A Year in America’s First COVID Epicenter


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.”

America’s first COVID-19 epicenter suffered fewer infections and virus-relateds deaths than nearly every major metropolitan area for several reasons. The factor cited most by all the elected officials I’ve spoken to, though, is the public’s early acceptance of the aggressive response that Duchin and his colleagues presented. “The infection rates compared to other regions really reflect that community-mindedness and trust in science and expertise,” Dow Constantine, the King County executive, told me.

More important, in contrast to the denialism and muddled messages emerging from the White House and the federal government, Constantine said, local leaders took the guidance to the public with a stern, unified voice. “The elected officials here, relatively speaking, were able to put their egos aside and their differences aside and chose to minimize the static.”

Behind closed doors, there were squabbles among elected officials, both Constantine and Jenny Durkan, Seattle’s mayor, admitted to me—about allocation of resources, which activities should be limited, and which kinds of businesses closed. However, unlike leaders in other jurisdictions (the public acrimony between New York’s Governor Andrew Cuomo and New York City’s Mayor Bill de Blasio comes to mind), leaders here quickly fell in line behind restrictions they knew would upend the lives of their constituents, knowing that mixed messages could result in more deaths.

Within seventy-two hours of the first reported fatality, Durkan, Constantine, and Governor Jay Inslee had all declared states of emergency. (Investigators would conclude months later that two COVID-19 deaths in California preceded the January 29th Kirkland death by a few weeks.) All three leaders became regular fixtures on our screens, as they announced each successive—and, at the time, shocking—measure. School closures. Moratoriums on indoor dining. The tech giants Amazon and Microsoft, which employ a combined hundred thousand people in the region, announced that most of their employees would be working remotely.

These moves came at a high price. “Our ability to move people to a work-at-home situation in such a rapid fashion was a huge benefit. Unfortunately, it also accelerated the economic damage,” Durkan told me. “It emptied the downtown core.” As of February 21, 2021, a hundred and sixty-three downtown businesses—including restaurants and retail shops—have permanently shuttered since the first stay-at-home orders went into effect, last March, according to reporting by the Seattle Times. And that’s just downtown. The closures hurt neighborhood retail and independent businesses citywide. “We had about two hundred and fifty thousand people employed by our small businesses, which is about five Amazons,” the mayor said.

Meanwhile, infection numbers continued to climb. King County hit 2,496 confirmed cases and a hundred and sixty-four deaths by the end of last March. Local leaders turned the screws. Inslee temporarily banned camping and other outdoor activities. Constantine limited King County Metro bus occupancy. Durkan instituted a mask mandate. Slowly, steadily, the measures began to work. The spread slowed. The region flattened its curve, never hitting the zero-per-cent I.C.U. capacity that we all feared, and which had happened in similarly sized metropolitan areas.

“If you’re going to fight a pandemic, you’d better develop the hide of a rhinoceros,” Jay Inslee told me recently, in his best, gruff Jay Inslee voice. “Because any decision you make that will save lives will also expose you to enormous criticism, and you’d better learn to accept that.” Few have taken more heat than Inslee, who presides over a blue state that tends to look redder and redder the farther you venture outside of King County. During the pandemic, he has sparred with the forty-fifth President, who called him a “snake” for criticizing the federal response; borne rebukes from county sheriffs who refuse to enforce his social-distancing measures; watched armed demonstrators gather in front of the state capitol to protest mask mandates; and endured a caustic general election against an opponent whom the Governor called “mini Trump.” Inslee won reëlection handily, though the challenger has contested the not-even-close results for months.

Inslee says that he is proud of his state’s handling of the coronavirus, and, like his city and county counterparts, he cites the public’s willingness to listen to expertise—the unmasked, armed protesters who show up outside the governor’s mansion notwithstanding. “This has reaffirmed the power of science to guide our decision-making,” he told me. No one, least of all Inslee, thinks that the region is in the clear. The morning we spoke, he had attended a briefing on the new virus variants. “It is a race for life, literally, right now,” he said.

So far, roughly six per cent of Washingtonians are fully vaccinated against the disease, according to numbers released by the state’s Department of Health. That figure does not address inequities inherent to not only vaccination rates but the response throughout the pandemic, something everyone I spoke to listed as a top concern. Hispanic Washingtonians represent thirteen per cent of the population, but constituted only six per cent of those who were vaccinated, as of early February. Four per cent of the state population is Black, yet only 2.7 per cent of full-vaccination recipients were.

On the county level, Constantine noted that his office has been directly connecting with people in historically marginalized communities: “We opened clinics, mass-vaccination sites in two cities, Auburn and Kent, which are among the most diverse and have the most economically challenged neighborhoods around the county.” Mayor Durkan has made similar efforts in Seattle, dispatching fire department-led mobile vaccination teams throughout the city.

Jeffrey Duchin still hasn’t forgotten a 1993 USA Today headline that referred to the hantavirus outbreak he investigated as a young C.D.C. officer as the “Navajo flu,” owing to some of the early confirmed cases’ proximity to a Native reservation. That sobriquet, also employed by the Washington Post and Reuters at the time, exposes the propensity for health crises to be weaponized as tools of racism and discrimination, as evinced by the last Presidential Administration’s sneering deployment of the term “China virus.”

The memory of that headline, and the ugly American tradition it reveals, guide Duchin now as he helps lead the region out of the current crisis. Yes, the early and consistent policies spared Seattle the death tolls experienced in other regions, but the measures taken to curtail the pandemic have left a path of social and economic destruction in their wake. “That suffering is disproportionately heaped upon certain communities, through no fault of their own, because of their racial or socioeconomic status,” Duchin said.

Economists predict that millions of jobs sidelined during the pandemic will never return, the Washington Post recently reported, particularly retail and food-service jobs, and work that requires a person to place their body at a specific time in a specific place. Seattle is not immune, despite its reputation as a tech hub filled with employees who can presumably power through their workday at the kitchen table in sweats. Before the pandemic, as Mayor Durkan noted, small businesses employed a quarter of a million people. A trip downtown or to any of the city’s neighborhoods dismantles any notion that we’ll be getting out of this crisis unscathed. A lot of those small businesses are gone.

Even that discussion somehow suggests that the pandemic is behind us. The vaccine is good news, Duchin concedes, but we can’t let up. Two Fridays ago, he gave a public address, as he has nearly every week since March of 2020, to provide updates on infections and vaccine distribution. He appeared on Zoom in a black T-shirt that poked up from an open-collared dress shirt. Against his chosen Zoom backdrop—a still image of Puget Sound, the water a faded blue, and the Olympic Mountains trapped in white clouds—the epidemiologist looked like part of a photo collage, as if a portrait of Jeffrey Duchin had been cut out of a magazine and glued atop a nature pic. “Over the last seven days, we’ve seen approximately one hundred and twenty-eight new cases reported daily,” he intoned. “And the trend of cases has been decreasing in the past month, which is very gratifying.”

He remained cautious. The new variants had him worried. So did the rate of vaccinations. “It’s critical not to become overconfident and complacent,” he said. “Because although we’ve slowed it, there’s plenty of virus out there and plenty of opportunities for it to spread.” In other words, we may have reached the anniversary of the pandemic’s U.S. début, but that doesn’t mean it’s time yet to return to life as normal. So much more must happen if we’re to survive this crisis—and recover from everything lost and broken between that first death and what will be, in the distant and unknown future, the last. “Thank you, everyone, again for joining. Appreciate it, especially as the numbers are going down,” Duchin said, at the end of the broadcast. “I’m glad you’re still interested.”


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