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U.S. Reaches COVID-19 Milestone: Death Toll Is Over 200,000

STEVE INSKEEP, HOST:

One of our colleagues walked into an Airbnb apartment the other day and discovered a magazine, a magazine from January, which offered suggestions for a better commute or packing lunch. It was a dispatch from a pre-pandemic world, a tiny reminder of how immensely life has changed. Saying the enormous number of dead, now more than 200,000, just begins to hint at the experience of this year.

And in this week as we've reached that point, we've called three reporters who've been covering the pandemic since the start. Martha Bebinger is on the line from member station WBUR in Boston, as is Blake Farmer at WPLN in Nashville. And NPR's Will Stone is in Seattle. Good morning to all of you.

MARTHA BEBINGER, BYLINE: Good morning.

WILL STONE, BYLINE: Good morning.

BLAKE FARMER, BYLINE: Good morning.

INSKEEP: Will, let's start with you. What were the early moments of this pandemic like in Seattle? It can be hard to remember now.

STONE: Well, it was terrifying because we were completely unsure of how widespread the virus was. And all of a sudden, the country was watching the Seattle area. And that did bring a lot of urgency to the response. I mean, if you remember, some of the very first deaths were residents of a nursing home outside Seattle. And the rate of people dying, getting seriously ill was shocking.

And I remember there was this creeping sense that it could be anywhere in the area. So this made the medical community and the public take it pretty seriously. There was a lockdown and this painful waiting period, bracing to have ICUs fill up. That never came to pass. Hospitals were not completely overwhelmed. But Washington did have its biggest spike in deaths during the spring.

INSKEEP: And as we watched Seattle, the rest of us, from a distance - it was the first major metro to be this affected. Other people were watching with creeping anxiety as the virus spread toward them. And Martha, what was happening in New York as we headed a little later into the spring?

BEBINGER: Well, the first case, Steve, you might remember, was on March 1. In that first week, cases doubled sometimes overnight. The first death was less than two weeks away. And then in early April, the death toll peaked at more than 800 one day, overwhelming hospitals and funeral homes. So many states in the Northeast shut down to try to control the spread. States around New York were scrambling to prepare, competing for mask purchases and demanding...

INSKEEP: Yeah.

BEBINGER: ...That the federal government release ventilators. Once the surge hit Massachusetts in mid-April, hospitals knew what was coming. But Steve, patients and health care workers were still really slammed. Dave McDonald (ph) is a nurse anesthetist who worked long shifts in an ICU putting patients on ventilators.

DAVE MCDONALD: You know, I know when I put that breathing tube in that patient is probably not going to make it. So coming in each day and then looking at that list and seeing those patients didn't make it, it hurts.

BEBINGER: I'm still just in awe of the doctors, the physician assistants, all the hospital maintenance folks who slept in their basements or their attics to avoid infecting their families. They took on new jobs in hospitals. Or they became the family for patients because visitors were banned. There were just so many people who went above and beyond during the pandemic.

INSKEEP: I'm recalling the period in late March when most of the country did shut down. But President Trump almost immediately began pushing for reopening in early April. That didn't happen. But parts of the South began to reopen late in April, Georgia especially. Blake Farmer, what was that like?

FARMER: Well, you know, people were just itching to get back to life. There were pockets of the South where the coronavirus had been, you know, as bad as folks feared, like New Orleans. But most places, the curve pretty well flattened out after businesses closed as they were required to do. And depending on how you look at it, the restrictions either staved off the worst of the pandemic or just wasn't as bad as predicted.

So states across the South were, really, all opening up just after Georgia in May. I was in South Carolina at the time. And, you know, stopping at a gas station or the grocery store, you wouldn't necessarily know there was a pandemic. This was before many jurisdictions in the region were mandating masks. And now you look back, this is when the pandemic really took off in the South. And of course, the surge of deaths was right behind.

INSKEEP: How did things evolve in the western United States, Will Stone? Let's go back to you.

STONE: Well, the death toll in Washington state just crossed 2,000, which is terrible but much lower than other places. But it was a really hard summer in the West, especially California, Arizona and Texas. Those three states alone make up nearly one in every five deaths in the country as a whole. Washington had a second wave, nothing as dramatic as other places. And by then, around the country, the demographics were also shifting. So it was younger people driving the spread. And that did lead to fewer hospitalizations and deaths.

And on the West Coast, outbreaks also began to hit some rural areas much harder. So these are places with agriculture and farm workers. And that tended to disproportionally affect Hispanic communities. And in general, the impact on communities of color is striking. Take Washington, more than 40% of deaths were among the Hispanic population even though that's only 13% of the state's population. And this kind of disparity is true in California. And it's true all over the country.

