The manslaughter of 200,000

A new book chronicles the confusion, incompetence, and devastation of a plague in America

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The 200,000th American will have died from the coronavirus in the coming days. Seven months after Donald Trump told Bob Woodward that he knew Covid-19 was “deadly stuff” but chose to “play it down,” 66 times more Americans have died of this plague than perished in the 9/11 attacks.

We all know we are living through what will one day be history — big, epic history, in many ways shameful history. And some writers are seeking to draft that history even as we live it.

Today The.Ink is bringing you the first glimpse of a devastating new book, “Unprepared: America in the Time of Coronavirus.” The book, edited and compiled by Jon Sternfeld, with an introduction from Timothy Egan, isn’t what you may think — a too-soon retelling of the pandemic. Rather, it’s a raw, diaristic, primary-source-only chronicle of America’s descent into a historic plague. Reading the passage below, I was struck by how much I have forgotten — especially the early, ignorant days of the pandemic in which most of us knew little, and many people in power were asleep on the job, and some people did know things and tried to warn us.

What follows, drawn from public speech over three weeks in January and February, is a reminder that this plague in America is first and foremost a political disaster. It could have gone another way. Instead, it went the way of massive manslaughter. The virus had found in the decaying United States an ideal host body.

“Unprepared,” which is excerpted here with permission, will be published on September 22 by Bloomsbury Publishing.

“Unprepared: America in the Time of Coronavirus”

The pages that follow are the tick-tock of a tragedy, perhaps the greatest collapse of American society in so short a time, ever. You can read it and weep — for the dead, those family and friends you thought had ten more good years but instead did not have ten days. You can read it and rage — at the idiocy, the indifference, the defiance of science. You can read it and feel humbled, even powerless, at the predatory power of a new virus to bring down the human species. Or you can read it and learn. It’s all here without filter, the words of people who tried to save us from ourselves, and the words of those who betrayed us. We know what happened. There’s no need to wait for the forensics from future historians. Why it happened on such a scale is the harder, more worthwhile question. 

How did a lethal pandemic, an economic depression, and civil unrest, all of historic magnitude, come together at a time when America was supposedly great again? It’s tempting to quote Hemingway’s explanation on going broke: “Two ways. Gradually and then suddenly.” But that isn’t quite expansive enough. The granularity in these pages tells the story of the gradual and sudden, both symptoms of something much larger. There’s no master narrative in this tale of a nation brought to its knees, no voice of God in the telling. It is us, in a tangle of contradiction, the leaders and followers, the experts and the crackpots, told without comment.  — Timothy Egan


The Arrival: Dec. 31 - Jan. 30

January 21, 2020 

National Public Radio (NPR): The World Health Organization will convene an emergency meeting tomorrow about a virus that has infected almost 300 people, most of them in China. It’s a type of virus known as a coronavirus. 

Centers for Disease Control and Prevention (CDC): Coronaviruses are a large family of viruses, some causing respiratory illness in people and others circulating among animals including camels, cats, and bats. Rarely, animal coronaviruses can evolve and infect people and then spread between people…When person-to-person spread has occurred with SARS and MERS, it is thought to happen via respiratory droplets with close contacts, similar to how influenza and other respiratory pathogens spread. The situation with regard to 2019-nCoV is still unclear. 

Korea Centers for Disease Control, South Korea: As of today, 21 January 2020, the first confirmed case of novel coronavirus, currently receiving treatment in isolation, is stable with no signs of pneumonia. In-depth epidemiological investigation on the case has been undertaken, and the contacts of the patient are under active monitoring. According to the investigation, there are 44 contacts who are either passengers or airport staff. Out of 44 contacts, nine of them have left the country and the rest are under active monitoring through local health facilities. They will be monitored for 14 days from the last day of contact with the patient and receive a call from health authority on first, second, and seventh day for fever or respiratory symptoms. If showing any signs or symptoms of illness, they will be isolated and tested. 

CDC: The Centers for Disease Control and Prevention today confirmed the first case of 2019 Novel Coronavirus (2019-nCoV) in the United States in the state of Washington. 

Governor Jay Inslee (WA): From November to January 15, we had a Washington State resident, a man in his 30s, who was in Wuhan, China . . . On January 20, samples were confirmed by the CDC in Atlanta that, in fact, he carried the novel coronavirus, and he was hospitalized. 

CDC: While originally thought to be spreading from animal-to-person, there are growing indications that limited person-to-person spread is happening. It’s unclear how easily this virus is spreading between people. 

Gov. Inslee (WA): This is certainly not a moment for panic or high anxiety. It is a moment for vigilance. 

