Reporter's Notebook

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 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.

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.

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.

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.

In 1940, in the second month of the Blitz, the announcer of a BBC Radio program called Children’s Hour told listeners that they were about to hear the most important episode in the show’s history: Princess Elizabeth was going to address the children of the empire.

Fourteen years old, her voice clear and piping, Elizabeth told the evacuated children of England that she, too, was away from her family: “My sister, Margaret Rose, and I feel so much for you, as we know from experience what it means to be away from those we love most of all.” She reminded England’s children that they were engaged in something noble: “We are trying, too, to bear our own share of the danger and sadness of war.” But more important, “we know—everyone of us—that in the end all will be well.”

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.

Hello fellow New Yorkers. You want to leave. So badly. I know. Me too. But don’t. Don’t do it.

It is absurd at this point that it’s even your choice. The bridges should be closed to all but essential traffic. The airports should be shuttered. Instead, Hertz is still renting cars at its 17 Manhattan locations, AirBnB is listing “Corona free” homes in New Jersey, and airlines are offering (apocalyptically cheap) tickets from all three New York airports to Anywhere But Here.

I know all that because I spent one morning this week Googling a dozen possible escapes, in a moment of claustrophobia and panic. I share 900 square feet with two kids and a dog. My wife is a physician who is still seeing patients. And even though I trust her precautions and protocols, I can’t shake the feeling of dread. Mixed in with the uncertainty is the certainty that everything is going to get much, much worse, as the cases spike and people I love or know or admire begin to die. My impulse is to do something—to move, to flee. I’m sure virtually everyone else in the city feels the same way.

One of the few mercies during this crisis is that, by their nature, individual coronaviruses are easily destroyed. Each virus particle consists of a small set of genes, enclosed by a sphere of fatty lipid molecules, and because lipid shells are easily torn apart by soap, 20 seconds of thorough hand-washing can take one down. Lipid shells are also vulnerable to the elements; a recent study shows that the new coronavirus, SARS-CoV-2, survives for no more than a day on cardboard, and about two to three days on steel and plastic. These viruses don’t endure in the world. They need bodies.

But much about coronaviruses is still unclear. Susan Weiss, of the University of Pennsylvania, has been studying them for about 40 years. She says that in the early days, only a few dozen scientists shared her interest—and those numbers swelled only slightly after the SARS epidemic of 2002. “Until then people looked at us as a backward field with not a lot of importance to human health,” she says. But with the emergence of SARS-CoV-2—the cause of the COVID-19 disease—no one is likely to repeat that mistake again.