theatlantic--2020-03-31--Private Labs Are Fueling a New Coronavirus Testing Crisis

Testing isn ’ t important only because it helps track the pandemic .
For hospitals , coronavirus tests are a crucial tool in managing scarce resources .
If a patient comes in with COVID-19-like symptoms , doctors and nurses must act as if the patient has the virus .
They must don personal protective equipment , or PPE , every time they interact with the patient until he or she tests negative for the coronavirus .
Because the majority of tests still come back negative in most places , hospitals wind up burning through their supply of PPE while taking @ @ @ @ @ @ @ have the coronavirus .
There is a national shortage of PPE , and some places in California , including Los Angeles County , have already used up their emergency supply .
“ Lab turnaround time is PPE , ” says Geoff Baird , the acting laboratory-medicine chair at the University of Washington .
“ More than a day is a tragedy .
Three to five is okay for outpatients if they can sit at home , but it doesn ’ t address the problem in a hospital.
” One physician at a community @ @ @ @ @ @ @ to protect her job , echoed the sentiment that waiting on negative results hurts her ability to provide care .
“ Time to negative result for a mildly ill patient is maybe the most worrisome thing right now , ” she told us , because it is creating “ the bottleneck which will result in denial of care to patients we can save.
” At the same time , patients who do have COVID-19 also suffer from testing delays , because they can not access all possible treatments , Greene said .
“ @ @ @ @ @ @ @ critical care , and even your spouse has tested positive , if you don ’ t have a positive result , they can ’ t give you the experimental drugs , ” she said .
A Quest spokesperson , Wendy Bost , told us that the company ’ s initial effort in California had been overwhelmed by demand .
“ There was a tremendous demand because we only had the one laboratory [ in San Juan Capistrano ] for about a week or more , and all the demand was being funneled into @ @ @ @ @ @ @ She claimed that the situation has improved for current testing .
“ The average turnaround time nationally is four to five days , from the time where we collect the specimen to when we report the results out , ” Bost said .
“ However , there have been cases that have been several days longer than that.
” Quest did not disclose how many pending tests it has at the San Juan Capistrano facility or in California or in the nation .
Quest faces two major problems in dealing with its backlog @ @ @ @ @ @ @ on March 9 , Quest started using a labor-intensive , laboratory-developed test , Bost said .
Then , sometime after March 13 , it switched to using a highly automated , high-throughput test created by the Swiss manufacturer Roche .
* The problem is that specimens collected for the first type of test can not be used in the new machinery—and many of the early samples were meant for the laboratory-developed test .
It does not matter how many high-speed Roche machines Quest is using now : They can not be brought to @ @ @ @ @ @ @ could be one reason for the existing backlog , though Bost told us she could not say so for sure .

