‘The Reality Is, It’s Incredibly Hard’ Preexisting staffing shortages and dismal pay are colliding with a crisis that’s testing the limits of the nurses and health aides caring for the sick and elderly. by BRYCE COVERT

Shelly Hughes’s typical day starts at 9 p.m. She’s used to not wanting to get out of bed and go to work, but now the feeling is much stronger. Her son, home from college because of social-distancing measures, tells her every day to quit her job. Lately her husband takes extra care to set out her scrubs and make sure that she has coffee. “He is just a little bit extra affectionate,” she told me. He reminds her to wash her hands and avoid people who cough. It’s “like he’s sending me off to war or something.”

In a sense, he is. Hughes is a nursing-home aide in Washington State, and her patients are among the most vulnerable to COVID-19. Hughes’s work has always been intimate, and hard: She helps her patients use the bathroom, changes their incontinence products, and repositions her patients so that they don’t get bedsores. She comforts them when they are worried and unable to sleep. But now she’s responsible for keeping them—and herself—safe in spite of staffing and equipment shortages that put both patients and health-care workers at risk.

“It is physically demanding, and it’s emotionally taxing,” Hughes said. The 50-year-old has “pretty bad asthma” and an autoimmune disorder, but, like her mother, she feels called to care work—even though her health issues put her at increased risk of contracting and suffering from COVID and the pay is barely enough to cover her bills. She tries not to let the fear consume her thoughts.

Only when her shift is over at 7 a.m. and she’s driving home, along empty, “eerie” streets, does she let her mind wander: What the hell am I doing? she thinks to herself. Oh my God, this is scary.

Nursing-home employees, nurses, and home health-care workers—the majority of whom are women—are at the forefront of the coronavirus crisis, and they have long been underpaid, overworked, and under-resourced. Registered nurses can expect to make less than $72,000 annually at the median; home health- and personal-care aides earn just $24,000 a year. A quarter of home care workers are uninsured.

These phenomena are common in majority-female industries. Women dominate 23 of the 30 lowest-paying jobs in America. In occupations where women make up more than half of the workforce, weekly compensation is roughly 15 percent lower than for jobs predominantly filled by men. In fact, as soon as women flock to any given profession, pay drops. According to Ariane Hegewisch, program director of employment and earnings at the Institute for Women’s Policy Research, care work, which “traditionally was done in the home for free by women” is particularly undervalued; these jobs pay less than others that require similar levels of education and skill.

The fact that these jobs compensate people poorly and burn them out quickly means that health-care workers have been in short supply across the United States for years. Now, it has deepened the coronavirus crisis, as staffing shortages are colliding with a huge increase in patients. “Nobody wants to stay in these jobs because you don’t earn enough and you don’t get treated well enough,” Hegewisch said. “The fact that we come into an existing underinvestment in staff [makes] it harder to respond now.”

Health-care workers are setting up COVID-19 wards and makeshift field hospitals, putting in long hours, and wearing protective gear fashioned from trash bags and swim goggles. Nurses and nursing-home staff are already starting to get sick and die, and those who haven’t contracted the virus know that they don’t have the time off or the financial cushion to cope if—when—they do. Without paid leave—and after healthcare workers were mostly exempted from Congress’s paid leave expansion in its aid package—“you’re super exposed, [but] you have much less choice about stepping back, so you have to work,” Hegewisch said.

“This layer of protection around you is super brittle,” she added. “Any little thing can pierce it.”

When Hughes first began her career, she was responsible for 18 patients who needed hands-on care for the most basic tasks: eating, bathing, dressing, walking. Even then, she told me, “I felt like I didn’t have enough time to take good care of people.” Things have improved, but the nursing home still doesn’t have enough staff. Then came the coronavirus. Some of Hughes’s co-workers opted to stay home for fear of contracting the virus—one colleague is in her 50s and has respiratory issues; another is seven months pregnant—so when we spoke, Hughes was responsible for 16 patients. “Staffing is pretty abysmal,” she said.

It’s unlikely to get better, even after this particular crisis. The shortage of health-care workers is projected to only grow as the population ages: The government estimates that the country will need an additional 1.6 million registered nurses and nursing assistants, and more than a half million home aides, within the next decade.

Well before the pandemic, 46-year-old Melanie Arciaga, who has worked as a registered nurse for more than 12 years, struggled to take a break during her 12-hour shift at Harborview Medical Center in Seattle. “If it’s a very busy night, I don’t get my breaks at all. I don’t eat or drink [for] 10 hours,” she told me. “Sometimes I just have time to just run to the bathroom and take a gulp of water once in a great while.” Occasionally Arciaga has three different alarms from patients who need help going off at once. “Which one do you run to?” she asked.