January 22 

President Donald Trump: We have it totally under control. It’s one person coming in from China, and we have it under control. It’s going to be just fine. 

January 23 

Dr. Sylvie Briand, Director, Global Infectious Hazard Preparedness, WHO: Currently, we use the name of 2019 Coronavirus, but we will convene a committee to decide on the official name. 

Dr. Michael Ryan, Executive Director, Health Emergencies, WHO: The data we presented was referring to what we were reported [up] to today, which was 291 cases. 

Dr. Tedros Adhanom Ghebreyesus, Director-General, WHO: Make no mistake. This is an emergency in China, but it has not yet become a global health emergency. It may yet become one. 

January 26 

Ma Xiaowei, Minister, National Health Commission, China: Experts from the World Health Organization are invited to visit Wuhan, and experts from Hong Kong, Macao, and Taiwan are arranged to conduct field trips to Wuhan. After an assessment, the World Health Organization has announced that the epidemic situation will not be identified as a “public health emergency of international concern” for the time being . . . An epidemic is an order, and prevention and control is our responsibility. 

January 27 

Mayor Zhou Xianwang, Wuhan, China: We understand that the public is unsatisfied with our information disclosure. On one hand, we failed to disclose relevant information in a timely manner; on the other, we did not make sufficient use of valid information to improve our work. As for the late disclosure, I hope the public can understand that it’s an infectious disease, and relevant information should be released according to the laws. As a local government, we can only disclose information after being authorized . . . It’s unprecedented to lockdown a city with more than 10 million people in human history. However, faced with the current situation, we’ve closed the city gate and possibly besieged the virus within the city. We might leave a bad name in history. 

Dr. Scott Gottlieb, Former Commissioner, Food and Drug Administration (FDA): Global spread appears inevitable. So too are the emergence of outbreaks in the U.S., even if a widespread American epidemic can still be averted. When pockets of the outbreak arrive on our shores, we shouldn’t have undue panic. But we need to be ready. 

Bavarian Ministry of Health, Germany: A man from the district of Starnberg has been infected with the novel coronavirus . . . the patient is clinically in good condition, monitored medically and isolated. The close contact persons are informed in detail and informed about possible symptoms, hygiene measures and transmission channels. 

January 28 

President Xi Jinping, China: The virus is a devil and we cannot let the devil hide. China will strengthen international cooperation and welcomes the WHO participation in virus prevention . . . China is confident of winning the battle against the virus. 

Senator Elizabeth Warren (MA): With well over 2,000 people infected and a rising death toll, China has restricted the movement of 56 million people . . . Instead of building capacity to combat these problems, Donald Trump has deprioritized global health security and risked putting us on our heels in a crisis. Trump has repeatedly tried to nickel and dime federal programs essential to health security, proposing billions of dollars in cuts so drastic that even a leading House Republican thought they would leave Americans vulnerable. Trump eliminated the key position that coordinates global health security across the many federal agencies that work to keep us safe. 

Dr. Michael Osterholm, Director, Center for Infectious Disease Research and Policy, University of Minnesota: The idea that we could create this seal around China is just totally unrealistic. I think at that point, you have to assume we’re going to see widespread transmission around the world. 

Former Vice President Joe Biden: The outbreak of a new coronavirus, which has already infected more than 2,700 people and killed over 80 in China, will get worse before it gets better. Cases have been confirmed in a dozen countries, with at least five in the United States. There will likely be more . . . I am concerned that the Trump administration’s shortsighted policies have left us unprepared for a dangerous epidemic that will come sooner or later. 

Federal Open Market Committee, the Federal Reserve: The threat of the coronavirus, in addition to its human toll, had emerged as a new risk to the global growth outlook, which participants agreed warranted close watching. 

January 30 

Dr. Tedros, Director-General, WHO: I’m declaring a public health emergency of international concern over the global outbreak of novel coronavirus. In total, there are now 7,834 confirmed cases, including 7,736 in China, representing almost 99% of all reported cases worldwide. 170 people have lost their lives to this outbreak, all of them in China. We must remember that these are people, not numbers . . . WHO doesn’t recommend limiting trade and movement. We call on all countries to implement decisions that are evidence-based and consistent. 

Prime Minister Giuseppe Conte, Italy: We have two confirmed cases of coronavirus in Italy. We have already prepared all the precautionary measures to isolate these two cases. There is no reason to create social alarm or panic. 

