A year in America’s first Covid epicenter

By | March 14, 2021

James Ross Gardner writes:

America’s coronavirus nightmare began on the last day of February, in a leap year. On that scarce, quadrennial appendage of a date, the twenty-ninth, we learned of what was then believed to be the first Covid-19 fatality in the U.S. A man in his fifties had died of the virus at a Kirkland hospital, about ten miles northeast of Seattle. Though there had been a few other, as yet non-fatal cases, the death marked an obvious turning point, the moment—immortalized in headlines and cable-news chyrons—when the nation finally woke up to the threat.

There will not be another February 29th until 2024. Because of this odd coincidence—that day of all leap-year days—and the peculiarities of the Gregorian calendar, we’re left with a sort of phantom anniversary. A date that wavers out of reach. A date that we can never quite adequately clock. Within twenty-four hours of that first death, dozens of suspected cases emerged at a nearby nursing home, Life Care Center of Kirkland. Ambulances rolled in and out of its parking lot, marking not only the nation’s first Covid-19 fatalities but providing a dramatic visual—in siren-strobe red—of its first mass outbreak as well.

Overnight, as I wrote at the time, Seattle became a laboratory of America’s immediate future—a test case for the way that the rest of the country would live for the next year and beyond. Handshakes, indoor dining, and multi-person elevator rides disappeared in Seattle before anywhere else; boarded-up windows, empty store shelves, and business districts turned to ghost towns made their earliest débuts.

In those first days, so little was known about the virus that officials scrambled to draft a playbook, Jeffrey Duchin, the health officer for Public Health–Seattle & King County, recently told me. “We had never done these large-scale community-mitigation measures before,” he said. “There was no real understanding of what’s the best timing, the best combination of strategies to implement. There were also just the basic uncertainties about infection control, isolation, quarantine, and personal protective equipment.”

Still, a year later, of the fifty most populous U.S. counties, King County has reported the second-lowest Covid-19 incidence rate, according to information compiled by Johns Hopkins University. Only Honolulu County, in Hawaii, has a lower figure. King County also has a lower mortality rate—about fifty deaths per every hundred thousand residents—than all but six of the fifty most populous counties. To date, 1,396 people have died of Covid-19 in King County.

How that comparative success was achieved will likely be studied for decades—early analyses from local and state officials that I’ve spoken to cite the Seattle community’s inherent trust in science, expertise, and public institutions—as will the racial inequities, economic ruin, and long-term physical- and mental-health impacts that those relatively good rankings mask. Globally, as Benjamin Wallace-Wells recently wrote, researchers are finding that what appears to have mattered most was the speed of shutdowns: places where leaders acted quickly suffered staggering economic losses but generally had fewer cases. For now, on what passes for an anniversary of the first publicly declared Covid-19 fatality in the U.S., local leaders have just begun to take measure of the past twelve months.

Though the calendar allows no precise way to observe the anniversary, the events of that day and the days immediately after flicker, vividly, in memory, spooling out in little jump cuts, as if remembered from a dream, or from a different life altogether. That’s especially true for those who remained at the center of it all, like Duchin. Eighteen-hour days. Twenty-hour days. Fielding calls from every sector of the community—businesses and schools and hospitals, all desperate for information that you don’t yet have. No sleep. Off-the-charts exhaustion.

Duchin, who is sixty-three and keeps his head shaved, speaks in a calm, low voice, which soothes the way that, say, an NPR host’s voice can soothe, even in the face of tragic news. Throughout the past year, via almost weekly live updates, Seattleites have come to know that placid, untroubled voice and the man behind it—a former C.D.C. investigator—as the most trusted source of information in town, the closest thing the region has to its own Anthony Fauci.

When Duchin speaks about those first few weeks and months of the outbreak, though, his voice catches, the vocal cords seemingly feeling their way around a barbed memory, particularly when he recalls early revelations about the virus’s assault on the body, the specific way that Covid-19 ravages a human being: “Hearing about an emergency-room physician . . . who is inches away from death. This guy was critically ill, put on life support . . . his lungs were so bad, they couldn’t provide oxygen to the blood. Just hearing the stories of health-care workers becoming infected. . . . It’s just incredibly stressful under any circumstance.”

Duchin had successfully managed the community spread of viruses for decades. While at the C.D.C., in the early nineteen-nineties, he investigated a high-profile eruption of hantavirus in the Four Corners region, including parts of New Mexico and Arizona, which predominantly affected Native Americans. In recent years, as the head of Public Health–Seattle & King County, he has helped tamp down outbreaks of routine communicable diseases—hepatitis A, measles.

Like his colleagues around the country, Duchin had monitored the 2019 novel coronavirus from afar, tracking its emergence from Wuhan, China, in December, to the first known U.S. case, in January, 2020. A thirty-five-year-old man in Snohomish County, Washington—King County’s northern neighbor—was believed to have been infected while visiting family in Wuhan. The message from China, and initially from U.S. officials, was that transmission begins only after patients develop symptoms, meaning heath officials should, in theory, be able to identify cases and contain the spread. So Duchin and his colleagues believed the situation to be manageable.

Much of what they had learned was wrong. The virus can also spread, it became increasingly clear, through asymptomatic transmission. King County residents who showed no signs of infection could nonetheless mist a deadly contagion into the air. “When we acknowledged the reality of asymptomatic transmission, and the fact that the so-called containment strategy was not going to be successful,” Duchin recalled, “we had to switch to mitigation, which was something new, something basically almost nobody alive was familiar with.” [Continue reading…]

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