On the surface, the American COVID-19 testing regime has finally hit its stride. Over the past five days, the states have reported a daily average of 104,000 people tested, according to data assembled by the COVID Tracking Project, a volunteer collaboration incubated at The Atlantic. Today, the U.S. reported that 1 million people have been tested for the coronavirus—a milestone that the White House once promised it would hit the first week of March.
But things are not going as smoothly as the top-line numbers might suggest. Our reporting has unearthed a new coronavirus-testing crisis. Its main cause is not the federal government, nor state public-health labs, but the private companies that now dominate the country’s testing capacity. Testing backlogs have ballooned, slowing efficient patient care and delivering a heavily lagged view of the outbreak to decision makers.
Though the problem is national in scope, California is its known epicenter. Over the past week, the most populous state in the union—where the country’s first case of community transmission was identified, in late February—has managed to complete an average of only 2,136 tests each day, far fewer than other similarly populous states, according to our tracking data. Yet California also reports that more than 57,400 people have pending test results. Tens of thousands of Californians have been swabbed for the virus, but their samples have not yet been examined in a lab.
That is actually an improvement over the state of affairs this weekend, when California reported that more than 64,000 people had pending results. That number turned out to be incorrect, the result of an “inadvertent over-reporting error” at a private lab, the state said yesterday. But even with that downward adjustment—and even assuming that labs keep finding ways to test more samples per day—the numbers suggest that California will take weeks to work through the backlog.
Read: How Los Angeles is preparing for a worst-case scenario
In the meantime, California has completed fewer tests per capita than the country’s next five-largest states—and fewer tests per capita than any of the 34 states that regularly report their full testing data. New York has tested 13 times more people, on a per capita basis.
The overreporting error, the lackluster testing rate, and that persistently huge number of pending tests suggest something is rotten in the Golden State’s testing regime. Even more troubling, they raise the possibility that all across the country, huge numbers of results are stuck in purgatory.
Within the clinical-testing world, it is an open secret that Quest Diagnostics—one of the industry’s two big players, along with Labcorp—has struggled to scale up its operations in California. And yet, Quest has continued to accept specimens from across the country, leading to a huge backlog of tests at the company’s facility in San Juan Capistrano.
This failure accounts for at least some of the tens of thousands of pending tests reflected in the state’s reported numbers. According to experts, it isn’t Quest’s fault that the company has so far been unable to meet the technical challenge of testing thousands of people every day. Setting up such “high throughput” operations is difficult. But Quest failed to come to terms with its ongoing problems, and it continued to accept specimens—and generate revenue—when other laboratories could have done some of the tests faster.
Dina Greene encountered the problem firsthand. She is the regional laboratory director for Kaiser Permanente in Washington State. At first, she had Kaiser facilities send their suspected COVID-19 specimens to the University of Washington’s virology lab, an academic clinic that has become a major tester for the Seattle area. But then Quest came knocking, promising that it could deliver results within 24 to 48 hours.
She did a trial run with the company, but “we quickly realized that it was a no-go and we needed to stick with UW,” she told us. “Quest has overpromised to prestigious institutions and medical centers around the country, and people are used to relying on Quest for quick and cheap results, but those time and time again have proven not to have the best quality. And in this situation, it has been disastrous to patient care.” (Greene is also an associate professor at the UW School of Medicine.)
Testing isn’t important only because it helps track the pandemic. For hospitals, coronavirus tests are a crucial tool in managing scarce resources. If a patient comes in with COVID-19-like symptoms, doctors and nurses must act as if the patient has the virus. They must don personal protective equipment, or PPE, every time they interact with the patient until he or she tests negative for the coronavirus. Because the majority of tests still come back negative in most places, hospitals wind up burning through their supply of PPE while taking care of patients who do not actually have the coronavirus. There is a national shortage of PPE, and some places in California, including Los Angeles County, have already used up their emergency supply.
“Lab turnaround time is PPE,” says Geoff Baird, the acting laboratory-medicine chair at the University of Washington. “More than a day is a tragedy. Three to five is okay for outpatients if they can sit at home, but it doesn’t address the problem in a hospital.”
One physician at a community hospital in California, who requested anonymity to protect her job, echoed the sentiment that waiting on negative results hurts her ability to provide care. “Time to negative result for a mildly ill patient is maybe the most worrisome thing right now,” she told us, because it is creating “the bottleneck which will result in denial of care to patients we can save.”
At the same time, patients who do have COVID-19 also suffer from testing delays, because they cannot access all possible treatments, Greene said. “If you’re intubated, in critical care, and even your spouse has tested positive, if you don’t have a positive result, they can’t give you the experimental drugs,” she said.
A Quest spokesperson, Wendy Bost, told us that the company’s initial effort in California had been overwhelmed by demand. “There was a tremendous demand because we only had the one laboratory [in San Juan Capistrano] for about a week or more, and all the demand was being funneled into that laboratory,” she said. She claimed that the situation has improved for current testing. “The average turnaround time nationally is four to five days, from the time where we collect the specimen to when we report the results out,” Bost said. “However, there have been cases that have been several days longer than that.”
Quest did not disclose how many pending tests it has at the San Juan Capistrano facility or in California or in the nation.
Quest faces two major problems in dealing with its backlog, whatever its size. First, on March 9, Quest started using a labor-intensive, laboratory-developed test, Bost said. Then, sometime after March 13, it switched to using a highly automated, high-throughput test created by the Swiss manufacturer Roche.* The problem is that specimens collected for the first type of test cannot be used in the new machinery—and many of the early samples were meant for the laboratory-developed test. It does not matter how many high-speed Roche machines Quest is using now: They cannot be brought to bear on those other samples. This could be one reason for the existing backlog, though Bost told us she could not say so for sure.
The second problem is that the federal government has asked that certain tests—such as those for hospitalized people and frontline health workers—be prioritized. But those early samples probably do not have the metadata attached to them that would allow Quest to move them higher up in the queue. So samples meant for the slower test must simply be run on a first in, first out basis.
Both of these problems were, to some degree, foreseeable. Quest must have known that it was building an enormous backlog, yet it did not turn down the revenue that came with accepting more testing specimens. Bost said that her company was trying to “support the public-health response” in continuing to take specimens.
By contrast, when the Utah-based nonprofit ARUP Laboratories realized that it could not fulfill any more COVID-19 tests, it refused to take more specimens. In mid-March, the University of Washington hit a similar wall, and stopped taking specimens for a time. The Mayo Clinic laboratory in Minnesota, which often tests samples from across the country, has slowly opened up its capacity to avoid running a backlog.
“It may be that Quest has mountains and mountains of specimens that they can’t get to,” said a clinical-laboratory director who requested anonymity for fear of damaging their relationship with Quest. “If so, they should tell someone.”
And though we know about the backlog in California, the problem may—and probably does—extend beyond the state, and for that matter beyond Quest too, based on our conversations with laboratory-testing experts, public statements by governors, and the accounts of patients and physicians.
Unlike the country’s first testing crisis, which was defined by a needless struggle between federal agencies and a pattern of blundering from the White House, fault for the new testing problem resides largely in the private sector.
But the Trump administration did play a role in the present crisis. Early this month, the White House Coronavirus Task Force realized that most of the country’s testing capacity existed in commercial laboratories. In particular, those labs specialized in the logistics of testing, the raw expertise needed to specimens in and results out. So the administration leaned into what Vice President Mike Pence called “not just a whole-of-government approach, but a whole-of-America approach.”
Read: The president is trapped
On Wednesday, March 4, the vice president stood next to lab-testing executives in the White House and made solemn assurances to the American people. The Centers for Disease Control and Prevention had abruptly stopped reporting the number of Americans tested for the coronavirus, but Pence promised that materials for “1.5 million tests are arriving at hospitals around the country.” Alex Azar, the Health and Human Services secretary, went even further, thanking his colleagues for “unbelievably fast work that is leading to 1 million tests being available by the end of the week.”
Two days later, speaking alongside President Trump at CDC headquarters in Atlanta, Azar claimed there would be “up to 4 million tests available in the United States by the end of next week.” Then the president said: “Anybody that wants a test can get a test. That’s what the bottom line is.” That was not true then, and it is not true now.
The net effect of these announcements was to raise hopes and, with them, demand for tests. Americans got the impression that hundreds of thousands of tests were available or would be soon. They were not. And this put all of the nation’s laboratories in an impossible position.
On the day of Trump’s CDC briefing, the country had conducted perhaps 2,000 tests total, according to our investigation for The Atlantic. Twenty-six days have elapsed since Azar first promised that “1 million tests” would soon come online, and 17 days have passed since his deadline for “up to 4 million tests” becoming available. Yet just today the U.S. passed 1 million cumulative people tested for the coronavirus. It is a major accomplishment and a testament to the thousands of labs and their workers across the country. But it is far short of the timeline that officials promised.
And while testing has ramped up in absolute volume—the country is now doing roughly 100,000 tests a day—the United States still lags behind other hard-hit countries in per capita testing. In Italy and South Korea, roughly 800 of every 100,000 people have been tested for the virus. But in the United States, only about 320 of every 100,000 have been tested. Testing is also wildly uneven among states. While New York, Washington, and Massachusetts have experienced large outbreaks, they’ve also tested extensively. But in large states like Georgia and Texas (and of course California), the number of tests that have been completed remains troublingly small.
The public-private partnership can work. In New York, the company BioReference Laboratories made the decision to bring up all available COVID-19 test assays, regardless of manufacturer, in the last week of February. “It was pretty clear at that time that the chance of this breaking open was pretty much certain,” Jon Cohen, the executive chairman of BioReference, told us. “It was just a matter of when and how big it was gonna be.” The company brought online five different platforms for testing, including Roche’s.
As BioReference scaled up, New York Governor Andrew Cuomo brokered a deal for it to provide testing capacity to the state. “To his credit, [he] actually reached out,” Cohen said. (The two men had a preexisting relationship.) Working with Northwell Health, the largest New York health-care provider, BioReference committed much of its processing capacity to the state. “The result of that is that we ended up being the lab that is doing all the drive-throughs of all of New York State,” Cohen said, “including New Rochelle,” the site of one of the most intense early outbreaks. He said his company’s turnaround times are 24 to 48 hours for outpatient testing and “within 24 hours” for hospitals.
Read: A New York doctor’s warning
Through BioReference and other commercial companies, as well as its own laboratories, New York now has almost 20 percent of all the completed tests in the United States. As a consequence, the number of confirmed cases has skyrocketed, but at least New York knows the severity of its outbreak.
If New York is on one end of the spectrum, California is on the other. What’s unclear is how common California’s and Quest’s situations are. No other state reports that it has such a huge backlog of tests stuck in private laboratories, but California’s reporting idiosyncrasy likely reflects reality better than other states’ reporting. For example, Illinois Governor J. B. Pritzker tweeted yesterday that private-lab results in his state are taking “4-7 days and sometimes even up to 10 days.”
In the best-case scenario, new capacity rises to meet stabilizing demand for tests. Quest’s Bost said that “in recent days, our capacity, which now exceeds 30,000 tests a day, has been at or above the level of demand.” So perhaps the backlogs are no longer growing.
One month ago today, the CDC still claimed that only 15 Americans were sick with the coronavirus. Community transmission of the virus seemed like a fluke, limited to the West Coast or perhaps just Northern California.
It’s now clear that this was an illusion: The virus was already everywhere. Even rudimentary models suggest that roughly 10,000 Americans may have been infected by March 1. Looking back with barely any hindsight at all, February already seems like a lost month, a different era in American history. In the past several weeks, much of the country has moved swiftly to confront the coronavirus, which has today infected at least 184,000 Americans and killed more than 3,746. A month from now, the backlog in California may seem just as naive as the CDC’s minuscule count from February seems to us today. California is the flare alerting the nation to systemic problems in our testing regime. Will we heed it?


