Coronavirus Strikes a Nation Unprepared
The first coronavirus infection in the United States was confirmed in Seattle 100 days ago. A team of DER SPIEGEL reporters has documented what has happened since, following a dozen people as they struggle to come to terms with the health catastrophe.
By Anne Backhaus, Britta Kollenbroich, Katrin Kuntz, Guido Mingels, Ralf Neukirch, Dietmar Pieper, Yannick Ramsel, Christoph Scheuermann and Daniel C. Schmidt
A bus passenger in New York on April 3: A world power in freefall. / SPENCER PLATT/ AFP
It all began with a cough on the very western edge of the United States, in the state of Washington. On Sunday, Jan. 19, a 35-year-old walked into an emergency clinic just north of Seattle.
He had just returned from visiting his family in the Chinese city of Wuhan, the epicenter of the outbreak. The patient is thought to be the very first case of the novel coronavirus in the Unites States. It marked the beginning of what has turned into an American disaster.
Almost 100 days have passed since that clinic visit. Over a million people have been infected by the coronavirus since then and close to 61,000 people have died, though the real number is likely much higher. Factories have shut down, airplanes have been parked on the ground and workers are digging hundreds of graves on an island off New York City.
What a calamity: a global power in freefall. Social restrictions have been imposed on 300 million people and, even though discussions have begun on loosening those restrictions, 39 states have announced that schools will remain closed until summer. More than 26 million people have lost their jobs and the unemployment rate for the entire country is trending toward 20 percent.
Those are the statistics. But what has really happened during these 100 days? In Indiana, Aimee Howard, the mother of 12 children, suddenly found herself out of work. In Georgia, nurse Dorothy Johnson's attendance at a funeral had deadly consequences. In Jefferson Parish near New Orleans, parish President Cynthia Lee Sheng set to work developing an emergency plan. In New York, a nurse named Christina, struggled to keep up with the huge number of patients. And in Colorado, a businessman named Bruce Penman insisted that the lockdown orders are akin to government overreach.
A team of DER SPIEGEL reporters followed - by telephone, WhatsApp and Skype – more than a dozen people through the pandemic over the course of several weeks.
Their stories show just how negligently the U.S. president acted as he sought to play down the pandemic and how dramatically the federal government has failed in the face of this health emergency.
At the same time, people who had little knowledge of viruses until now – public administrators, policewomen, company executives and more – rose to the occasion. It became the hour of the courageous and resolute – and also of the preachers of hate.
Jan. 4: In Topeka, Aimee Howard builds her dream.
A new era in Aimee Howard's life has begun. For the last 14 months, the 42-year-old and her husband have been living in a trailer with nine of their children, but on this morning, they wake up in their new home for the first time.
"It felt surreal," she says. They will be saddled with monthly mortgage payments of $1,150 for the foreseeable future, but that doesn't look like it will be a problem: Both of the Howards have jobs. For now.
Topeka lies in the northeastern corner of the state of Indiana and the region is a hub of mobile home manufacturing. Ronnie Howard works as a welder in one of the factories, while Aimee is a self-employed driver for a kind of taxi service for the Amish, the religious group that has settled in the area and whose members don't drive themselves.
Every morning at 3:30 a.m., Howard gets up, climbs behind the wheel of her Ford E-350 and drives the Amish to a factory where they build cabinet doors.
Aimee Howard is a Christian, a cheerful woman who posts videos of her day-to-day life on Facebook along with Bible verses. She says she doesn't need much: a house, her family and church on Wednesdays. They have planned a summer vacation to Tennessee with two sisters, a friend and their families.
She can't know that in just two months, her life will be upturned by a virus.
Jan. 8: In Baltimore County, Melissa Hyatt begins her first year in office. Health officials issue a warning about the virus.
Melissa Hyatt still knows who she last shook hands with - back before COVID-19. An exciting year for her has just come to an end, a year in which she became the police chief of Baltimore County in the state of Maryland seven months earlier – the first woman ever to hold the position. She isn't yet thinking about COVID-19, even though the Centers for Disease Control issue an initial warning on this day. Hyatt has faith in President Donald Trump, who sees no cause for concern.
Feb. 25: Thousands celebrate Mardi Gras in New Orleans. Cynthia Lee Sheng develops an emergency plan.
