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July 3 - August 13, 2021
It is an intensely modern city, but like all of China, it sits atop a mountain of trauma.
Graham and McLellan designed the modified proteins within a day after downloading the sequence for SARS-CoV-2. The key accelerating factor was that they already knew how to alter the spike proteins of other coronaviruses. On January 13, they turned their modified spike protein over to Moderna, for manufacturing. Six weeks later, Moderna began shipping vials of vaccine for clinical trials. Typically it takes months to years, if not decades, to go from formulating the vaccine to making a product ready to be tested, a process that privileges safety and cost over speed. The FDA required another
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Markel compared each intervention to a slice of Swiss cheese; one layer by itself was too riddled with holes to be effective, but a layer upon a layer made a profound difference. Cities that acted early, for an extended period of time, did far better in terms of cases and deaths. “Early, layered, and long” was the formula for success.
Why not send them everywhere? He learned that the CDC makes tests, but not at scale. For that, you have to go to a company like Roche or Abbott—molecular-testing powerhouses which have the experience and capacity to manufacture millions of tests a month. The CDC, Matt realized, was “like a microbrewery—they’re not Anheuser-Busch.”
More than a month had passed since the first known patient arrived in the U.S., and in that time the CDC had conducted fewer than 500 tests. South Korea, which had its first case one day before the U.S., had already tested 65,000 people. China was reportedly testing 1.6 million per week. The United States remained blind to the spread of the contagion, unable to fight what it couldn’t see.
For many, March 12 was a moment of dismal clarity. The stock market suffered its biggest drop since the Black Monday crash of 1987. The Federal Reserve Bank of New York announced that it would generate $1.5 trillion in short-term loans to calm the financial markets. In Washington, Speaker Nancy Pelosi and Treasury Secretary Steven Mnuchin were about to conclude their negotiation of the $2.2 trillion CARES Act. It wouldn’t be nearly enough.
Social scientists have pointed out the decline of membership in clubs, unions, civic organizations, scouting, and churches; the bonds of community have been fraying for decades as people retreat into their virtual lives and politics becomes the main source of identity. Theater still brings us together. The experience can’t be digitized. Being together, hearing a laugh or a sob caught in the throat, is solidifying. And when the house lights come on and we stand and look into each other’s faces, there’s acknowledgment that our feelings are shared and we’ve melded, at least for that moment, into
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They knew a moral cost was exacted, along with the physical and emotional toll. The people in the blue cotton scrubs were carrying the city’s guilt along with its grief. That’s part of what made them heroic.
It was a national problem, but there would be no national plan. The pandemic was broken into fifty separate epidemics and dumped into the reluctant embrace of the surprised and unprepared governors.
“Minorities are less likely to be tested, which means they might go back home, where they have the capability to infect their entire community.” People of color were also more likely to be exposed because so many are essential workers. “Only one in five African-Americans can work remotely,” she said. “Only one in six Hispanics can work from home. So they were having to go out into the community, face-to-face with the virus.”
On April 3, the CDC finally concluded that masks were vital in slowing the spread of infection. It was the last opportunity to do something meaningful to curb the pandemic.
Redfield admitted that the sudden reversal by the CDC was awkward and confusing. “When you have to change the message, the second message doesn’t always stick.” The president made things worse when he announced the new mask advisory in a Coronavirus Task Force briefing. “This is voluntary,” he stressed, adding, “I don’t think I’m going to be doing it.”
In part because of the president’s courtship of the virus, millions of people followed his example, giving the pandemic access to new communities, infecting new families, endangering healthcare workers, prolonging unemployment, sabotaging efforts to open the economy, and causing untold numbers of people to die.
An enlightening natural experiment occurred in Kansas, when the governor issued an executive order in July to wear masks in public but allowed counties to opt out. It was as if Kansas were performing a clinical trial on itself. Within two months, infections in mask-wearing counties had fallen by 6 percent; elsewhere, infections rose 100 percent.
In that conflict, 53,000 American soldiers died in combat, and 63,000 by disease. Howard Markel estimates that the total number of Americans who died of the 1918 pandemic was between 500,000 and 750,000; the average life expectancy in the U.S. fell by nearly twelve years.
In Minnesota, African Americans make up only 6 percent of the population but 19 percent of confirmed cases of Covid-19; 5 percent of the population was Hispanic, but they made up 17 percent of the cases. Added to the list of comorbidities leading to racial disparities in health outcomes was the frustration of minority citizens with constant reforms that never led to meaningful improvements in their lives. Incrementally, there was progress. Minnesota attorney general Keith Ellison took over the George Floyd case. Ellison was the first Black person elected to the U.S. House of Representatives
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The protests called to mind the Liberty Loan parades in 1918, which served as potent vectors for the killer flu. And yet, in 2020, the marches did not appear to be significant drivers of transmission. “We tested thousands of people,” Michael Osterholm, the director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told me. “We saw no appreciable impact.” One study found lower rates of infection among marchers than in the surrounding community. Epidemiologists concluded that mask-wearing and being outdoors protected the marchers.
And yet, women voted for him at about the same rate as they did for Mitt Romney in the election prior to that—actually voting against the first woman presidential nominee in favor of a sexual predator in the #MeToo era. We thought that blue-collar workers and those without college degrees would be repelled by a plutocrat who didn’t pay his contractors and left lenders holding his bankrupt properties, and yet he carried non-college graduates by the widest margin in thirty-six years. We thought religious people would be outraged by his impiety and agnosticism, not to mention his divorces and
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Gaining such knowledge might give science a head start on creating vaccines for diseases that could evolve in nature, but it’s also possible that a slip in the lab would cause the very pandemics the research is meant to deter.
By the end of the year, the United States had more cases and more deaths than any other country. The actual tally will never be known, but a retrospective serological study estimated that 35 percent of Covid deaths went unreported. Total deaths increased by 15 percent, making 2020 the deadliest year in recorded U.S. history. The figure that will haunt America is that the U.S. accounts for about 20 percent of all the Covid fatalities in the world, despite having only 4 percent of the population.
He boasted, “If I can get better, anybody can get better.” More than a thousand Americans died that day.