Graeme Wood

Graeme Wood is a staff writer at The Atlantic and the author of The Way of the Strangers : Encounters With the Islamic State • John Bolton Tries to Recover His Dignity In his new memoir , the former national security adviser assesses and defends his time in the Trump administration .
• The United States is Now in the Midst of an Extended Moral Holiday When the going gets tough , the law gets suspended • Destroying the statues won ’ t erase the past .
Why not let them deteriorate in a public space instead ?
• How @ @ @ @ @ @ @ Nine Minutes ?
I don ’ t see how anyone could remain in that position unless he was , at best , totally indifferent to the person ’ s survival .
• Outrage is warranted .
But outrage unaccompanied by analysis is a danger in itself .
• The Best Shaming Happens in Private Internet mobs go after those who break social-distancing rules , but society has a better way to enforce norms .
• There ’ s No Simple Way to Reopen Universities How do you operate institutions designed to mix people @ @ @ @ @ @ @ • Doctors Are Holding Up Their End of the Bargain .
Society Is Not .
Sending health-care workers into hospitals with too few masks is a betrayal akin to sending soldiers into battle without armor .
• The WHO Defunding Move Isn ’ t What It Seems Trump is yet again attempting to distract the public from his own failures .
• Think 168,000 Ventilators Is Too Few ?
Try Three .
The coronavirus has been slow to spread across Africa .
But a wave may soon hit , and health-care workers are @ @ @ @ @ @ @ Are Coming , but They ’ re Not What You Think These novel approaches could fail in many ways .
• The ‘ Chinese Virus ’ Is a Test .
Don ’ t Fail It .
You should be more offended by Trump ’ s incompetence than by his attempt to racialize the pandemic .
• Iran Has Far More Coronavirus Cases Than It Is Letting On The surprising number of Iranian government officials succumbing to COVID-19 offers a hint that the disease is far more widespread than the official statistics indicate .
@ @ @ @ @ @ @ President As presidents slow down , more decisions get made by other people .
• The government has refused to impose quarantines and is encouraging people to visit the city of Qom , the center of the outbreak .
• Americans Are Suckers for a Certain Kind of Grifter For a time , Michael Avenatti fulfilled the left ’ s most destructive psychological needs—much as Donald Trump has done for the right .

Graeme Wood is a staff writer at The Atlantic and the author of The Way of the Strangers: Encounters With the Islamic State
He joined the magazine in 2006 after working as a translator, courier, and bootlegger in northern Iraq. He has since reported for The Atlantic from every continent except Antarctica, and on subjects ranging from foreign policy to pro wrestling. He is a member of the Council on Foreign Relations and teaches at Yale University.
Photo-illustration by The Atlantic. Sources: Bettman / Getty; … What Happens When a Carnival Barker Writes Intellectual History Christopher Rufo doesn’t understand that radicals and nutjobs make universities great.
Nicolás Ortega. Source: Alamy. How Bronze Age Pervert Charmed the Far Right An internet personality who espouses fascism, racism, and bodybuilding has won influential converts.
Gilles Peress / Magnum On the Death of Cormac McCarthy The worlds depicted in his novels are not built for mortal humans like you and me.
Photograph by Bill McCullough for The Atlantic Inside the Garden of Evil Harlan Crow wants to stop talking about Clarence Thomas.
Chris Goodney / Bloomberg / Getty Clarence Thomas’s Billionaire Friend Is No Nazi He has a signed copy of Mein Kampf. That doesn’t mean he admires Hitler.
Jonathan Ernst / Reuters The God That Couldn’t Possibly Fail An afternoon at the New York Young Republican Club in Manhattan, now a house of worship for Trump
Ben Stansall / AFP / Getty Blasphemy Forever Schoolboys scuffed a Quran. Why did the police care?
Thomas Simonetti / The Washington Post / Getty DEI Is an Ideological Test New College is not a weak target, and if Christopher Rufo wants to challenge an entrenched bureaucracy, then he will have a fair fight.
Eric Thayer / Getty The Mayhem Is Not About You Most shooters don’t think straight. For that matter, most nonshooters don’t either.
Jenn Ackerman / NYT / Redux Who’s Afraid of a Portrait of Muhammad? When Hamline University cut ties with a professor who showed a painting of Muhammad, it sided with the most intolerant element of the American Muslim spectrum.
Morteza Nikoubazl / NurPhoto / Getty You Can’t Reform the Morality Police Why half measures are a trap
Illustration by James Lee Chiahan. Source image: Karol … The Incandescent Wisdom of Cormac McCarthy His two final novels are the pinnacle of a controversial career.
Cole Wilson / The New York Times / … Who’s Afraid of Masih Alinejad? The journalist and activist is caught between a regime that hates her and a diaspora whose elite isn’t eager to give her credit for anything.
Paul Spella / The Atlantic; Getty This Is What Decadence Looks Like Saving democracy shouldn’t be the Democrats’ main pitch to voters.
Tai Power Seeff / The New York Times … Cowardice at Sundance Why was Jihad Rehab canceled? And who is behind the most serious charges leveled against the documentary?
The Atlantic Iran’s Knucklehead Assassination Strategy Three recent incidents suggest that Iran is ready for another round with the United States, this time with new, more amateurish tactics.
Erik Carter / The Atlantic; Getty The Move to Eradicate Disagreement What troubles me when the censorious types speak is not that they speak but that their response is to call for less speech.
Severin Carrell / Camera Press / Redux Salman Rushdie and the Cult of Offense This is what happens when you debase free expression in the name of free expression.
Getty; The Atlantic Not Even the President Can Declassify Nuclear Secrets Fan letters and snapshots are one matter, and launch codes are another—and here the details of classification might decide just how much trouble Trump is in.


Shadi Hamid

The senator from California seems like the obvious choice to be Joe Biden ’ s running mate .
So why is she keeping mum about her thinking ?
A few weeks ago , an adviser to Kamala Harris called me to talk through some polling data .
“ We understand that Joe Biden ’ s the nominee , but the party is so much different than a septuagenarian white male , ” the adviser said .
“ Kamala Harris is more symbolic of that changing America—America coming together—than some of the other potential candidates ” for vice president .
The @ @ @ @ @ @ @ because , officially , Harris is pretending that she ’ s not campaigning to be Biden ’ s running mate .
In public , Harris has repeatedly insisted that she ’ s not talking about or thinking about her prospects of being picked .
But judging from my conversations with people around Harris , she and her team use her prospects to book events and television hits that aim to show she ’ s neither overeager nor overambitious .
She and her team are avoiding situations that could create stumbles .
They ’ @ @ @ @ @ @ @ background , and the force of her personality propel her .
They ’ re picking specific moments for her to grab attention on the Senate floor or send a calibrated tweet .
They ’ re tuning out political reporters who are stuck on their couches , looking to drum up content during the pandemic .
They ’ re trying to ease concerns in Biden ’ s orbit that if she ’ s picked and they win , she ’ ll start running for president the morning after the inauguration .
They want her @ @ @ @ @ @ @ be the Democratic nominee in 2024 .