Mardi Gras in New Orleans and in the surrounding communities comes to an end on this day, the highpoint of the party season. Cynthia Lee Sheng is the president of Jefferson Parish, a community near New Orleans of around 432,000 residents, a population bigger than that of the city itself. Hundreds of thousands of people have descended on the region to drink, dance and kiss.
Jefferson Parish President Cynthia Lee Sheng / Privat
Lee Sheng has only been in office for seven weeks and she doesn't yet know that "Area One," as her area of responsibility is called in bureaucratese, is currently in the process of turning into one of the largest infection hotspots in the entire country. Thus far, only 45 confirmed cases have been documented in the country, including more than a dozen cruise ship passengers.
"We never talked about cancelling Mardi Gras," Lee Sheng says. She is a friendly, energetic woman. A Republican. A few days earlier, Trump said that warmer weather would help get the virus under control, and Lee Sheng believes him.
Yet she is still doing the right thing. She has ordered the development of an emergency plan in the completely unlikely event that the virus should find its way to Jefferson Parish. What offices must remain open in the event of a catastrophe and which officials can work from home? How can people be kept informed? "I thought it might be useful for the summer, when hurricane seasons begins," she would later say.
Feb. 28: In Washington, the president plays down the threat. In Baltimore County, Melissa Hyatt establishes a taskforce.
The rally, Trump says, standing on the South Lawn of the White House before heading off to South Carolina, is going to be very exciting, with thousands of people. Regarding corona, he says: "As you know, with the flu, on average, we lose from 26,000 to 78,000 people a year."
At about the same time, Melissa Hyatt is busy establishing a taskforce at her police department in Baltimore dedicated exclusively to fighting the virus 24 hours a day, seven days a week. It is now up to people in local communities to prepare people for the outbreak. With the government in Washington doing nothing, governors, doctors, nurses, police and public health officials must pick up the considerable slack.
Hyatt is responsible for more than 1,800 employees, and she wants to set a good example, which means keeping her distance from others and refraining from shaking hands. "I would say that I started one or two weeks before it became the social norm," she says. She starts only communicating with her family by video chat or through a pane of glass.
Feb. 29: Dorothy Johnson buries her brother in Albany.
Around 200 people show up for Andrew's burial. Afterward, they all come together for a wake. None of them are concerned that doing so could be dangerous.
Andrew's sister Dorothy Johnson spoke to him on the phone just the day before he died, with his wife finding him dead in the living room a short time later. Nobody knows what caused his death.
Johnson has worked in the cancer ward of the local hospital for the last 28 years and she loves her job. In Dougherty County, where Albany is located, 70 percent of the population is black. Poverty is a widespread problem, Johnson explains over the phone.
She heard about corona for the first time just yesterday, on the day before the funeral, having seen Trump on the television. According to her recollection, he said that the virus is in China and there is no cause for concern - and that the Democrats are merely using the disease to make him look bad.
At the funeral for Andrew, his wife has such a high fever that she can hardly get out of the car. "We had to carry her into the house for the wake," Johnson says. That evening, one of the guests has to go to the hospital. The pastor, who held the eulogy, and the woman who prepared Andrew's body also get sick.
On the day of the funeral, the CDC reports the first coronavirus death in Seattle, but it is likely that the first deaths from the disease actually took place in California in early February. The case numbers are low, but that is likely due to the massive problems with testing. On March 6, Trump promises that anyone who wants to be tested for the illness can receive one.
March 9: Christina, a nurse in New York, goes on vacation. The first confirmed coronavirus case is recorded in Jefferson Parish.
The impact is still far away and it is Christina's last day of work before her vacation. The young New Yorker, who asked that only her first name be printed, works in the intensive care unit of a hospital in Queens. She is familiar with the images from China and Italy, but the situation in her own clinic remains relaxed. One patient has tested positive for SARS-CoV-2 and has been isolated in a quarantine room that can only be entered through an airlock. Four additional cases are under observation.
The next day, she boards a plane for Costa Rica, excited about a few days on the beach.
In Jefferson Parish near New Orleans, Parish President Cynthia Lee Sheng is called into her office that same day for a phone call from John Edwards, the governor of Louisiana. "We have the first case," he told her over the phone. "It's in your parish."