Now her hospital is scrambling to train and outfit employees who have volunteered to work on the coronavirus floor—which in turn means that covering scheduling gaps elsewhere in the hospital is harder. If more workers get reassigned to care for an influx of COVID-19 patients, she and her coworkers will shoulder “a big, heavy, heavy burden for sure,” Arciaga said. “Being in the epicenter, it’s very overwhelming.” But Arciaga can’t help her coworkers anymore. Three weeks after we spoke, she started having mild body aches. She now has a fever and worsening symptoms, so she’s been in quarantine at home.

Fear is creating challenges beyond outbreak centers, too. Melissa Bloom, a 53-year-old nurse in Muskegon, Michigan, was already stretched thin when her co-workers began calling in sick during the pandemic. Employees are now asked to come into work even with symptoms. “If they’re keeping everybody home with a fever and a cough, eventually there’s not going to be people to work,” Bloom told me. Everyone has to wear a surgical mask for their entire shift. Over the course of Bloom’s 12 hours, the elastic cuts into her ears and her breath makes her face hot, fogging up her glasses. Communicating with patients is difficult. N95 masks are in scarce supply, so Bloom made a homemade mask herself—a last resort.

Nurses and doctors across the country are facing equipment shortages like Bloom’s. A week before I spoke with Bartie Scott, a nurse practitioner in Fayetteville, Tennessee, one of the nurses from her clinic took the vital signs of two potential COVID-19 patients in the hospital parking lot, wearing just a cotton scrub jacket, glasses, plastic gloves, and a flimsy surgical mask to protect herself. “We just don’t have the resources like big towns,” Scott said. She took goggles from her garage to wear at work. Her co-worker’s husband donated hazmat suits.

“It was hard to come to work this morning,” she said, choking up. Her husband is an ex-smoker, and she worries about his lungs. “I do feel like it’ll be my fault if I bring it home.” Scott could quit, but her family would be plunged into poverty.

Like Scott, many health workers struggle to make ends meet on low salaries. Adarra Benjamin, a home health- and personal-care aide in Chicago, makes just above the city’s $13 minimum wage. She gets no paid time off and no benefits. She’s able to get health care only through her union, the Service Employees International Union. “This is not something that you can really live off of,” Benjamin told me. She’s constantly making decisions about where her paycheck goes: food or transportation? Rent or her mother’s diabetes medications? “It really is a struggle; it really is,” she said.

Benjamin works a grueling schedule to care for multiple patients. Starting at 9 a.m., she runs errands, cooks, and tidies for her client who has chronic obstructive pulmonary disease. After a three-and-a-half-hour break, she heads to her next client, her great-grandmother, helping her shower and fixing her a small meal before her great-grandmother falls asleep. Benjamin’s day ends only at midnight, after she helps her final client undress, shower, and get ready for bed, and changes her client’s cat litter. “I go a lot of days when I forget to eat,” she said. She repeats this five days a week.

These days, Benjamin is afraid she’ll be exposed to the coronavirus and bring COVID-19 home to her mother, who has diabetes, high cholesterol, and high blood pressure. Benjamin has been “using hand sanitizer every five seconds”; she keeps a bottle in her purse and has one attached to the outside too. “I know it sounds crazy, but I have washed the same jacket five times in the last week because I brush past people or people have walked by and touched me,” she said. But she has to keep going to work. “I have no other choice,” she said. “My bills still have to be paid.” So she’s “compartmentalized” the fear, turning off the news.

Hughes, the Seattle nursing-home aide, is struggling to make ends meet too. Her work “used to be considered a pretty good job; you could support your family, pay your rent and your mortgage,” she said. “Now we’re competing literally with McDonald’s for wages.” The starting pay for her job is $15 an hour. With nearly 17 years of experience, Hughes makes less than $17.50. The cheapest health-care plan that her employer offers still has a $5,000 deductible, so she gets insurance through her state’s Medicaid expansion. Hughes and her husband live paycheck to paycheck and share one car. Most months, she can’t find the gas money for the three-hour drive to visit her family, which means she’s met her baby niece only once.

“Maybe if the job were much, much easier, you could justify [it] not paying a lot,” Hughes said. “But the reality is, it’s incredibly hard.” Hughes and her co-workers are on their feet and “dealing with human tragedy every single day.”

When Hughes arrived at 10 p.m. for a shift in late March, she had her temperature taken and she filled out a form screening her for possible COVID-19 exposure. Then she took every patient’s temperature, a new protocol to monitor for signs of the disease. A few visitors used to come at night, but now the front doors are locked. There’s a wing on her floor behind closed double doors: the quarantine area for the newly arrived. The heavy doors make hearing anything on the other side difficult, so she struggles to ensure that patients stay safe throughout the night. That March evening, a patient got out into the hallway with no pants on before Hughes could tend to him.