In a culture devoid of moral education, generations are growing up in a morally inarticulate, self-referential world.
This article was featured in One Story to Read Today, a newsletter in which our editors recommend a single must-read from The Atlantic, Monday through Friday. Sign up for it here.
Over the past eight years or so, I’ve been obsessed with two questions. The first is: Why have Americans become so sad? The rising rates of depression have been well publicized, as have the rising deaths of despair from drugs, alcohol, and suicide. But other statistics are similarly troubling. The percentage of people who say they don’t have close friends has increased fourfold since 1990. The share of Americans ages 25 to 54 who weren’t married or living with a romantic partner went up to 38 percent in 2019, from 29 percent in 1990. A record-high 25 percent of 40-year-old Americans have never married. More than half of all Americans say that no one knows them well. The percentage of high-school students who report “persistent feelings of sadness or hopelessness” shot up from 26 percent in 2009 to 44 percent in 2021.


theatlantic--2020-03-21--The Crisis Could Last 18 Months. Be Prepared.

From a public-health standard , the pandemic will not end for another 18 months .
The only complete resolution—a vaccine—could be at least that far away .
The development of a successful vaccine is both difficult and not sufficient .
It must also be manufactured , distributed , and administered to a nation ’ s citizens .
Until that happens , as recent reports from the U.S. government and from scientists at London ’ s Imperial College point out , we will be vulnerable to subsequent waves of the new coronavirus even if the current wave happens to ebb .
@ @ @ @ @ @ @ hunkered down at home will keep doing so through late 2021 .
The economic consequences of an indefinite lockdown are unsustainable .
And at a certain point , the emotional tensions that staying home imposes upon families , as spouses grate upon each other and children get bored and fall behind on their schoolwork , become a danger to domestic harmony , and maybe even to everyone ’ s sanity .
At the moment , we are just playing for time .
Whether social distancing is working will be clearer in a month @ @ @ @ @ @ @ then we will not know to a moral certainty when adults can safely go back to the office and children can go back to school .
Which is partly why employers , university officials , and others have given such widely varying time frames for how long they are shutting things down—two weeks , until the end of April , until the end of the academic year , until sometime later .
Two weeks , for what it ’ s worth , is just a way of breaking the bad news easily .
@ @ @ @ @ @ @ see more draconian distancing measures if the data start to show success .
The goal of social distancing , as everyone now knows , is to “ flatten the curve ” —to keep the number of COVID-19 cases from spiking faster than the medical system can mobilize to handle them .
But a flatter curve is longer ; a failure of social distancing would mean the peak comes sooner—at a horrifying cost of lives—but also that Americans are back outside sooner .
If entirely suppressing the coronavirus is a public-health ideal , crisis @ @ @ @ @ @ @ goal is to minimize risk , maximize defenses , and maintain social cohesion at the same time .
In a society that must start moving again at some point , emergency-management planners looking at the metrics may seem heartless .
Read : Why the coronavirus has been so successful In the military , commanders must make calculations about acceptable losses ; the benefits of a mission have to be weighed against the certainty that some soldiers will be lost .
We don ’ t have such language in the homeland-security world , but @ @ @ @ @ @ @ decision to open up again—to accept more exposures to the coronavirus as the price of an earlier economic revival—is simply a judgment call .
It is too late to prevent tragedy entirely ; our goal is to manage it within the limits of scientific progress and public tolerance .

Get your battle rhythm, I keep telling myself, as I put on my oversize sweatpants for the third day in a row. Staying inside, away from our offices, routines, and community, feels jarring even for those who, on a rational level, understand the need for extreme social distancing. The good side is having more family time. But everything seems upended, even to homeland-security professionals who argued for upending everything to slow the spread of COVID-19.
Just as seasickness abates once you can see the shore, the disruptions that the country is now experiencing would be easier to manage if we knew they would end soon. The community-isolation effort happened remarkably fast—within days, whole communities all but closed down, and earlier this week the federal government finally recommended the same. On Thursday, Governor Gavin Newsom ordered the entire state of California to stay home “until further notice.” But the way the crisis ends will be far more muddled. There isn’t going to be one all-clear signal—and certainly not one anytime soon.
Read: What you need to know about the coronavirus
As the days and weeks in isolation go by, and the shock of What just happened? turns to Family time is overrated, people will become more insistent on knowing two things: When will the pandemic end? And when can we go back to normal? Those questions have different answers, and the answer to the latter—far from being a purely scientific decision—will be guided by ice-cold moral and political calculations that nobody wants to discuss out loud.
From a public-health standard, the pandemic will not end for another 18 months. The only complete resolution—a vaccine—could be at least that far away. The development of a successful vaccine is both difficult and not sufficient. It must also be manufactured, distributed, and administered to a nation’s citizens. Until that happens, as recent reports from the U.S. government and from scientists at London’s Imperial College point out, we will be vulnerable to subsequent waves of the new coronavirus even if the current wave happens to ebb.
None of which means that people now hunkered down at home will keep doing so through late 2021. The economic consequences of an indefinite lockdown are unsustainable. And at a certain point, the emotional tensions that staying home imposes upon families, as spouses grate upon each other and children get bored and fall behind on their schoolwork, become a danger to domestic harmony, and maybe even to everyone’s sanity.
At the moment, we are just playing for time. Whether social distancing is working will be clearer in a month than it is now, but even then we will not know to a moral certainty when adults can safely go back to the office and children can go back to school. Which is partly why employers, university officials, and others have given such widely varying time frames for how long they are shutting things down—two weeks, until the end of April, until the end of the academic year, until sometime later.
Two weeks, for what it’s worth, is just a way of breaking the bad news easily. If anything, we are likely to see more draconian distancing measures if the data start to show success. The goal of social distancing, as everyone now knows, is to “flatten the curve”—to keep the number of COVID-19 cases from spiking faster than the medical system can mobilize to handle them. But a flatter curve is longer; a failure of social distancing would mean the peak comes sooner—at a horrifying cost of lives—but also that Americans are back outside sooner.
If entirely suppressing the coronavirus is a public-health ideal, crisis management is the homeland-security standard. The goal is to minimize risk, maximize defenses, and maintain social cohesion at the same time. In a society that must start moving again at some point, emergency-management planners looking at the metrics may seem heartless.
Read: Why the coronavirus has been so successful
In the military, commanders must make calculations about acceptable losses; the benefits of a mission have to be weighed against the certainty that some soldiers will be lost. We don’t have such language in the homeland-security world, but trade-offs are still inevitable. The wrenching decision to open up again—to accept more exposures to the coronavirus as the price of an earlier economic revival—is simply a judgment call. It is too late to prevent tragedy entirely; our goal is to manage it within the limits of scientific progress and public tolerance.
In the weeks to come, we should see a surge not only of patients, but also of supplies. The federal government has two main jobs right now: to get testing kits distributed nationwide, and to quicken the flow of money and expertise to support state and local efforts and expand the capacity of the health system. Go big or go home—the classic warning against half measures—is an old emergency-management maxim, and current circumstances give it an ironic twist: Because Americans are at home, the federal government needs to go big.
Managing the pandemic well doesn’t mean eradication; it means that our ability to mitigate how many people die—our ability to isolate those sick, test their contacts, care for them in available intensive-care beds with available respirators—is working. Social distancing, currently our primary tool to manage the burdens on our health-care system, will eventually give way to efforts to quickly identify those infected, before they can expose others, and also to treat those already exposed. Even before a vaccine is available, the United States will fall into a steady-state suppression effort—which is to say, life will go on, even as public-health officials play whack-a-mole with individual outbreaks.
So, that’s the plan. Sometime between now and when a vaccine becomes available, restaurants and schools and offices will reopen. It won’t happen all at once, as if by official decree, but as individual households and workplaces conclude one by one that they’ve had enough—and that the surge in testing kits, intensive-care beds, and other resources is finally sufficient to meet the need. That won’t take a year and a half. But I expect to be in these sweats for at least another month—and I’m planning for two.