Lee Sheng now knows that the wave of infections is just getting started. Mardi Gras came to an end 13 days before, but in Miami, college students are still celebrating Spring Break on the packed beaches while restaurants in Texas remain open. Lee Sheng decides to cancel the St. Patrick's Day parade that was planned for March 15. The parade took place for the first time in 1971 and has become an institution. Many are angry about the decision to cancel it.
March 10: Dorothy Johnson falls ill in Albany. In Baltimore, Randall Harward works to create the perfect mask.
Ten days after burying her brother, Dorothy Johnson reports to the emergency room at Phoebe Putney Memorial Hospital in Albany. "I was having trouble breathing and a high fever," she says. It felt, she says, like she was dying.
After three days, she is sent home and told to self-isolate and learns that she is suffering from COVID-19. Six of her siblings, all of whom attended the funeral, are also sick. Her 51-year-old daughter, meanwhile, is in intensive care with pneumonia in both lungs. She is in a hospital located two hours away because the one in Albany is full.
The virus continues to spread unhindered in Albany for the next 10 days. Hundreds of runners take part in a marathon and a city festival is celebrated. Around 60 million people live in rural regions of America, and they tend to be older and have more chronic health problems than those who live in the cities.
Dougherty County, with its approximately 90,000 people and more than 1,000 coronavirus cases, rapidly climbs to the top of the nationwide statistics for the disease.
Randall Harward quickly comes to the realization that nobody is safe from the virus as he watches the evening news in his Baltimore home, some 788 miles from where Dorothy Johnson is struggling with COVID-19. Harward is a product developer for the sportswear company Under Armour. A doctor from Italy is on the television and the reporter asks him what advice he has for the U.S. His answer, according to Harward's recollection, is essentially: Everything you have done up until now isn't enough. You have to start preparing.
Product developer Randall Harward / Daniel Schmidt/ DER SPIEGEL
The comments hit a nerve with Harward. In challenging situations, he often turns to Hollywood films to get his co-workers moving, he says. "I show my team scenes from 'Apollo 13,' where there was an explosion on board and the crew had little more than a day before they would run out of oxygen," he says. "They had to solve the problem with what was available to them."
Soon, a competition for protective gear will erupt between the various states. And the product developer Randall Harward will be right in the middle of it.
March 13: The number of victims is climbing. In Baltimore, a worker has an idea.
There are now more than 2,000 infections and 50 deaths and Donald Trump declares a national emergency. Many hospitals are suffering from a shortage of face masks and demand for gloves is skyrocketing. There is a lack of protective equipment, ventilators and protective visors. States are doing all they can to find help.
On the previous day, Under Armour received a query from the University of Maryland Medical System, asking if the company could help with the production of masks. Randall Harward quickly comes up with a prototype, but it is rejected by the medical professionals.
But then, a member of Harward's team proposes a design using a lighter material. The mask she comes up with is essentially a single piece of fabric, with the strap being attachable through slits in the fabric cut by a machine. A simply folding technique creates a second layer in front of the nose and mouth. It is quickly approved by medical professionals and Harward's company begins churning out hundreds of thousands of masks.
A few days later, in a teleconference with governors, Trump says: "Respirators, ventilators, all of the equipment - try getting it yourselves."
March 14: The first coronavirus case in New Haven is confirmed.
It's a cold day when Steven Winter turns on his computer in New Haven, Connecticut. Winter is a member of the city council with the Democratic Party, and the first coronavirus case has just been confirmed in his city.
The mayor had already closed down the schools and announced that bars and restaurants can only continue operations at half capacity. The problem, though, is that the people of New Haven feel that the measures are excessive. It is Winter's job to convince them otherwise.
He begins writing the first of many emails, directing readers to the city's website and to its emergency newsletter. He writes about the planned testing regimen and that the number of cases will likely rise once more tests are performed. His underlying message: Take this virus seriously.
March 15: In San Francisco, Aimee Knight is growing concerned for her employees. In Maryland, Melissa Hyatt pushes through a lockdown.
Aimee Knight receives a text message from an alarmed business partner: "Oh nooo." Attached is a link to the announcement that San Francisco will be issuing a strict "shelter in place" order, requiring residents to remain at home and most shops and businesses to close.