At the end of her shift, so many people had called out from the next one that Hughes wasn’t sure whether anyone would be coming to relieve her and her co-workers after their nine hours. Eventually, a few showed up. She’d already signed up for hours that she wasn’t supposed to work later in the week, because nobody was on the schedule. “But that’s not sustainable at all,” she said. Every shift had openings every day for the next week.

After we spoke, Hughes drove home and conducted a newly honed ritual: stripping off her scrubs and putting them directly into the washing machine. She leaves her shoes in a box by the front door. Even so, she thinks that she has a “fairly good chance” of getting the virus. She has friends who work at the Life Care Center nursing home just over an hour’s drive away, in Kirkland, Washington, where at least 37 people have died from coronavirus complications.

“I plan to keep working until I can’t,” Hughes said, walking to her car after her shift, shivering in the chilly morning air. “This is my calling. This is what I’ve chosen to do with my life. I can’t abandon my residents, and I can’t abandon my co-workers.”

‘The Enemy Isn’t Going Anywhere’ “I think people haven’t understood that this isn’t about the next couple of weeks,” one expert told our science reporter Ed Yong. “This is about the next two years.” by CAROLINE MIMBS NYCE

When will things go back to normal?  

Ed Yong, our science reporter who wrote “How the Pandemic Will End,” is back, taking a closer look at that question. Here are just three takeaways from his analysis:

1. This virus isn’t going away anytime soon.

“The pandemic is not a hurricane or a wildfire,” Ed writes. “The SARS-CoV-2 virus will linger through the year and across the world.”

2. Even when the U.S. reopens, the fight won’t be over.

Hospitals will face new challenges and may be forced to reckon with future waves. America will need to stay vigilant and avoid falling into a panic-then-neglect cycle.

3. Steel yourself psychologically.

Vice Admiral James Stockdale was held as a prisoner of war during Vietnam. To survive the experience, Stockdale said he relied on a mix of hope (“the need for absolute, unwavering faith that you can prevail” ) and realism (“the discipline to begin by confronting the brutal facts, whatever they are”). The same strategy can be applied to this pandemic.

“The enemy isn’t going anywhere,” Ed reminds Americans. “To forget it would be to beget further horror.”

One question, answered: Can pets spread the coronavirus to people?

There’s no evidence of that. But before you rush off to take Fido to get a trim, consider this: Several dog groomers told Olga Khazan that they fear for their safety. “If you’re actually doing what you’re supposed to be doing at home, you don’t need a dog groomer,” said one Petco groomer in New York State, who asked to remain anonymous because she feared losing her job.

What Italy’s ‘Patient One’ Teaches Us Controlling the pandemic will require reshaping family life in much of the world. by RACHEL DONADIO

The first person diagnosed with COVID-19 in Italy was a healthy 38-year-old who arrived at his local emergency room in Codogno, south of Milan, with flu-like symptoms. His condition quickly worsened, and doctors had the foresight to test him for the coronavirus. On February 20, his results came back positive. Within days, Codogno and other nearby towns in the region of Lombardy were on lockdown, and within weeks so was the entire country.

Patient One—for privacy reasons, we know just his first name, Mattia—spent weeks on a ventilator before he could breathe on his own again, and was released from the hospital only on March 22. In Italy, Mattia is most often portrayed as a success story, a story of resilience, in a country where more than 21,000 people have died from the coronavirus and some good news is needed. “Mattia teaches us that you can also recover from serious illness,” Raffaele Bruno, the head of infectious diseases at the San Matteo Hospital in Pavia, where Mattia was treated, told me.

But his story is also in some ways unsettling. While Mattia was still in the hospital, his father died of COVID-19, and his wife, nearly eight months pregnant, tested positive as well, though she eventually recovered. Mattia turned out to be a “super-spreader” who infected scores of others, including in his amateur soccer league, and at the hospital where he was diagnosed. His is a cautionary tale of asymptomatic contagion and the unpreparedness of hospitals. In an audio message after his release, Mattia urged his fellow Italians to stay inside, and said he was lucky to have been treated in the early days of the outbreak, before Lombardy started running low on ventilators. (Officials believe Italy’s Patient Zero, the first person to have brought COVID-19 to the country, is likely a German who traveled to northern Italy around January 25. I use the terms Patient One and Patient Zero cautiously: They’re important concepts in epidemiology, but morally complex—outbreaks have multiple causes, and we don’t want to stigmatize the infected.)