theatlantic--2020-03-21--How the Coronavirus Became an American Catastrophe

In other places , the criteria have prevented residents from understanding the true extent of community spread .
Nebraska , which hewed closely to the rules , insisted it had only one case of community spread , even as suspicious cases filled ICUs , according to a 35-year-old doctor who asked not to be named , because she was not authorized to speak with the press .
Nebraska announced its second case of community spread on Wednesday .
The state has tested 800 people , total , for the coronavirus , the chief medical officer said .
The federal government @ @ @ @ @ @ @ the severity of the outbreak froze efforts to stop it .
Even after Bedford ’ s warning , the government published no studies of viral mutation .
The void forced leaders to act on the basis of risk , not solid information .
How could a mayor shut down her city if it had only 10 for-sure cases ?
How could a CEO tell employees to call off their trips—and not to Western Europe or central China , but to Seattle ?
American cities , blinded by the lack of testing data , @ @ @ @ @ @ @ .
On March 7 , as the severity of the local outbreak was becoming known , huge events were allowed to go on .
More than 30,000 people attended a Seattle Sounders game that night .
No one wanted to say what has now become clear : February was our chance to get this right .
We lost that entire month .
And we now live in a new era of work stoppages , overwhelmed hospitals , dead elders , and a wrecked economy .
No one had the guts to say what @ @ @ @ @ @ @ month : To save our people , we will have to keep our cities in a chokehold and decimate our economy .
It would have taken guts and the full-throated backing of every level of government and agency , as well as irrefutable data , for local officials to do something like that .
No one told them to , and the data did not exist for them to come to that conclusion on their own .
Without strong federal leadership , each state has been going after its own solutions and running @ @ @ @ @ @ @ residents would stay neatly within their own state lines .
Despite the rising number of cases and hospitalizations , President Trump tried to use partisan rhetorical tactics to fight the virus , and in so doing , encouraged Americans to ignore legitimate , dire warnings .
Now , though Trump has begun to mobilize a response to the pandemic , his base has been slow to acknowledge that precautions are necessary .
This dangerous remove from reality was possible for too long because of the absence of data showing how bad things already @ @ @ @ @ @ @ debacle started with testing , it may end there as well .
South Korea , which on March 1 was the site of the largest confirmed coronavirus outbreak outside of China , has aggressively tested a huge percentage of its population , and continues to screen massive numbers of people .
Now , just three weeks later , new COVID-19 cases are declining , and only 102 people have died as of Friday .
Washington State , with one-seventh the population of South Korea , already has 83 fatalities .
The U.S. caseload @ @ @ @ @ @ @ than twice South Korea ’ s total .
Bedford and other experts believe that Korean-style massive-scale testing will be essential to restoring normal economic conditions .
“ This is the Apollo program of our times , ” he said this week .
“ Let ’ s get to it.
” A week ago , an NBC reporter asked Trump during a White House briefing whether he took responsibility for the deadly testing delays .
His reply was immediate : “ No .
I don ’ t take responsibility at all.
” Frankie Dintino @ @ @ @ @ @ @ and Ed Yong contributed to this report .
This article uses data from the COVID Tracking Project at The Atlantic , supported by a grant from the Benificus Foundation .