Knight is the founder of a medical company in the Bay Area, called Reveal Diagnostics, with 10 employees and four locations between San Francisco and San José. All are outfitted with computer tomography scanners and the company specializes in dentistry diagnostics.
"Suddenly, we had just 10 patients a day instead of 50," Knight would say later. Initially, she spends most of her time on the telephone, trying to reach her insurers, her adviser for personnel issues and her financial adviser. "Do I have to lay off my employees? If yes, what will happen to them? For how long can the company survive?"
At the same time, she is trying to keep her five-year-old son Loxton occupied, since his daycare center closed its doors a few days earlier. And, as irony would have it, she is suffering from a terrible toothache and an appointment to treat it was cancelled because of the pandemic.
Revellers on Bourbon Street in New Orleans on March 15: One of the largest sources of infection / William Widmer/ The NewYorkTimes/ Redux/ laif
The strict lockdown begins in seven counties in California, but it is quickly followed by similar measures across the country. One day later, the state of Maryland closes down bars, restaurants and movie theaters, while the governor of Ohio says: "We are at war." South Dakota, by contrast, allows restaurants to stay open and in Texas, students in many parts of the state continue going to school.
March 18: New York becomes a hotspot. Christina breaks off her vacation.
New York Governor Andrew Cuomo reports 2,382 cases, an increase of around 75 percent over the day before.
Christina, the nurse from Queens, has been following the news from the beach in Costa Rica. With the numbers continuing to skyrocket, she decides to fly home early so she can help out in her hospital.
When she walks into the clinic, she hardly recognizes it. Three wards have been dedicated exclusively to COVID-19 patients and dozens of them have had to be intubated. They have all been sedated, a measure taken to facilitate artificial respiration.
March 23: In San Francisco, Aimee Knight lays off six employees. In Connecticut, Steven Winter freaks out.
New hotspots of infection are emerging in New Jersey, Seattle, Chicago, Detroit and Denver. In Louisiana too, the number of new infections increases exponentially, leading the governor to impose strict restrictions. The next day, a staff member bursts into Jefferson Parish President Cynthia Lee Sheng's office holding a sheet of data. "I didn't want to believe it, but we had a higher death rate than New York," Lee Sheng says.
Meanwhile, in San Francisco, the entrepreneur Aimee Knight has to lay off six of her 10 employees. "We hardly had any customers left, I had no choice," she says. "Hire and fire" may be one of the basic tenets of the American working world, but there's generally a widespread culture of self-help and solidarity at small companies. Knight decides to keep paying for her former employees' health insurance. They may lose their jobs, but at least they won't be uninsured, which is what usually happens to people who are laid off in the U.S.
In New Haven, Connecticut, the town councilman Steven Winter picks up his phone. A black activist from the neighborhood has been pestering him, insisting that African Americans are hardly affected by COVID-19. Winter considers such statements to be extremely dangerous. "That's bullshit," he shouts into the receiver. In fact, there's a good chance the virus is even more dangerous for black Americans due to the widespread prevalence of pre-existing health problems. His neighbor says: "Fuck you, Steven." And hangs up.
More and more Americans are fed up with the lockdowns, including Donald Trump. "Our country wasn't built to be shut down," Trump says at a White House press briefing.
March 24: In Indiana, Aimee Howard loses her job. In Washington, Congress debates a $2 trillion bailout package.
When Aimee Howard's life comes to a halt, she's waiting in a parking lot in her Ford E-350. It's early in the afternoon and, as usual, she's there to take home a bunch of factory workers. But the head of the company also walks out, approaches the driver-side window and tells her that he doesn't need his employees anymore at the moment.
For the first time in her life, Howard is out of work.
Aimee Howard and her husband / Privat
The week before, 3.3 million Americans filed for unemployment benefits. Howard now belongs to a rapidly growing army of people who have lost their jobs due to the coronavirus. At the same time, Congress is debating a bill, the CARES Act, that in addition to aid for companies, would make $560 billion available to private individuals.
A few days later, Aimee Howard is struggling to fill out an online application for Indiana state unemployment benefits. She doesn't know how to answer many of the questions, such as if she is willingly registering as unemployed. "Nobody fired me, but because I was self-employed, I was kind of unemployed," Howard says. Next question. Did she have a full-time job where she worked 45 hours a week? Howard worked maybe half that, so no.
