Three months ago, no one knew that SARS-CoV-2 existed. Now the virus has spread to almost every country, infecting at least 446,000 people whom we know about, and many more whom we do not. It has crashed economies and broken health-care systems, filled hospitals and emptied public spaces. It has separated people from their workplaces and their friends. It has disrupted modern society on a scale that most living people have never witnessed. Soon, most everyone in the United States will know someone who has been infected. Like World War II or the 9/11 attacks, this pandemic has already imprinted itself upon the nation’s psyche.

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A global pandemic of this scale was inevitable. In recent years, hundreds of health experts have written books, white papers, and op-eds warning of the possibility. Bill Gates has been telling anyone who would listen, including the 18 million viewers of his TED Talk. In 2018, I wrote a story for The Atlantic arguing that America was not ready for the pandemic that would eventually come. In October, the Johns Hopkins Center for Health Security war-gamed what might happen if a new coronavirus swept the globe. And then one did. Hypotheticals became reality. “What if?” became “Now what?”

The new coronavirus has brought American life to a near standstill, closing businesses, canceling large gatherings, and keeping people at home. All of those people must surely be wondering: When will things return to normal?

The answer is simple, if not exactly satisfying: when enough of the population—possibly 60 or 80 percent of people—is resistant to COVID-19 to stifle the disease’s spread from person to person. That is the end goal, although no one knows exactly how long it will take to get there.

There are two realistic paths to achieving this “population-level immunity.” One is the development of a vaccine. The other is for the disease to work its way through the population, surely killing many, but also leaving many others—those who contract the disease and then recover—immune. “They’re just Teflon at that point,” meaning they can’t get infected again and they won’t pass on the disease, explains Andrew Noymer, a public-health professor at the University of California at Irvine. Once enough people reach Teflon status—though we don’t yet know if recovering from the disease confers any immunity at all, let alone lifelong immunity—normalcy will be restored.

For his entire adult life, and for his entire presidency, Donald Trump has created his own alternate reality, complete with his own alternate set of facts. He has shown himself to be erratic, impulsive, narcissistic, vindictive, cruel, mendacious, and devoid of empathy. None of that is new.

But we’re now entering the most dangerous phase of the Trump presidency. The pain and hardship that the United States is only beginning to experience stem from a crisis that the president is utterly unsuited to deal with, either intellectually or temperamentally. When things were going relatively well, the nation could more easily absorb the costs of Trump’s psychological and moral distortions and disfigurements. But those days are behind us. The coronavirus pandemic has created the conditions that can catalyze a destructive set of responses from an individual with Trump’s characterological defects and disordered personality.

In the emergency-department waiting room, 150 people worry about a fever. Some just want a test, others badly need medical treatment. Those not at the brink of death have to wait six, eight, 10 hours before they can see a doctor. Those admitted to the hospital might wait a full day for a bed.

I am an emergency-medicine doctor who practices in both Manhattan and Queens; at the moment, I’m in Queens. Normally, I love coming to work here, even though in the best of times, my co-residents and I take care of one of New York City’s most vulnerable, underinsured patient populations. Many have underlying illnesses and a language barrier, and lack primary care.

By now, the global timeline of the coronavirus’s development has been well established: The first case reportedly appeared in mid-November; in December, the Chinese government was still attributing hospitalizations to a peculiar form of pneumonia; through January and February, the outbreak began spreading around the world; and its epicenter is today firmly in Europe and the United States.

Throughout, another set of events were occurring here in India. Late last year, Prime Minister Narendra Modi’s Hindu-nationalist government introduced and passed a controversial new law, ostensibly in support of minorities in neighboring countries, that in fact openly discriminated against Muslims and undermined India’s secular foundations. Then, early this year, protests over that new law snowballed into a pogrom in which dozens of people—mostly Muslims—have been killed.

I can pinpoint the exact moment I started feeling off. My partner, Will, and I were on a bike ride on the afternoon of Wednesday, March 18, to escape our apartment and get some exercise. This was back when leaving a New York City apartment to get some exercise was still okay, or at least that’s what we’d read, or at least that’s what we thought? If the coronavirus pandemic has taught us anything, it’s that what is considered dogma today might change tomorrow.

Ten minutes into our bike ride, I was overcome by an intense fatigue. “I think I have to go back,” I said.

Back home, I felt chilled. Took my temperature: 99.1. I’m normally 97.1, but still, not a huge deal. We’d been so careful about wiping down doorknobs, washing our hands, and keeping everyone except for our family out of our apartment. I’d been ambiently worried enough that my 13-year-old son could be a silent carrier of the virus that I’d yanked him out of his public middle school and off the crowded subways four days before Mayor Bill de Blasio pulled the plug– (far too belatedly, in my opinion). I was getting over a urinary-tract infection, so my fever, I thought, must be from that.

When, in January 2016, I wrote that despite being a lifelong Republican who worked in the previous three GOP administrations, I would never vote for Donald Trump, even though his administration would align much more with my policy views than a Hillary Clinton presidency would, a lot of my Republican friends were befuddled. How could I not vote for a person who checked far more of my policy boxes than his opponent?

What I explained then, and what I have said many times since, is that Trump is fundamentally unfit—intellectually, morally, temperamentally, and psychologically—for office. For me, that is the paramount consideration in electing a president, in part because at some point it’s reasonable to expect that a president will face an unexpected crisis—and at that point, the president’s judgment and discernment, his character and leadership ability, will really matter.

The morning before my shift, I try to stay busy with emails, writing, cleaning the house, anything really. If I sit and think about it too long, undisturbed, I get nervous. I’m afraid to go to work, and yet I’m told I must. The flitting anxiety swells as I pull on my scrubs and head to the car. The streets are empty. I drive alone into the epicenter. It peaks when I first step through the door into the jumble of patients in chairs, stretchers, and beds crowded around our cramped workstation, staff jammed together discussing care, writing notes, calling reports. Then I start, surrounded by my colleagues, and am too busy to think about it. The fear is as much for my family and friends as for me. Probably more. I’m a physician who works in an emergency department in Washington, D.C., and the coronavirus is spreading.

In times of upheaval or natural catastrophe, the State Department often advises Americans to avoid some of the world’s poorest nations. When ISIS took over large parts of Syria and Mali descended into civil war, the federal government implored Americans not to go to those countries. One of the pieces of advice it offers to those who insist on visiting them anyway is rather blunt: “Draft a will.”

These warnings speak to a set of assumptions so obvious, they seem almost silly to spell out. America is a rich and stable country. So long as U.S. citizens stay home—or restrict their travel to other developed nations—they are likely to remain safe. Travel warnings tend to flow from north to south, rich to poor, democracy to dictatorship.

HONG KONG—As the number of confirmed coronavirus cases exploded in China early this year, Hong Kong, densely populated and connected to the mainland, was able to largely contain the virus’s spread. A combination of community response and official action held back the pace of infections, with the number of patients discharged from treatment until recently outpacing those remaining in the hospital. This month, civil servants on work-from-home orders were allowed to return to their office. Soon, private businesses started to do the same. Commuters began to refill the buses and subways. Bars and restaurants left largely vacant for weeks saw patrons remerge. As reports of outbreaks abroad worsened, Hong Kong appeared to be slowly returning to form.