Wilbur Ross, U.S. Secretary of Commerce: I don’t want to talk about a victory lap over a very unfortunate, very malignant disease. But the fact is, it does give businesses yet another thing to consider when they go through their review of their supply chain. On top of all the other things, you have SARS, you have the African swine virus there, now you have this. It’s another risk factor that people need to take into account . . . So, I think it will help accelerate the return of jobs to North America — some to the US, probably some to Mexico as well. 

CDC: The 2019 Novel Coronavirus (2019-nCoV) has spread between two people in the United States, representing the first instance of person-to-person spread with this new virus here. Previously, all confirmed U.S. cases had been associated with travel to Wuhan, China, where an outbreak of respiratory illness caused by this novel coronavirus has been ongoing since December 2019. However, this latest 2019-nCoV patient has no history of travel to Wuhan, but shared a household with the patient diagnosed with 2019-nCoV infection on January 21, 2020. 

President Trump: We only have five people. Hopefully, everything’s going to be great. They have somewhat of a problem, but hopefully, it’s all going to be great. But we’re working with China, just so you know, and other countries very, very closely. So it doesn’t get out of hand. 

Dr. Tedros, Director-General, WHO: There are now 98 cases in 18 countries outside China, including eight cases of human-to-human transmission in four countries, Germany, Japan, Vietnam, and the United States of America. So far, we have not seen any deaths outside China, for which we must all be grateful . . . We don’t know what sort of damage this virus could do if it were to spread in a country with a weaker health system. 

Dr. Li, Wuhan Central Hospital, China: After receiving the new coronavirus pneumonia patients, I started to have cough symptoms on January 10, fever on the 11th, and hospitalization on the 12th...In the ward, I also saw a lot of netizens’ support and encouragement to me and my mood will be easier. Thank you for your support. I would like to clarify in particular that I have not had my license revoked. Please rest assured that I will actively cooperate with the treatment and strive to be discharged early! 

THE EMERGENCY: JANUARY 31–MARCH 14

January 31 

Alex Azar, Secretary of Health and Human Services (HHS): I have today declared that the coronavirus presents a public health emergency in the United States . . . In accordance with the declaration, beginning at 5:00 p.m., Eastern Standard Time; Sunday, February the 2nd, the United States government will implement temporary measures to increase our abilities to detect and contain the coronavirus proactively and aggressively . . . The President has signed a presidential proclamation temporarily suspending the entry into the United States of foreign nationals who pose a risk of transmitting the 2019 novel coronavirus. As a result, foreign nationals, other than immediate family of U.S. citizens and permanent residents, who have traveled in China within the last 14 days will be denied entry into the United States for this time. 

February 1 

Salvador Illa, Health Minister, Spain: Yesterday, after 10 pm, the National Center for Microbiology confirmed that one of the five samples from La Gomera has tested positive . . . The person who has tested positive is isolated and receiving medical attention. We are in contact with the Minister of Health of the Canary Islands, Teresa Cruz, and we want to convey a message of confidence in the national health system. 

Dr. Li Wenliang, Wuhan Central Hospital, China: Today the nucleic acid test result is positive, the dust has settled and the diagnosis has finally been confirmed. 

February 2 

Governor Andrew Cuomo (NY): We take a situation like this very seriously. We understand the density of New York, the complexity of New York. Whatever happens internationally it winds up at our doorstep relatively quickly. So we’ve been through situations like this before. We’re very proactive. I don’t take anything for granted. Precaution is always the best practice. 

President Trump: We pretty much shut it down coming in from China. But we can’t have thousands of people coming in who may have this problem, the coronavirus. So, we’re going to see what happens, but we did shut it down, yes. 

Donald G. McNeil Jr., science and health reporter, New York Times: The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe, according to many of the world’s leading infectious disease experts. The prospect is daunting. A pandemic—an ongoing epidemic on two or more continents—may well have global consequences, despite the extraordinary travel restrictions and quarantines now imposed by China and other countries, including the United States. 

February 4 

CNN: The total number of confirmed cases in China stands at 20,438 as of today, an increase of 3,235 from the previous day — a jump of over 18%. The death toll is now at 425 in mainland China, an increase of around 65 from Sunday. The numbers have been jumping by huge margins in recent weeks. Less than a month ago, the first coronavirus patient died in China on January 9. By January 28, the death toll had topped 100; by January 31 it topped 200; the very next day, February 1, it topped 300. Today it topped 400. 

President Trump: Protecting Americans’ health also means fighting infectious diseases. We are coordinating with the Chinese government and working closely together on the coronavirus outbreak in China. My administration will take all necessary steps to safeguard our citizens from this threat.