I see something else in Mattia’s experience—a story of pathos, in which life and death, pain and resilience are intertwined. Italy is a place of intricate family and community ties. Two and three generations often live in the same city, the same neighborhood, or even the same apartment building. People commute by train to other cities for work, while keeping their residence, and their family, in their hometowns, where a network of relatives can help raise their children. Without the extensive state-supported childcare of France and other European countries, many Italian grandparents are the primary babysitters, allowing parents to work and keep the gears of the economy turning. These ties are strong in Italy, where reliance on the family is typically greater than on the state.

They are also part of what put the country, with the second-oldest population in the world, after Japan, at such mortal risk, as contagion spread among relatives. It’s a pattern that is now being repeated around the world—especially in countries and cultures where large extended families are the rule, not the exception, and in lower-income communities in which people live in close quarters, where social distancing is fine in theory but nearly impossible in practice. All this bears a strange irony—in the recognition that for those of us able to look after ourselves, being alone, away from other humans, from our kin, is probably safer than being together. Controlling the pandemic will reshape family life for a long time to come.

Bruno told me that knowing whether Mattia infected his own father, or any of his other relatives, is “impossible.” Still, the sense of guilt that particular possibility might involve—or the generalized survivor guilt of weathering the pandemic when other family members or friends don’t—is something that will likely grow. “There’s a strong sense of shame and guilt that’s been underestimated,” David Lazzari, the president of Italy’s National Council of Psychologists, told me. “It often compels people to hide their symptoms, because maybe they’re afraid of identifying themselves as a carrier of the virus and then as someone who infects others.” Imagine, he continued, how people will live in the aftermath “with the idea that they infected half the town.” A lot of post-traumatic stress will ensue, he said. Now the pain is more immediate: a sense of powerlessness. Mourning without funerals. And being separated from the people we love. “We need to show our closeness, but from a distance,” Lazzari said.

For weeks now, I’ve been thinking about Patient One, from my apartment in Paris, where I live alone. All of us living far away from loved ones, especially older and more vulnerable relatives, have had to think long and hard about how best to offer support. Our immediate instinct is to want to gather together, to show closeness. Yet that is now the worst thing we could possibly do. Governments in France and Israel, where generations of families also tend to live in close proximity, have ordered older people to stay home, and told grandchildren to steer clear. In Germany, some health experts have suggested that children not see their grandparents until well into the fall, or even after Christmas. In Britain, where the government has told citizens to save lives by staying home, a cabinet minister was criticized for visiting his own parents.

Showing closeness from a distance requires overturning our most basic understanding of human contact and connection. But we have to stay distant, no matter how anathema that is to our world view. At least that’s what I like to tell myself, half a world away from my family in the United States. Weeks ago, the State Department raised its global travel advisory to its highest level—“Do Not Travel,” the ranking typically assigned to war zones—and began issuing warnings for American citizens to “arrange for immediate return to the United States unless they are prepared to remain abroad for an indefinite period.” But where was home? And how long was an indefinite period?

One of my closest friends in Paris, who is also American, gamed it out: If you went back to the U.S., he reasoned, you’d have to self-quarantine for two weeks when you got there. And if someone you loved were dying, you couldn’t actually be with them anyway. I had been reading L’Eco di Bergamo, the paper of a province north of Milan, with its 10 daily pages of square-inch-size obituaries, in which many of the dead were remembered as loving grandparents. I already understood, well before the reality set in in the United States, that when you die of COVID-19, you die alone. This truth was nearly impossible to bear.

I stayed in Paris—my life is here, my work is here, and I’m grateful my apartment has an unobstructed view of the sky. I called my parents and told them not to leave the house, not even to go to the grocery store. At the time, there were three presumptive COVID-19 cases in the state where they live. Doesn’t matter, I told them. The day before Mattia was diagnosed, Italy had no known cases. I called other relatives in the U.S., who were already hunkering down in their respective cities.

My solitude is not unendurable. I may be on my own here, but I’m in daily contact with friends and family around the world. We compare notes on lockdown measures. Some confide that they’re struggling—depressed, anxious, sometimes furious with their partners and children, worried about their unstable finances, angry at the world. I wish I could do something, at least babysit; instead, I listen. Everyone is scared. Has there ever been another moment when so many of us shared the same forebodings at the same time? I’m familiar with grief and existential powerlessness. I’ve wrestled, and tried to make peace, with loss. I’ve also worked from home, remotely, for years, and know how misunderstandings can be amplified with distance, and how hard reading the room is when there is no room.