The death and economic damage sweeping the United States could have been avoided—if only we had started testing for the virus sooner.
How many people are sick with the coronavirus in the United States, and when did they get sick?
These are crucial questions to answer, but they have never been answered well. Archived data from the Centers for Disease Control and Prevention—illustrated in the chart below—reveal that the government dramatically misunderstood what was happening in America as the outbreak began.
On the last day of February, the CDC reported that 15 Americans had tested positive for COVID-19, the disease caused by the coronavirus.
Data: The Internet Archive’s cache of CDC.gov
In the past week, as the country’s testing capacity has increased, officials have discovered more cases. Today, more than 17,000 people have tested positive.
Data: The COVID Tracking Project, an ongoing investigation co-founded by The Atlantic in collaboration with more than 100 volunteers
That may sound like a lot. But experts believe that the United States still isn’t testing enough people to detect the outbreak’s true spread. The virologist Trevor Bedford has found evidence that the coronavirus began spreading in the United States in January. It has already infected approximately 87,000 Americans, he says.
Here’s what his estimate of the pandemic’s arrival in America looks like—compared with how many people we thought were sick at the time:
Data: Trevor Bedford, the Internet Archive, the COVID Tracking Project
The truth is: We don’t know how many Americans are infected with the coronavirus.
The United States is a country soon to be overrun with sick people. As the positive tests for the new coronavirus have ticked upward, so, inevitably, will the deaths.
A study published this week by Imperial College London predicted that unless aggressive action is taken, the coronavirus could kill 2.2 million Americans in the coming months. A day after that study was published, its lead researcher developed a dry cough and fever. He had COVID-19.
When Wuhan began burning with infections in December, the U.S. government took only illogical, inadequate actions to stop the virus’s spread: It banned foreigners from entering from China, but inconsistently monitored Americans returning from the country. The president laughed off the virus and the Democrats’ response to it, calling it their “new hoax,” which immediately polarized the citizenry’s response to precautionary public-health information. When the sparks of this conflagration hit, Seattle was aflame before anyone at the CDC had started to reach for water.
COVID-19 is an American catastrophe, a slow-motion disaster only now coming into view. When its true proportions have been measured, it will make the early government response look even more outrageous than it already seems. What’s happening here, in this country, was avoidable. Nearly every flaw in America’s response to the virus has one source: America did not test enough people for COVID-19.
Read: How many people have been tested for coronavirus in your state?
Testing should have told doctors how to triage patients and hospitals when to prepare their wards. It should have allowed governors to gauge the severity of a local outbreak and informed federal officials as they allocated scarce masks and ventilators. Testing should have answered the all-important question in any pandemic: How many people are sick right now? Had the nation known that, the systems that were put into place over years of pandemic planning could have powered on, protecting millions of Americans and containing the illness.
Instead, the CDC botched its own test development. It sent testing kits to state public-health labs with a nonfunctioning ingredient. And by then, the virus was already spreading. It was already spreading as the Food and Drug Administration held up independent labs that had made their own tests. It was spreading as samples piled up, as the world’s top virology researchers pleaded to be permitted to test them and as the FDA denied their requests.
The virus was spreading as a delay in test kits became a national shortage. When community transmission in the United States was discovered, and states and hospitals lacked the supplies to diagnose even a dangerously ill patient, it was spreading. When a week passed, and the market began to collapse, and the country had barely tested 1,000 people, it was still spreading. Even as kits started to trickle out, the CDC and many state officials clung to restrictive rules that allowed only patients who had traveled internationally or been exposed to a known case to be tested, even though the coronavirus was already clearly spreading in American offices, day cares, and movie theaters. Doctors and nurses with all the symptoms of COVID-19 were denied tests because they could not prove exposure. The virus was still spreading.
Every six days that the country did not test, every six days that it did not act, the number of infected Americans doubled.
“The way no one expected how this response would fail in the U.S. is the testing,” Nahid Bhadelia, the medical director of the Special Pathogen Unit at Boston University School of Medicine, told us. She is an expert in infectious diseases and pandemics, and oversees the medical-response program at one of the few labs in the country permitted to handle the pathogens that cause Ebola, anthrax, and the bubonic plague.
“If you don’t know where the disease is early in the epidemic, you have no hope of containing it,” Bhadelia said. “Even now, [testing is] that Achilles’ heel; it’s the crack that is making its way throughout our entire response.”
Read: Why the coronavirus has been so successful
Without testing, there was only one way to know the severity of the outbreak: counting the dead. On February 29, Washington State confirmed that a man who had been at the Life Care Center outside Seattle had died, the first American death officially attributed to the virus. According to a now-archived version of the CDC’s website, the United States had, by then, tested 472 total people.
The death came at the end of a month that was America’s last chance at containing COVID-19. But it was too late. February had been lost.
On the last day of January, Trevor Bedford, a scientist at the Fred Hutchinson Cancer Research Center, in Seattle, hit Publish on a 484-word blog post that should have shaken the nation.
Bedford is one of the country’s experts on the evolution and infectiousness of viruses. Virus genomes are like tree rings: They provide clues to where a virus came from and how many times it’s been passed from person to person. With the outbreak raging in Wuhan, Bedford had been studying the genetic sequences of the new coronavirus that Chinese researchers had posted. By January 11, six were in the record, which allowed him to reconstruct the relationships between the individual strains. Though the World Health Organization insisted that this new coronavirus had “limited human-to-human transmission,” the genomes told Bedford otherwise. Whatever this virus was, he suspected it could spread easily among strangers, like the common cold or the flu.
Six days later, when a pair of travelers in Thailand came down with a similar illness, and researchers published the genome of the virus that had infected them, Bedford’s worst fears were confirmed. An epidemic had already begun. The new coronavirus had slipped the cordon in Wuhan, and was out in the world.
“As this became clear to me, I spent the week of Jan 20 alerting every public health official I know,” Bedford wrote that month. On January 23, the Chinese government, which had spent weeks trying to cover up the virus, swung into action. It locked down the city of Wuhan and by mid-February had restricted the movement of 700 million people. On January 24, the CDC announced it had developed a test for the disease. The FDA wouldn’t approve it for another week and a half.
This was the moment that epidemiologists had spent years dreading and anticipating. Almost every city and state in America had a pandemic-preparedness plan, reams of paper ready to put into action.
Read: Amazon confirms first known coronavirus case in an American warehouse
King County, in which Seattle and Kirkland sit, had a plan, of course. The last revision, dated October 2013, forecast the consequences of a pandemic flu in now-eerie detail. The country, they predicted, would be faced with deaths that could range into the millions. The pandemic “has the potential to suddenly cause illness in a very large number of people, who could easily overwhelm the healthcare system throughout the nation.” No vaccines would be available at first. Community services could break down. Everything could become disrupted “for several weeks, if not months.” So many of the steps that then seemed unthinkable to regular people—closing schools for months, social distancing, curfews, and more—were not only contemplated but gamed out.
Except for one thing. The plan took as a given that a functional testing apparatus would catch diseases on the way in, or at least before the fire started raging. Under its “Planning Assumptions” section, the second bullet point read, “There will be a need for heightened global, national and local surveillance.” Surveillance is public-health jargon for testing and the system that surrounds it. The planners knew there would be a need; they barely considered that it would not be met.
“A heightened local surveillance system … serves as an early warning system for potential pandemics and a critical component of pandemic response plans,” they wrote in another section of the report. “Local surveillance during a pandemic outbreak provides important information regarding the severity of disease, characteristics of the affected population, and impacts on the healthcare system.”
For every contingency that was considered, every difficulty and problem was assumed to be downstream of the high-quality information that would flow from the testing system. Without data about American cases in hand, how to handle the virus would become a matter of guesswork, not judgment.
In late January, as Bedford began to warn public-health officials, there remained, according to the president, nothing to worry about. “We have it totally under control,” President Donald Trump said at Davos. “It’s one person coming in from China, and we have it under control. It’s going to be just fine.”
On or about January 15, someone infected by the coronavirus arrived in the Seattle area, Bedford’s research would later show. The virus began to silently spread in the region. It would not be detected for another six weeks.
If there is one thing about the novel coronavirus that you must understand, it’s that it is a firecracker with a long fuse. Here is what the explosion looks like: Every six days, the number of people infected by the disease doubles, according to estimates from Bedford and other epidemiologists. At the start of February, Bedford now believes, the United States had something like 430 infections; if American interventions have done nothing to slow the disease’s spread, then his simple calculations show that more than 120,000 people could be infected by this weekend. Because of the great uncertainty, it’s probably most appropriate to give Bedford’s range: About 60,000 to 245,000 people are now infected with COVID-19 in the United States.
An invisible fuse sets off this burst of disease. If someone is infected with the coronavirus on Monday, she may start being contagious and infecting other people by Wednesday. But she may not start showing symptoms until Friday—meaning that she was spreading the virus before she even knew she had it. And in some cases, infected people take 14 days to start showing symptoms.
The onset of symptoms starts another awful clock. Many people will recover in a few weeks. But if someone’s case is severe, he may not recover for a month. And even if someone’s case is fatal, she may still survive for three weeks. This means that, first, cases discovered now may not become deaths for weeks; second, some people who will die in early April may only start showing symptoms today.
Read: Should you take Advil for COVID-19?
Mitigation efforts must burn through the same fuse. Even the decision to lock down the Bay Area, the country’s richest region, will not relieve pressure on the medical system for weeks.
Both of these factors mean that time is of the essence. This virus hides effectively and doubles quickly, but it kills slowly and painfully, and it kills most effectively when medical care isn’t available. This makes the coronavirus a particular disaster for the American hospital system, which after decades of streamlining has little spare capacity.
If the coronavirus was in the United States, it had to be found early, before too many explosions could go off.
Helen Y. Chu, an infectious-disease specialist at the University of Washington, thought she had a way to detect COVID-19’s arrival. She directed a monitoring program called the Seattle Flu Study, which studied the spread of the seasonal flu and collected samples from sick people on an ongoing basis. What if some of those patients didn’t have the flu at all, but COVID-19? In January, she and her colleagues began asking federal and state officials for permission to repurpose specimens to test for this other, similar respiratory disease, according to The New York Times. They turned her down then—and they kept rejecting her requests as the weeks wore on. There were legitimate privacy concerns, and government officials were not ready to authorize Chu to look.
On the last day of January, roughly 380 people were already infected with the coronavirus, most of them in the Seattle area, according to Bedford’s estimate. (Bedford is also part of the Seattle Flu Study.)