At the end, the website informs Howard that her application has been rejected.
March 26: In Colorado, Bruce Penman defends freedom.
More than 81,000 infected, more than 1,000 dead. Sure, Penman says, from an epidemiological standpoint, the world needs to be put on hold for a year. But that's not how he wants to imagine his country. Not the U.S.
Penman is a 58-year-old businessman from the town of Monument, Colorado, and a Trump voter. Every morning, he turns on the TV and watches "Mornings with Maria" on Fox Business. He then scrolls through Twitter and reads articles on Fox News. But he also keeps an eye on the enemy, such as the New York Times. The company that he and his wife own provides janitorial services, including for the telecom giant AT&T, which is considered essential. Penman is therefore also considered systemically relevant.
In the past few weeks, Penman has had to hire new employees. But he still says: "The government should get out of the way of the free market. People should decide for themselves if they want to isolate."
Penman doesn't think the pandemic will be worse than a slightly more intense flu season. He says the media have been fueling fears of the virus, which, in turn, harms the economy. Penman isn't alone with his criticism. Soon rage against the lockdown measures will spill into the streets.
March 27: The U.S. overtakes China and Italy. In New York, Christina arranges a phone call for a dying man.
There are now more confirmed cases of coronavirus in the U.S. than in China, Italy and Spain, and almost half of those infected live in the state of New York. Hospitals are struggling to keep up with the number of new patients. There are 6,481 people who are so seriously ill with COVID-19 that they have to be admitted overnight. Of those, 1,583 are in intensive care. One of them is being looked after by Christina.
Things aren't looking good for the man. Christina has been taking care of him for three days, changing his diapers, washing him and changing his sheets. She stands at the edge of his bed, between computers, tubes and ventilators, and points her phone screen at her patient. Relatives and friends from Haiti want to say goodbye.
Christina doesn't really have time for such things, but she wants to at least give the relatives a chance to see him one last time. It's a bit of dignity in a situation that otherwise leaves sick people feeling lonely and dehumanized.
In Washington, Trump tweets to the automakers General Motors and Ford: "START MAKING VENTILATORS, NOW!!!!!!"
March 30: In Albany, Dorothy Johnson's daughter is fighting for her life.
The virus is rapidly spreading to rural areas of America. For weeks, hardly anyone has been paying much attention to more remote regions, but now, even Washington has recognized the danger. Deborah Birx, the government's top coronavirus coordinator, advises rural communities to prepare for the pandemic: "No state, no metro area will be spared."
Word doesn't reach Dorothy Johnson, the nurse, in Albany. She herself has been released from quarantine, but her daughter Tonya's condition is only worsening. She's in the hospital, breathing with the help of a machine.
April 3: In Michigan, Roslyn Bouier is fighting for water. Health officials have advised all people to wear masks.
Roslyn Bouier is behind the wheel of her car, bringing several gallons of water to a foodbank in northwestern Detroit.
A spirited, 60-year-old Creole woman with tightly curled hair, Bouier's job as a pastor has led her to monitoring six foodbanks for the needy these days. And when she talks about water, she tends to get loud. Since 2014, Detroit has shut off water to around 141,000 households for not paying their water bills. "How are you supposed to flatten the curve when people can't even wash themselves?" Bouier yells into her mobile phone.
She erupts into bitter laughter over the phone when she thinks of Michigan Governor Gretchen Whitmer. Just a couple of days earlier, Whitmer had tweeted that everyone should regularly wash their hands for at least 20 seconds at a time. "How can you wash your hands when your water has been turned off?" The city of Detroit has announced that water would be temporarily turned on again, but that doesn't go far enough for Bouier.
One of the poorest cities in the U.S., Detroit is also one of the top five hardest hit cities in this crisis. And just like elsewhere in the state of Michigan, the virus has hit African Americans the hardest. Calls for social distancing, Bouier says, are a bad joke for many black people in Detroit because of the small apartments they live in.
April 5: In San Francisco, Aimee Knight is hoping for $150,000. In New York, Christina is struggling to contain the madness.
Aimee Knight, who runs Reveal Diagnostics in San Francisco, has just laid off her last employee. She has done her best to make sure that her people don't have too hard a landing, but she must now shift her focus to preventing the company itself from collapsing - with the help of a bank loan made available through crisis aid.