We need to show our closeness, but from a distance. On a new weekly Zoom call with my entire extended family, a cousin recalled that my adored Great Aunt Natalie once shared with him her childhood memories of people walking around in masks during the 1918 flu pandemic. Aunt Nat had wanted to be a newspaper reporter but after high school, she wound up working as a stenographer and selling classified ads for the Cleveland Press to support her widowed mother and her two sisters during the Great Depression. How strange that the youngest generation in my family will also have childhood memories of adults wearing masks.

I think again of Mattia, the infector who survived. So much pathos and trauma, but also joy. Last week his wife gave birth to their daughter, Giulia. What kind of world will she inherit? I see my niece and nephew on screens. Sometimes I cannot even bear to call, because afterward, I miss their fierce faces and remember the feeling of their little warm bodies when we’d curl up together on the sofa to read books. This is now the price we pay for maintaining a safe distance, never knowing whether a physical visit might be a comfort or a threat. Everyone is so close but so impossibly far.

America’s Fault Lines Are Showing Not everyone can just work from home. by CAROLINE MIMBS NYCE

America’s fault lines are showing. As my colleague Joe Pinsker put it last week, there are really two pandemics:

One will be disruptive and frightening to its victims, but thanks to their existing advantages and lucky near misses with the virus, they will likely emerge from it relatively stable—physically, psychologically, and financially. The other pandemic, though, will devastate those who survive it, leaving lasting scars and altering life courses.

Where you end up depends on “a morbid mix of a sort of demographic predestination—shaped strongly by inequality—and purely random chance.”

Across the U.S., this outbreak is already exposing stark race, class, and gender divides—and threatening to exacerbate them.

CLASS

The coronavirus could create a new working class.

Not everyone can just work from home: Data suggest that benefit lies disproportionately with high-income Americans. And while the wealthy hunker down, essential workers remain at cash registers, fearful for their own health.

Plagues, counterintuitively, can be good for workers, my colleague Olga Khazan reports. One study of 15 major pandemics in history found that they increased wages afterward. Experts anticipate a turn toward populism post-outbreak, but whether it will be the Bernie Sanders or Donald Trump variety is unclear.

RACE

Stop blaming black people for dying of the coronavirus.

We now know for sure: The data show major racial disparities in COVID-19 cases. And yet too many politicians and commentators—relying only on anecdotal evidence—are engaging in victim blaming, Ibram X. Kendi argues.

“What if black people have been taking the coronavirus more seriously than white people for weeks, as the survey data suggest? What if despite all that, black people are still being infected and dying at higher rates from COVID-19?”

GENDER

This outbreak is a disaster for feminism.

No nurseries, no schools, no babysitters. As child care moves into the home, many families may fall back into a 1950s parenting model.

“With the schools closed, many fathers will undoubtedly step up, but that won’t be universal,” Helen Lewis wrote last month. “Some women’s lifetime earnings will never recover.”

One question, answered: The world is a scary place, outbreaks and otherwise. How do you raise a resilient child in 2020? Kate Julian, a senior editor and the mother of two children under 10, takes a long look in our latest magazine cover story:

To protect children from physical harm, we buy car seats, we childproof, we teach them to swim, we hover. How, though, do you inoculate a child against future anguish? For that matter, what do you do if your child seems overwhelmed by life in the here and now?

What to read if … you just want practical advice:

• The four possible timelines for life returning to normal
• Here’s how many people have the coronavirus in your state
• How you should get food during the pandemic
• 12 free things to watch, listen to, and learn in quarantine
• 30 unexpected movie masterpieces to watch

Tonight’s Atlantic-approved quarantine activity:

Dip your toe into video-game utopia. The best-selling game Animal Crossing is subtly subversive, our technology writer Ian Bogost argues.

The WHO Defunding Move Isn’t What It Seems Trump is yet again attempting to distract the public from his own failures. by Graeme Wood

President Donald Trump announced yesterday evening that he will withdraw funding for the World Health Organization, on the grounds that it helped China cover up the origin and extent of its coronavirus outbreak. The United States pays for the largest fraction (in recent years, about 17 percent) of the WHO’s budget. The WHO, in turn, funds the COVID-19 responses of dozens of countries around the planet, some of which are extremely vulnerable to the disease.

At about this point in the analysis, the expected move might be to explain why hobbling the WHO is unwise—how doing so will make us all less healthy and less safe; how it will be remembered as a moment when the U.S. chose to hasten its decline as a superpower; how funding the WHO gives the U.S. power over the group, and China will step in to seize the control the U.S. has ceded.