February 5 

Dr. Nancy Messonnier, Director, National Center for Immunization and Respiratory Diseases (NCIRD), CDC: The total number of confirmed positives in the United States remains at 11. Right now, 206 persons under investigation or PUIs have tested negative for infection with this Novel virus . . . This is the beginning of what could be a long response. Right now we’re aggressively intervening to contain introduction into the United States. 

Jennifer Nuzzo, Associate Professor, Johns Hopkins Center for Health Security: All of the evidence we have indicates that travel restrictions and quarantines directed at individual countries are unlikely to keep the virus out of our borders. Simply put, the virus is spreading too quickly and too silently and our surveillance is too limited for us to truly know which countries have active transmission and which don’t. 

February 7 

President Trump: Just had a long and very good conversation by phone with President Xi of China. He is strong, sharp, and powerfully focused on leading the counterattack on the Coronavirus . . . he will be successful, especially as the weather starts to warm & the virus hopefully becomes weaker, and then gone. Great discipline is taking place in China, as President Xi strongly leads what will be a very successful operation. 

Alex Azar, Secretary of HHS: Although the virus represents a potentially very serious public health threat, and we expect to continue seeing more cases here, the immediate risk to the American public is low at this time. 

U.S. Bureau of Labor Statistics, Department of Labor: Nonfarm payroll employment rose by 225,000 in January 2020. Construction, health care, and transportation and warehousing added jobs over the month. Average hourly earnings of all employees on private-sector payrolls rose by 7 cents or 0.2 percent in January. Over the year, hourly earnings have risen by 3.1 percent. 

CNBC: Economists surveyed by Dow Jones were looking for payroll growth of 158,000 and the jobless rate to stay at 3.5%, its lowest in more than 50 years. 

Wuhan Central Hospital: In the fight against the pneumonia epidemic of the new coronavirus infection, our hospital’s ophthalmologist, Li Wenliang, was unfortunately infected. He passed away after all the efforts we’ve taken to resuscitate him. We deeply mourn his passing. 

Monday, February 10 

CDC: CDC today confirmed another infection with 2019 Novel Coronavirus (2019-nCoV) in the United States that was detected in California. The patient who was under a federal quarantine order recently returned from Wuhan, China, where an outbreak of respiratory illness caused by this novel coronavirus has been ongoing since December 2019. This brings the total number of 2019-nCoV cases in the United States to 13. 

President Trump: They’re working hard. Looks like by April, in theory when it gets a little warmer, it miraculously goes away. I hope that’s true, but we’re doing great in our country. China, I spoke with President Xi and they’re working very, very hard and I think it’s going to all work out fine. 

Dr. Tedros, Director-General, WHO: There’ve been some concerning instances of onward #2019nCoV spread from people with no travel history to China. The detection of a small number of cases may indicate more widespread transmission in other countries; in short, we may only be seeing the tip of the iceberg. 

President Trump: I had a long talk with President Xi . . . two nights ago and he feels very confident. He feels very confident. And he feels that, again, as I mentioned, by April or during the month of April, the heat, generally speaking, kills this kind of virus. 

February 11 

Dr. Tedros, Director-General, WHO: First of all, we now have a name for the disease and it is Covid-19 and I will spell it: C-O-V-I-D-19. Co—C- O—stands for corona, as you know; V-I stands for virus; D for disease, so Covid . . . We had to find a name that did not refer to a geographical location, an animal, an individual or group of people and which is also pronounceable and related to the disease. 

Dr. Briand, Director, Global Infectious Hazard Preparedness, WHO: Scientists have done some phylogenetic studies and they have identified that this virus is very similar to a coronavirus that can be found in bats. But when they did some sampling in the Wuhan Seafood Market, they didn’t find so many bats and so it’s very likely that there is an intermediate host that has been contaminated. 

Princess Cruises: Princess Cruises confirms an announcement, from the Japanese Ministry of Health, of 39 new positive cases of Coronavirus onboard Diamond Princess. We are following guidance from the Japan Ministry of Health on plans for disembarkation protocols to provide medical care for these new cases. 

Dr. Tedros, Director-General, WHO: The number of cases in the rest of the world [besides China] is less than 400 and there is only one death. That’s a window of opportunity so I’m reminding: there is time, the time is ticking and time is of the essence in this outbreak. 

Dr. Michael Ryan, Executive Director, Health Emergencies, WHO: If fires are left unchecked, they can burn down a lot of the forest and one can speculate how far a fire like this can burn. 


“Unprepared: America in the Time of Coronavirus” will be released on September 22 by Bloomsbury Publishing.

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Photo: Andrew Theodorakis / Getty Images