BEBINGER: Yeah. Will, that's definitely true on the East Coast. So infection rates are often highest in low-income and minority communities, where residents live in crowded housing and are essential workers maybe in the food industry and hospitals. But overall, the mandatory mask orders, the limits on public gatherings, working from home, school and business closures, those steps have all slowed transmission. Reopening has been slower in the Northeast, though, you might recall. Restaurants in New York City are just scheduled to resume limited indoor dining next week. The mask orders, strict crowd limits, those are still in place. And many officers are still remote.

INSKEEP: Blake Farmer, I want to recall the deaths in New York state nursing homes were extreme in the beginning. An enormous percentage of deaths were in those nursing homes. Has that pattern repeated itself in other parts of the country?

FARMER: Well, it certainly did. In those early weeks of the pandemic, one facility outside Nashville here had 23 deaths from an initial outbreak. And there were many other facilities that were the same way. One of those residents who died was the mother of Stacy Thomas (ph), who I talked to in early April. Her mom had survived a lot already.

STACY THOMAS: You know, when they told me that she was positive with - for the COVID-19, I was scared that she wouldn't pull through this one.

FARMER: So this nursing home was fully evacuated in late March after more than 100 cases were discovered, many of them without symptoms. And at the same time, at that time, they didn't know the best way to manage nursing home outbreaks. But nursing homes were really locked down to outside visitors nationwide. Staff has to be tested regularly now. And it's been effective. However, federal authorities are now loosening up those restrictions.

INSKEEP: So we'll have to monitor that to see what happens with nursing home fatalities in weeks and months to come. Now, I do want to ask about the South, the region you report on, Blake. We mentioned that Southern states opened up earlier than other places. There was a different political attitude in some places about the pandemic itself. But we have to say that some Southern states have not had the number of deaths per capita that the Northeast did.

FARMER: Well, you're right. You know, Tennessee, North Carolina, Kentucky, others, they've had tons of cases now, but a fraction of the deaths per capita. Epidemiologists tell me it's partly because, like Will said, younger, healthier people are passing the virus more often now, you know, whether that's essential workers or college students. Hospitals are also not overwhelmed and have room for everyone who needs care. And doctors have learned a lot from those scary days early in the pandemic. Yeah, there's no cure. But some treatments seem helpful. And they know more about managing COVID patients on ventilators. Still, I will say, COVID will likely become the third leading cause of death in many of these states this year, which, you know, is sobering.

INSKEEP: Martha, how much better is the Northeast than it was?

BEBINGER: Well, the positive test rate across the region is pretty low. It's 1 or 2% in most states. The main concern right now, though, is outbreaks tied to schools. And we've seen a few on college campuses. Now there's a lot of attention on the elementary, middle and high schools that are just resuming classes both in-person and remote.

INSKEEP: And we're skipping back and forth across the country here. But that's the way the hot spots seem to do. Will, you've been watching the Midwest recently. What's happening there?

STONE: Well, the improvements in the West and the South are being counterbalanced by what's going on in the middle of the country. And that's the Great Plains and parts of the Midwest. This is where cases and deaths are going up. For example, North Dakota now has the most new cases per capita in the country. I asked Dr. Bill Powderly at Washington University in St. Louis about this geographic shift. He says part of it is policy, not having social distancing or mask requirements in this region. But it's not just that. He uses Missouri as an example, where St. Louis had a surge of cases in the spring.

BILL POWDERLY: St. Louis experienced this. But in other parts of the state of Missouri, where they didn't have that experience, they're now seeing rapid rises in cases and increases in hospitalizations. And I think part of the challenge we have is that communities have to go through this in order to realize how bad it is.

STONE: Deaths have not skyrocketed there yet. But it's also just too early to tell. And the big thing Powderly and many experts are worried about is whether there will be a shift back to more urban areas this winter, which could lead to another surge of deaths.

INSKEEP: Martha, as you look back over the last many months, what do you think about at this moment when we're hearing of 200,000 dead?

BEBINGER: Steve, I think back to that collective gasp I heard at the end of March when Dr. Tony Fauci said that there could eventually be 200,000 deaths during this pandemic. And we've hit that once unimaginable milestone after just seven months. Now there's a model the White House has used that says we could see 410,000 deaths by the end of the year. And I worry that we've become kind of numb to these staggering figures. And they don't even take into account the patients who've survived COVID but with lasting lung, heart or brain damage. That's a really wrenching toll, too.

INSKEEP: Martha Bebinger of WBUR in Boston, NPR's Will Stone in Seattle and Blake Farmer of WPLN in Nashville. Thanks to all of you.

FARMER: Thank you.

BEBINGER: Thank you.

STONE: Thank you. Transcript provided by NPR, Copyright NPR.

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