All these points are true—but only a sucker would focus on them. Defunding the WHO (or at least threatening to do so) is yet another instance of Trump’s signature move, one that I described just weeks ago, when he insisted on calling SARS-CoV-2 “the Chinese virus,” and for a few days journalists and social-media scolds obediently modified their criticisms to fit his latest outrage. The move is simple. When Trump is ensnared in controversy, when he is being asked straightforward, damning questions and his inquisitors do not stop asking them, he says or does something outrageous to change the subject. It works every time. It is working now.
At some point, it is hard not to admire his ability to deploy this move, transparently, over and over, and have it serve its purpose. It is like watching Kareem Abdul-Jabbar’s skyhook, or Lionel Messi’s nimble dribbling; everyone has seen him do it hundreds and hundreds of times and has had ample time to practice a defense against it. But the execution is perfect, and as his opponents helplessly watch the points rack up, they should acknowledge that they are in the presence of rare talent.

The trick, as with the “Chinese virus,” is to choose a plausible enemy, one whose misdeeds are not only undeniable but vital to acknowledge. It is, of course, true that COVID-19 originated in China, and anyone who suggests otherwise should not be trusted. As for the WHO, its errors were serious and unforced. Its delegation to Wuhan helped China underplay the severity of the outbreak, costing the rest of the world precious weeks. It denied that COVID-19 was contagious among humans as late as January 14, in an infamous tweet. At that point, when the disease may have already been spreading silently in the United States, people who trusted the WHO for medical advice would reasonably have believed that they were safe as long as they skipped the bat carpaccio. Then Bruce Aylward, a senior WHO official, appeared to suffer a neurological glitch on television when the presenter uttered the word Taiwan, a term forbidden by mainland China. Aylward had led the WHO delegation to Wuhan in February, and his aphasic reply to the presenter’s question suggested not only that the WHO had understated the outbreak and overpraised China’s response, but that the delegation had been brainwashed during its stay. These are all good reasons to criticize the WHO.

But to weigh these reasons, good and bad—the WHO’s sins against its virtues—is to go back to playing the sucker’s game, and to have an excellent view of Abdul-Jabbar’s armpit as the basketball hurtles overhead toward the hoop. Cutting off money to the WHO is not about policy. It is misdirection: Look here, not there, because you are calling attention to something you are not welcome to see.

The crisis in the United States has passed the point where literally everyone in the country feels personally affected—grieving for the dead or dying; in fear of poverty or hunger; robbed of beloved cultural figures; or just stuck at home. The question Are you better off than you were four years ago? is a sick joke, and Trump knows that it is going to be at his expense, electorally speaking. Naturally, he responds with the tactic that has served him well before: Swap a question with an answer that damns him for one with a complicated, controversial answer that tends to damn someone, anyone, else. Watch CBS’s Paula Reid at Monday’s press conference, asking the first question: “What did you do with the month of February?” Why don’t we have extensive testing capabilities, and why are hospitals still scrambling for the gear and equipment they need to protect health-care workers and save patients?

Trump, caught having completely bungled the only issue anyone will remember him for, will do anything to escape prosecutorial inquiries like these. He will be pleased, instead, to field complaints about his treatment of the WHO. The tactic he is using is one that has fooled too many people, too many times. We should hope, along with the WHO, that we won’t get fooled again.

Trump’s Backwards Federalism Could Actually Work Even if the president can’t mandate the states to reopen their economies, he can still do plenty to force that outcome. by Jane Chong

Things unraveled the usual way.

Earlier this week, President Donald Trump tweeted that whether to “open up the states” and restart the economy “is the decision of the President,” not state governors. He doubled down on his position at an afternoon White House news conference, where he added that, as president, he has “total” authority on the subject. Fact-checkers and legal experts rushed to repudiate the claim, citing, as usual, both the Constitution and Trump’s own prior statements. Trump lacks the legal authority to override the safety measures put in place by the states, they pointed out, and his tweets are inconsistent with his own insistence earlier this month that it’s up to state governors whether to impose the lockdowns in the first place.

The commentators aren’t wrong. But the interesting question is not really whether Trump has constitutional footing to forcibly compel states and municipalities to rescind the lockdown orders, but why he is inclined to assert that the decision to do so lies with him. And the even more interesting question is what powers Trump could, within his constitutional bounds, invoke to get businesses back open and Americans back on the streets.

Trump’s claim that he can unilaterally restart the economy is legally hard to square with his decision not to issue national lockdown guidance and to place the onus for such decisions on state governors. But politically, the two positions can be reconciled. An administration attuned to the latest public-health data on the coronavirus threat might be expected to move decisively toward a lockdown and to exhibit caution and incrementalism in advising rollbacks. Call it the London Breed model, for the San Francisco mayor now being lauded for declaring a citywide emergency and banning large gatherings back in February, in the face of intense political flak and well before most of the rest of the country’s leaders took action. An administration that views the risks and rewards of its response primarily through unemployment figures, however, might be expected to take the opposite tack—that is, hesitate to recommend widespread lockdown measures for fear of being blamed for the financial fallout and then seek a conspicuous role in easing those measures in the hopes of reaping the political upside that comes with an economic rebound. This is the Trump model.

