITA SHAH: We're afraid for each other. I'm afraid for myself. I'm a single mom.

STONE: Here was Dr. Sachita Shah at Harborview Medical Center in Seattle at the time.


SHAH: I'm afraid to leave my kids without a parent. This week, we started taking care of our own. You know, our - some of our residents are sick. This is a disease of health care workers, too.

STONE: And there's also this realization that no one is going to have enough of anything to make it through - masks, gowns, test kits.

CORNISH: Which sounds really bad and was really bad, but then things sort of slowed down as the country moved into May, right?

STONE: Yeah. So this is sort of the third big moment of the pandemic, this temporary reprieve towards the end of May as the bigger cities are seeing deaths go down.

CORNISH: And it leads to a sense of complacency going into Memorial Day, right?



DEBORAH BIRX: You can't tell who's infected. And so that's why you have to continue to social distance.

STONE: And officials like Deborah Birx of the White House Coronavirus Task Force are worried.


BIRX: When you go out for this weekend, Memorial Day, and you want to do some kind of social gathering, it's very important to maintain that six-feet distance and very important to have your mask with you...

CORNISH: So it's not long before we start to see things basically tick back up again.

STONE: That's right. And that's when we get to the fourth big moment, this summer surge in California, Arizona, Texas, the South, which is also when we realized the type of people driving up the case numbers now is shifting. It's young people.

CORNISH: It sounded like officials in a way we're starting to blame young people or millennials for what was going on. Here's how the mayor of St. Petersburg, Rick Kriseman, put it.


RICK KRISEMAN: All of you millennials who thought you were immune to this virus, that the only people who were afflicted by coronavirus were baby boomers and those older than them, you were wrong.

STONE: Yeah, but that focus on young people also becomes somewhat of a distraction from the real problem, which is that states never closed down enough, and they're reopening too fast. You saw this playing out, especially in Texas.


GREG ABBOTT: We don't have to choose between jobs and health. We can have both.

STONE: That was Gov. Greg Abbott. That didn't turn out to be true. They needed further lockdowns.

CORNISH: And that's when you see states like Florida - right? - breaking records with daily case numbers - at one point 15,000 new cases a day, which was even worse than during New York's peak. And ERs are filling up.


DAVID DE LA ZERDA: So we are working many hours. I think at least three times more than we worked in the past.

CORNISH: Here's Dr. David De La Zerda at Jackson Memorial Hospital in South Florida.


DE LA ZERDA: I am really worried. If we continue to see the influx we've seen in the last few days, we are going to reach our capacity by the end of the week.

STONE: By midsummer, cases are peaking. And then by mid-August, they descend significantly.

CORNISH: There's another lull - right? - a brief one. It feels like a moment of calm. Is this when the U.S. starts to feel - the government starts to feel that things are somewhat under control?

STONE: Yeah, cases are coming down. But even during this dip, we were still seeing more than 30,000 cases a day. And then by late August, we started to see a pickup of cases in the middle of the country. And in September, nationally, cases start rising again. And that sort of brings us to the fifth moment, where we are right now.

CORNISH: Where we are right now is 212,000 people in this country who have died from coronavirus.

STONE: That's right, Audie.

CORNISH: Looking back at the way that the virus moved across the U.S., early on, we heard about different waves. Is this actually a good way to think about it?

STONE: A wave does not quite capture it because the pandemic has not crashed across the country all at once and then gone away. This is how Dr. Roger Shapiro at Harvard describes the U.S. coronavirus outbreak.

ROGER SHAPIRO: A better way of thinking about it is a wave that went into a pool. And in that pool, it's sloshing around. Wherever it hasn't been yet, it's going to go. The places where it has already been, it could go back.

STONE: So what we have now is this constant reservoir of disease splashing around, infecting people at different times in different places.

CORNISH: Now it's fall. We're going to be heading into winter. I'm not the only one, I'm sure, who's, like, heard these predictions that the U.S. is going to see a big rise in cases as people spend more time indoors. Is the country prepared for this?

STONE: It's not. Overall, it looks pretty grim. The hope early on was that the country could take advantage of the summer, bring infections down a lot to get some breathing room before the fall and flu season. But as a country, we never got there. So now the prediction is that by the end of the year, the death toll will reach about 360,000. That estimate comes from modelers at the University of Washington, like Professor Ali Mokdad. And Mokdad says the U.S. is just stuck in a cycle.

ALI MOKDAD: We are in this, like, roller coaster. And every location in the United States where it goes up - and then we change our behavior. We bring it down. Then we let down our guard. Then it goes up again.

STONE: And Mokdad says the data show this pattern of behavior all over the country. When infections get bad, more people put on masks, even where it's not required, and they stay home more. And then after cases drop, people aren't as careful. And this means places that have already gone through a really bad outbreak are vulnerable to another one. And immunity won't help because most of America still hasn't been infected.

CORNISH: So the biggest question going forward - are a lot of places that shut down in the spring, are they going to have to do that again in the winter?

STONE: As painful as they are, shutdowns can be effective. But Professor Mokdad also told me that timing matters. Shutdowns have to be in place before hospitalizations spike, otherwise they're not nearly as effective as they could be. And you still get the economic pain.

CORNISH: Will Stone, thanks for walking us through it.

STONE: Thank you.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.

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Will Stone
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