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?”

On March 13, President Donald Trump promised Americans they would soon be able to access a new website that would ask them about their symptoms and direct them to nearby coronavirus testing sites. He said Google was helping.

That wasn’t true. But in the following days, Oscar Health—a health-insurance company closely connected to Trump’s son-in-law, Jared Kushner—developed a government website with the features the president had described. A team of Oscar engineers, project managers, and executives spent about five days building a stand-alone website at the government’s request, an Oscar spokesperson told The Atlantic. The company even dispatched two employees from New York to meet in person with federal officials in Washington, D.C., the spokesperson said. Then the website was suddenly and mysteriously scrapped.

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.

Updated at 4:40 ET on March 30, 2020.

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.)*

On the surface, the American COVID-19 testing regime has finally hit its stride. Over the past five days, the states have reported a daily average of 104,000 people tested, according to data assembled by the COVID Tracking Project, a volunteer collaboration incubated at The Atlantic. Today, the U.S. reported that 1 million people have been tested for the coronavirus—a milestone that the White House once promised it would hit the first week of March.

But things are not going as smoothly as the top-line numbers might suggest. Our reporting has unearthed a new coronavirus-testing crisis. Its main cause is not the federal government, nor state public-health labs, but the private companies that now dominate the country’s testing capacity. Testing backlogs have ballooned, slowing efficient patient care and delivering a heavily lagged view of the outbreak to decision makers.

Donald Trump is presiding over one of the worst calamities to befall the nation in living memory, and anyone who has followed his response since the coronavirus morphed from a worrisome outbreak in a Chinese province into a global pandemic knows the truth: Trump’s response has been disastrous. It’s no wonder that just a couple of weeks ago, a writer in this magazine concluded that “the Trump presidency is over.”

It seemed reasonable, logical. But once the polls started coming in, it turned out the American public—at least for now—disagrees. Despite his well-documented incompetence and lies, Trump is now enjoying some of the highest approval ratings of his presidency. Even more baffling, a majority of Americans—as many as 60 percent in one poll—think he’s doing a good job tackling the crisis.

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.

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.  

In the United States, COVID-19 cases top 120,000—now the most of any country in the world—and deaths surpass 2,000. Many states are acting to contain viral spread through mass closures of businesses and orders to stay inside the home. However, in the absence of a national-level order, such measures are not uniform across the whole country, and Americans can still travel from one area to another—potentially carrying COVID-19 from “hot zones” such as New York and Seattle to low-risk areas.

Contrast that with China, once the epicenter of COVID-19 (the novel coronavirus disease), which on March 19 reported no new locally transmitted cases of the disease for the first time since the onset of the pandemic. Just a month ago, thousands of new cases were appearing in mainland China each day, and China’s Hubei province was considered the highest COVID-19 transmission zone on the planet. China’s success is the result of aggressive, far-reaching measures: About 60 million people were locked down in the cordon sanitaire, during which movement was restricted in and out of Wuhan and the larger Hubei province. Many people infected with or exposed to COVID-19 in these same areas were forcibly removed from the population and put into isolation centers for weeks. Public transportation was shut down. Armed guards, citizen informers, and high-tech surveillance helped ensure compliance with mass quarantines. The trade-off, of course, was between containing a fast-moving novel virus and wholesale violation of personal freedoms, including movement and privacy.

Updated at 5:44 ET on March 31, 2020.

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.