Whatever Trump’s political calculus in claiming authority over the decision to reopen the country, his ability to follow up with substantive action is significant, though bounded. Trump cannot force governors and mayors nationwide to rescind their shelter-in-place orders, but he has other options for shaping the public’s perception of and ability to seek reprieve from the coronavirus threat, as well as the states’ capacity to manage the threat.

He could appeal directly to the public and convince Americans that it’s time to get back to work, thereby creating pressure for states and cities to loosen existing restrictions and surely affecting policy on the ground in Republican-led states such as Florida, whose governor resisted action for weeks and explicitly looked to the White House for instruction before finally issuing his stay-at-home order. Trump could mandate a shift in the federal government’s messaging—that includes not only the president’s own coronavirus guidelines but also Centers for Disease Control and Prevention guidance relied on by states, the general public, schools, businesses, health-care providers, and first responders. His agencies could continue to calibrate the many rules and interpretations they are charged with issuing to implement the programs and initiatives laid out in Congress’s stimulus bill, affecting matters as fundamental as which employees can take sick leave and for how long, and businesses’ incentive to retain rather than lay off workers. And Trump has great discretion in the ongoing disbursement of relief funds and allocation of national resources to the states.

For two very different camps, those anxious about what Trump might do and those eager to defend him for not doing enough, the temptation is to fixate on the outer limits of the president’s powers—such as Trump’s inability to forcibly impose or lift lockdown measures—while giving short shrift to the many courses of action well within the executive branch’s purview. This kind of lopsided thinking is evident even among proponents of expansive executive power. For instance, the legal scholar John Yoo recently argued that the states bear the brunt of the responsibility for responding to the pandemic, because only they have the authority, and manpower, to forcibly restrict the physical movements of the citizenry, and that the federal government’s authority is confined to “truly national problems.” That position extrapolates too much from the bare fact that quarantine powers lie with the states, and overlooks all the ways and all the stages at which the federal government has been uniquely positioned to effectuate—or stymie—a coordinated response to an unfolding international health crisis.

The bottom line is that the president’s powers are immense, and particularly so in the midst of an emergency whose outcome so clearly hinges on the country’s ability to get on the same page about which sacrifices are necessary and for how long. Trump has indicated his intention to reopen the economy, and soon. There is plenty he could do to make good on that intention, including over the recommendations of his own medical experts, and not much comfort to be derived from what he can’t.

The Pre-pandemic Universe Was the Fiction What the coronavirus outbreak reveals is not the unreality of our present moment, but the illusions it shatters. by CHARLES YU

Years ago, I started writing a short story, the premise of which was this: All the clocks in the world stop working, at once. Not time itself, just the convention of time. Life freezes in place. The protagonist, who works in a Midtown Manhattan high-rise, takes the elevator down to the lobby and walks out onto the street to find the world on pause, its social rhythms and commercial activity suspended. In the air is a growing feeling of incipient chaos. I got about midway through page 3 and stopped. I didn’t know what it meant.

One word I’ve been hearing a lot lately is unreal. Mostly, I hear it from my own mouth, because I haven’t left the house in a month, but also I hear it from friends on Zoom or Skype, and from the news on TV or online. Unreal, or its variations: not real, surreal, this can’t be real.

Of course, the global catastrophe unfolding is nothing but real. Stock-market convulsions have destroyed, in a matter of days, nest eggs built over decades. More than 16 million people in the United States applied for unemployment over just three weeks. The case count and death toll grow with each refresh of the page.

And yet some part of me still doesn’t want to accept that these calamities are really happening. Not really. What does it mean to say that this doesn’t feel real? The feeling seems to derive from the assumption that life before the pandemic, “normal” life, was real. That we have departed from it into strange territory.

But what if it’s exactly the other way around?

What the current crisis and our responses to it, both individual and institutional, have reminded us of is not the unreality of the pandemic, but the illusions shattered by it:

The grand, shared illusion that we are separate from nature.

That life on Earth is generally stable, not precarious.

That, despite what we know from the historical and geological and biological record, human civilization—thanks to advancements in science and medicine and social and governmental structures—exists inside a bubble, protected from the kind of cataclysmic event we are currently experiencing.

What I’ve learned in the past few weeks is that this supposed technological bubble was just that: a thin layer that popped easily.