But then the CDC hit a disastrous roadblock, as it began to send test kits to public-health labs across the country. Two of the test’s reagents were fine, in most cases, but a third chemical initially deemed necessary for the test simply did not work. For the time being, every test for COVID-19 would have to be conducted by the CDC.
As the CDC struggled to find a solution, other laboratories tried to bring their own tests online. They found themselves hamstrung by the FDA, which, though it repeatedly loosened the rules, could not move as fast as the coronavirus.
Read: The U.K.’s “herd immunity” debacle
Alex Greninger, the assistant director of the clinical virology laboratory at the University of Washington, wanted to run a test of the lab’s own design. His lab would end up being one of the fastest to set up testing, and become the most important early source of information about the growth of the outbreak. But initially he, too, found himself caught up in the bureaucratic gears. On February 14, he sent a frustrated email to other clinical laboratories. The obstacles to setting up a test were unbelievable, he wrote: The FDA was asking him to show test results for more specimens than there were confirmed coronavirus cases in the United States—and the FDA wasn’t even making samples from those cases available to him. (The FDA did not immediately respond to The Atlantic’s request for comment.)
No one at the federal level was moving fast enough to actually deal with the looming disaster. “The most pernicious effect of the current regulatory environment is that it kneecaps our ability for preparedness should a true emergency emerge,” Greninger wrote to other laboratory directors. “Why bother getting ready as a clinical lab if you think that you won’t ever be allowed to do anything until May or June?” Even after his lab got FDA approval, another two to three weeks would pass before it could actually test a large number of samples. In coronavirus time, three weeks is about how long it takes for 100 cases to become more than 1,000. “We’ve been exceptionally fortunate to have so few positive cases,” he wrote. “Should that change in the coming weeks, this month will have been the time when we could have expanded our capacity for testing by including clinical labs.”
But the entire American testing effort, which would provide the crucial surveillance capability to understand any incipient outbreak, had stalled. The days ticked by; the virus spread. American public-health labs—which generally have far more capacity than the CDC—had completed only 16 tests, maybe a handful of people, by mid-February. All the way to February 26, only 102 specimens, or perhaps 50 people, had been tested by those labs. Overall, the CDC had tested fewer than 500 people. If the U.S. had a small number of cases, it was only because no one was looking for them. “We just twiddled our thumbs as the coronavirus waltzed in,” William Hanage, a Harvard epidemiologist, wrote in The Washington Post.
Perhaps because of the wildly constrained supply of tests, the criteria to get one were strict. You basically had to go to Wuhan, lick someone, and then develop pneumonia. No one from the federal government even tried to look for community transmission in the United States. In late February, the president voiced his hopes that “the numbers are going to get progressively better as we go along.”
They would not. In fact, as Trump spoke, the virus had reached a nursing home in the Seattle suburb of Kirkland, where it has so far killed 35 residents. The staff knew a mysterious virus was circulating, but life went on as normal. A concerned visitor who had gone to a Mardi Gras party at the center reached out to King County Public Health, the Los Angeles Times reported, and got the runaround.
Read: The dos and don’ts of social distancing
On February 26, the CDC confirmed what should have been clear much earlier: Community transmission in the United States had begun. The coronavirus was now spreading among Americans who had not traveled abroad or known a confirmed case. At least 60 people in the country now had the virus, according to the CDC’s totals at the time—and, as researchers and analysts soon realized, the true number was almost certainly much higher.
The CDC’s website now says that there were already 268 cases in the United States by that date. When Japan had nearly as many confirmed cases, it closed every school in the country. But because of the testing backlog, the United States remained unaware of its infection rate. And the president encouraged happy thinking. As CDC officials warned that the number of cases could soon quickly rise, Trump disagreed. “Within a couple of days,” he said, the number of cases “is going to be down to close to zero. That’s a pretty good job we’ve done.”
Bedford now estimates that roughly 7,640 people in the United States were already infected.
Chu, the Seattle infectious-disease specialist, decided not to wait for government officials any longer. As the United States declared the first cases of community transmission, she tested through Greninger’s lab without official approval and got a positive. The meaning was obvious to her. “It’s just everywhere already,” she later told The New York Times.
Under pressure to get tests out, the most important fix that our national agencies could make was to simply allow labs to start testing people. In a description that has now been removed from the CDC’s website, the agency gave labs simple instructions: They should use the two working reagents in the old kits. These instructions could have gone out weeks before they actually did, Greninger says, because they relied on the supplies that the CDC had already sent.
Meanwhile, Bedford began examining the new coronavirus strains from patients in Washington State, just as he had, six weeks earlier, analyzed the Asian samples. The Seattle-area specimens led him to a devastating conclusion: The viral genomes were too similar to have arrived in the United States at different times, from different people, but they were also too varied to have arrived recently. By the end of February, the disease had not only established itself in the United States. It had been circulating for close to six weeks. Seattle, on March 1, found itself in the same position as Wuhan did on January 1, with a growing coronavirus outbreak that was on the verge of exploding.
If Seattle went the route of Wuhan, the nation had three weeks before being set on a track in which hundreds or even thousands of people might die in Washington State alone. If a fire was raging in Seattle, it would throw off sparks across the country, hitting many more.
The clock required urgent action. On March 2, Bedford pressed Seattle officials to implement social-distancing policies immediately. If the epidemic grew any further … well, the CDC knew what might happen.
“Widespread transmission of COVID-19 in the United States would translate into large numbers of people needing medical care at the same time,” the agency warned in a passage titled “What May Happen” on the coronavirus page of its website. “Public health and healthcare systems may become overloaded, with elevated rates of hospitalizations and deaths.”
One day after Bedford published his warning, the CDC announced that it would stop reporting how many people in the United States had been tested for the coronavirus. Donald Trump shared his views on Fox News the following night. “A lot of people will have this, and it’s very mild,” he said. “They’ll get better very rapidly. They don’t even see a doctor. They don’t even call a doctor.”
The virus was now clearly spreading, but the CDC still seemed stuck in neutral. On March 10, CDC Director Robert Redfield described his agency’s strategy to The New York Times. “It’s going to take rigorous, aggressive public health—what I like to say, block and tackle, block and tackle, block and tackle, block and tackle,” he said. “That means if you find a new case, you isolate it.”
Redfield’s advice would have sounded reasonable back on Planet A, where the U.S. surveillance apparatus had not failed so spectacularly, but it was almost nonsensical on Planet B, where we all now live. Almost no one was getting tested, so how could anyone find a new case? A few days earlier, a state-by-state investigation by The Atlantic found little evidence that more than 2,000 people had been tested nationwide. We also found that many states had effectively no ability to test for COVID-19, and the few that did—Washington and California—were already deep into their local outbreaks. After we published the story, reports flooded in from across the country from people who had been denied tests, or doctors who couldn’t get one for patients who they believed needed them. In some cases, even doctors who had treated COVID-19 patients were not able to get tested.
As we heard from dozens of frightened and frustrated people across the country, President Trump told reporters, “Anyone who wants a test can get a test.” This was and is still not true.
The scarcity of tests forced officials to ration them. States, counties, and hospitals implemented strict rules about who could qualify for a test. The rules, while based on CDC guidance, were often too limited, given how widely the virus had already spread: They asked about foreign travel and confirmed exposure to a COVID-19–positive patient, weeks after it was clear that the virus was in the United States and that many cases were going undetected. At least 19 states have used a version of the rules that made it effectively impossible to detect the first signs of community spread in a state or city.
In the few places where officials have tested people without known exposure to COVID-19, they have found the virus. In Sonoma County, California, the public-health department asked four hospitals to test the first 20 patients who walked in the door each day with any coronavirus symptoms—even if the patient had not traveled abroad or been exposed to another known case. They started the project on a Friday. They had found a positive by Saturday. “All we needed was one case to say: Yes, we have community transmission,” Jennifer Larocque, a spokesperson for the county, told us.
In other places, the criteria have prevented residents from understanding the true extent of community spread. Nebraska, which hewed closely to the rules, insisted it had only one case of community spread, even as suspicious cases filled ICUs, according to a 35-year-old doctor who asked not to be named, because she was not authorized to speak with the press. Nebraska announced its second case of community spread on Wednesday. The state has tested 800 people, total, for the coronavirus, the chief medical officer said.
The federal government’s reliance on CDC data about the severity of the outbreak froze efforts to stop it. Even after Bedford’s warning, the government published no studies of viral mutation. The void forced leaders to act on the basis of risk, not solid information. How could a mayor shut down her city if it had only 10 for-sure cases? How could a CEO tell employees to call off their trips—and not to Western Europe or central China, but to Seattle?
American cities, blinded by the lack of testing data, did little as crucial days went by. On March 7, as the severity of the local outbreak was becoming known, huge events were allowed to go on. More than 30,000 people attended a Seattle Sounders game that night. No one wanted to say what has now become clear: February was our chance to get this right. We lost that entire month. And we now live in a new era of work stoppages, overwhelmed hospitals, dead elders, and a wrecked economy.
No one had the guts to say what needed to be said over the past month: To save our people, we will have to keep our cities in a chokehold and decimate our economy. It would have taken guts and the full-throated backing of every level of government and agency, as well as irrefutable data, for local officials to do something like that. No one told them to, and the data did not exist for them to come to that conclusion on their own.
Without strong federal leadership, each state has been going after its own solutions and running its own show, as if its residents would stay neatly within their own state lines. Despite the rising number of cases and hospitalizations, President Trump tried to use partisan rhetorical tactics to fight the virus, and in so doing, encouraged Americans to ignore legitimate, dire warnings. Now, though Trump has begun to mobilize a response to the pandemic, his base has been slow to acknowledge that precautions are necessary. This dangerous remove from reality was possible for too long because of the absence of data showing how bad things already were.
Ironically, given that the debacle started with testing, it may end there as well. South Korea, which on March 1 was the site of the largest confirmed coronavirus outbreak outside of China, has aggressively tested a huge percentage of its population, and continues to screen massive numbers of people. Now, just three weeks later, new COVID-19 cases are declining, and only 102 people have died as of Friday. Washington State, with one-seventh the population of South Korea, already has 83 fatalities. The U.S. caseload has ballooned to almost 20,000, more than twice South Korea’s total. Bedford and other experts believe that Korean-style massive-scale testing will be essential to restoring normal economic conditions. “This is the Apollo program of our times,” he said this week. “Let’s get to it.”
A week ago, an NBC reporter asked Trump during a White House briefing whether he took responsibility for the deadly testing delays. His reply was immediate: “No. I don’t take responsibility at all.”
Frankie Dintino, Quinn Ryan, Jacob Stern, and Ed Yong contributed to this report.
This article uses data from the COVID Tracking Project at The Atlantic, supported by a grant from the Benificus Foundation.