Aimee Knight had to lay off all her employees. / Privat
The government has earmarked $350 billion for smaller companies in the first aid package.
Knight clicks through the online forms and files her application with the bank on the first day possible.
Based on the size of her company, she is eligible for $150,000, which would take care of her fixed costs for several months. She receives a call that her application is being processed.
"That was a good day," Knight says. "I had the feeling that it would work, that there was hope." She has been waiting ever since.
The first fund has since been emptied and she thinks that her papers might have been lost in the chaos - in part because the world's leading economy doesn't have any emergency infrastructure. It has no Plan B for a pandemic.
In New York, meanwhile, Christina's shift begins at 7 a.m. with yet another fatality, with a man having died in the night of COVID-19-related complications. Christina makes a phone call to get help with removing the man. "You'll have to take him away by yourselves," she is told.
There is a shortage of personnel throughout the clinic, with more and more staff members testing positive for the virus. The parents of some workers are also being treated in the hospital. The protective clothing that Christina puts on at the beginning of her shift has to last for the entire day. She is so busy that she only takes her mask off a single time during her entire 13-hour shift.
A COVID-19 victim in Albany on April 7: "How are you supposed to flatten the curve when people can't even wash themselves?" / Christopher Morris/ VII/ Redux
April 15: Thousands are protesting against the lockdown measures. In Indiana, Aimee Howard begins wondering where she can cut corners.
Aimee Howard read in a New York Times article that the current crisis is comparable to the Great Depression of 1929. She says she immediately thought of her children and began wondering: "Should I start rationing our food just to be on the safe side?"
The Howards are now living off of their savings. To make her April mortgage payment, Aimee used the money she receives for her six adopted children, and she has had to put off paying her gas and electricity bills. Howard says she would feel better if Obama was still president. "The government didn't tell us the truth for several weeks."
April 16: In Jefferson Parish, Cynthia Lee Sheng is starting to get worried. In Georgia, Dorothy Johnson bids farewell to her neighbor.
Jefferson Parish President Cynthia Lee Sheng is standing in front of the administration building where her office is located. Aside from hers and those of a few other staff members, the building is completely empty. For the first time in this crisis, the mayor has good news to report: It looks as though the peak has past - the point at which hospitals were at their fullest.
But there is bad news as well: A doctor tells her that the number of patients coming to the emergency room for reasons other than the coronavirus is beginning to rise, perhaps an indication that people are no longer taking stay-at-home restrictions seriously. And the number of fatalities remains too high, with 261 dead out of 5,306 confirmed infections, says Lee Sheng. "That's still one of the highest rates in the country."
In Albany, the nurse Dorothy Johnson is once again sitting in her yard. Her daughter's funeral was 10 days ago, and her uncle has also since died of COVID-19. Then, her neighbor died, who had mowed his lawn religiously every day until the very end. In a few hours, Johnson says, she'll be heading back to the cemetery.
In several states, angry, flag-waving residents have begun protesting the stay-at-home orders, and Trump turns to Twitter to offer them his support: "LIBERATE MICHIGAN!", he writes, "LIBERATE MINNESOTA!" Finally: "LIBERATE VIRGINIA, and save your great 2nd Amendment. It is under siege!"
Demonstrators at a "Freedom Rally" against the Lockdown in San Diego on April 18: "We're keeping an eye on the situation." / Sandy Huffaker/ Getty Images
April 22: In Indiana, Aimee Howard is happy to receive financial support. Hope returns to New York.
Aimee Howard still hasn't received any state assistance, but her husband has been granted unemployment support of $390 per week from the state of Indiana and another $600 from the government's CARES Act, almost as much as his previous weekly wages.
In Baltimore County, Maryland, Police Chief Melissa Hyatt says she understands that the lockdown scares some people. "We're keeping an eye on the situation," she says.
In New York, by contrast, the situation seems to be relaxing somewhat. More staff have been assigned to the ward where Christina, the nurse from Queens, works. Every time a patient is taken off a ventilator, the nurses ask the hospital technician to play a song over the sound system.
Christina now hears the Beatles song "Here Comes the Sun" four or five times a day.
And back in Seattle, the 35-year-old thought to be America's "Patient Zero" has since recovered.
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