The stronger bubble, the one that persists, is the psychological one. Even as our stark new reality becomes clear, it remains hard to accept that “normal” was the fiction. It will take some time to let go of the long-held, seldom-questioned assumptions of everyday life: that tomorrow will look like yesterday, next year like the last.

These assumptions are a luxury. For me, they are a cross product of my intersecting privileges: born in the United States, to professional parents, at a point in history where my life has proceeded, for the most part, through a series of economic booms without major socio- or geopolitical upheavals. Or at least with upheavals far enough removed so as to allow me to feel physically and mentally insulated. Living with these assumptions for so long has created a kind of expectancy as to how things tend to go, that my life has to make some kind of sense.

But what if it doesn’t? Quantum mechanics might provide a useful, if rough, analogy. At a fundamental level, physical reality defies our most basic intuitions about causality and locality, which is to say about time and space. Our senses and perceptions evolved to evade tigers and catch food, not to understand the properties of photons and subatomic particles. Despite more than 100 years of effort by the world’s leading physicists and philosophers, the quantum realm remains incomprehensibly bizarre. As it turns out, science fiction cannot invent anything weirder than the brute reality of the universe itself. The fact that we cannot comprehend it is a form of environmental mismatch.

We may face a similar type of conceptual difficulty in grappling with a pandemic. Our brains may not be naturally suited to dealing with problems of this scale or nature. Even our language, our concepts, are inapt tools, artifacts of our previous reality. Unprecedented, historic, we proclaim, with each new, grim milestone. As if precedent and history have bearing on a virus that seeks only to maximize copies of itself.

Perhaps most revealing is how we say the damage, the fallout, and the speed at which things are happening feel unimaginable, a word telling both in its rightness and wrongness. We “imagine” this kind of disaster all the time, in our dystopian-novel trilogies, our bingeable streaming miniseries. And most famously, in our summer popcorn global-disaster blockbusters, a well-worn genre that derives its pleasure and dread from the same source: literally imagining the worst. We enter dark, cool theaters in the middle of July, portals to other universes in which various doomsday scenarios play out. But here’s the key: We’re always behind a scrim of safety, a barrier between what we think of as possible and impossible. We watch these movies as tourists in an alternate reality, knowing that our round trip lasts two and a half hours, and then we will be home, safe in the real—and boring—world.

And of course, novel, we call it, but SARS-CoV-2 has been around in some form for thousands of years or more. It is novel only to us, Homo sapiens, the one species that imagines its survival, its success, as the central narrative of the story of this planet. A story with a beginning and middle and end. A story that has structure and rules. A story that means something.

In the current chapter of this story, there are ostensible villains: some members of the Trump administration (including the president himself) and officials at the state level who have been reckless or incompetent or self-interested or shortsighted or all of the above. There are heroes as well: certain governors and mayors, science advisers and health-care professionals, individuals who, in a time of uncertainty, have performed with courage, duty, expertise, and sacrifice.

But the reality is, zooming out to the largest scale, fighting the pandemic effectively requires us to take actions that go against our instincts, our intuitions, the things we evolved to be good at. Cooperation—farsighted, strategic, collaborative action—is required to defeat an adversary that relies on our physical cohesion. We can find meaning in how we fight it, but relying on our old illusions, assuming that we, as humans, will prevail, is dangerous. Life, for us and the virus, is about genes propagating themselves. No amount of magical thinking or bluster or can-do attitude can change that fact.

As we hear reports of peak deaths and curves flattening, the quiet wonderings about when life will return to normal will get louder every day. As the whispers grow, it will be important to remember: Things don’t have to be resolved in a way that works out all right for us, or for our economy, for any particular systems or ways of living. Things aren’t necessarily going to be okay in a reasonable timeframe just because we want them to. To think otherwise is to succumb to the fiction, a sheltered, resource-rich mindset (presumably not shared by the billions of people who have long lived in volatile conditions and are thus under no such illusions).

Five hundred years ago, Copernicus re-centered the universe away from us, outward. The COVID-19 outbreak is a reminder: The world isn’t for us; we are part of it. We’re not the protagonists of this movie; there is no movie. After all the suffering and wreckage have subsided, one good thing for our long-term viability will be to have changed our ways of thinking. To have regained a humility.

I say humility because, as it turns out, unimaginable says more about the limits of our imagination than about reality itself. What we really mean when we say that this pandemic feels “unimaginable” is that we had not imagined it. Just as imagination can mislead us, though, it will be imagination—scientific, civic, moral—that helps us find new ways of doing things, helps remind us of how far we have to go as a species. How little we still understand about our place in this world—terrifying and awful at the moment—but also how much we still get to discover. How fragile and rare our ordered structures are, our fictions, and how precious. How next time, we might rebuild them, stronger.