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?”

For Geoff Frost, the first sign of the coronavirus culture war came last weekend on the golf course. His country club, located in an affluent suburb of Atlanta, had recently introduced a slew of new policies to encourage social distancing. The communal water jugs were gone, the restaurant was closed, and golfers had been asked to limit themselves to one person per cart. Frost, a 43-year-old Democrat, told me the club’s mix of younger liberals and older conservatives had always gotten along just fine—but the guidelines were proving divisive.  

At the driving range, while Frost and his like-minded friends slathered on hand sanitizer and kept six feet apart, the white-haired Republicans seemed to delight in breaking the new rules. They made a show of shaking hands, and complained loudly about the “stupid hoax” being propagated by virus alarmists. When their tee times were up, they piled defiantly into golf carts, shoulder to shoulder, and sped off toward the first hole.  

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 UC 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. (It may also turn out to be the case that people who are immune to the disease can still pass it on under certain circumstances.)*

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.

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.

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 coronavirus pandemic in the United States has reignited long-standing debates about the relationship between freedom and economic and personal security. After barely a week of a partial lockdown in many parts of the country, Donald Trump and others are now complaining that overly risk-averse public-health officials are threatening to strangle the economy. Trump insists that excessive caution is counterproductive and dangerous: “THE CURE CANNOT BE WORSE (BY FAR) THAN THE PROBLEM,” he tweeted on March 22. During a briefing at the White House the next day he added: “Our country wasn’t built to be shut down. America will again, and soon, be open for business.”

Conservatives have supported and extended Trump’s position. Writing in The Washington Post on March 25, the columnist Gary Abernathy claimed that both the stimulus plan passed by the Senate and the shelter-at-home proclamations had completed the nation’s march to socialism begun “incrementally decades ago.” “The delicate balance between freedom and risk was less than an afterthought as our economy was gutted in a matter of days,” Abernathy wrote:

When the coronavirus pandemic now sweeping the world was localized in China in January, many people argued that China’s authoritarian system was blocking the flow of information about the seriousness of the situation. The case of Li Wenliang, a physician punished for blowing the whistle early on and who subsequently died from the disease, was seen as emblematic of authoritarian dysfunction.

The situation now looks less rosy for democratic government. Europe now faces a larger disease burden than China, with Italy alone exceeding the number of deaths officially reported in China, despite having one-twentieth the population. It turns out that the leaders of many democracies felt similar pressures to downplay the dangers of the epidemic, whether to avoid injuring the economy or to protect their personal interests. This was true not just of Brazil’s Jair Bolsonaro or Mexico’s Lopez Obrador, but also of President Donald Trump, who until mid-March kept insisting that the U.S. had the disease under control and that the epidemic would disappear shortly. This explains why the U.S. lost two months in preparing for the onslaught, creating persistent shortages of testing kits and medical supplies. China, meanwhile, is reporting a leveling off of new cases. Chinese students in Britain have reportedly been astonished at the lax approach taken by Boris Johnson’s government.

Dear Therapist,

I know that everyone is going through loss during the coronavirus pandemic, but in the midst of all this, my beloved father died two weeks ago, and I’m reeling.

He was 85 years old and in great pain from complications due to congestive heart failure. After years of invasive procedures and frequent hospitalizations, he decided to go into home hospice to live out the rest of his life surrounded by family. We didn’t know whether it would be weeks or months, but we expected his death, and had prepared for it in the time leading up to it. We had the conversations we wanted to have, and the day he died, I was there to kiss his cheeks and massage his forehead, to hold his hand and say goodbye. I was at his bedside when he took his last breath.