David Frum

David Frum is a staff writer at The Atlantic and the author of Trumpocalypse : Restoring American Democracy ( 2020 ) .
In 2001 and 2002 , he was a speechwriter for President George W. Bush .
• It All Happened in Full View What if there is no cover-up ?
• He will attack the independence and integrity of the legal system , try to benefit from foreign help , and benefit from voting obstacles .
• Trump Is Losing Credit Where He May Soon Need It Most The president is not wrong to feel a personal sting in @ @ @ @ @ @ @ • The president is exposing problems in America that most did not want to see .
• The System Failed the Test of Trump The story of recent years is of institutions that were unable to constrain the presidency .
• Trump Is Attacking Global Trade .
Would Biden Bring It Back ?
The presumptive Democratic nominee doesn ’ t yet have a bold and assertive plan to resist the rise of protectionism .
• The president is talking about things most Americans can ’ t comprehend , let alone care about .
@ @ @ @ @ @ @ Conceal The former national security adviser ’ s lies protected himself .
But they also protected Trump .
• The Very Real Threat of Trump ’ s Deepfake The president ’ s first use of a manipulated video of his opponent is a test of the boundaries .
• Why Mitch McConnell Wants States to Go Bankrupt The Senate majority leader is prioritizing the Republican Party rather than the American people during this crisis .
• Trump ’ s Two Horrifying Plans for Dealing With the Coronavirus If he can ’ t confine @ @ @ @ @ @ @ is prepared to incite a culture war to distract his supporters .
• The president is failing , and Americans are paying for his failures .
• The Coronavirus Is Demonstrating the Value of Globalization We are experiencing a painful introduction to anti-globalism and its consequences .
• Those seeking to support Trump ’ s party line need an excuse for their months of denial and deception—and they ’ ve found it .
• What If the President Gets Sick ?
The public deserves to know right away whether the chief executive is @ @ @ @ @ @ @ have gotten tested sooner .
• If somebody other than Donald Trump were in the White House , the coronavirus crisis would not be unfolding this way .

David Frum is a staff writer at The Atlantic.
He is the author of 10 books, most recently Trumpocracy (2018) and Trumpocalypse (2020). In 2001 and 2002, David was a speechwriter for President George W. Bush. From 2014 to 2017, he chaired the prominent U.K. center-right think tank, Policy Exchange. He writes for The Atlantic on topics including politics, policy, art, literature, and history.
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theatlantic--2020-03-04--Here’s Who Should Be Avoiding Crowds Right Now

A surprising number of people with a wide array of health conditions—including diagnoses as common as asthma—should be more cautious than usual .
But most Americans shouldn ’ t necessarily be avoiding crowds and airplanes at this point , experts say .
Instead , some risk assessment , both on an individual level and a societal level , is going to be required.. Read : You ’ re likely to get the coronavirus Currently , the Centers for Disease Control and Prevention recommends that all Americans avoid nonessential travel to five countries : China , Italy , South Korea , @ @ @ @ @ @ @ , including Twitter , have suspended all employee travel .
But beyond that , there are weddings , conferences , vacations , and funerals to get to by plane .
COVID-19 is transmitted through coughing or sneezing , so staying six feet away from people will help minimize the risk that someone else ’ s cough droplets will land on you .
If you ’ re getting on a plane , however , that won ’ t be possible .
And the closer you ’ re sitting to a fellow passenger who ’ @ @ @ @ @ @ @ to get COVID-19 from that person .
On a more typical day , the average American city dweller might take a crowded train to a packed , open-plan office , then go to a bustling PTA meeting after work .
According to Chu , people who already have a chronic illness or are at risk of getting one should avoid these types of crowds as much as possible .
This includes people with cancer , people over the age of 65 , and people with respiratory diseases such as chronic obstructive pulmonary disease @ @ @ @ @ @ @ People with asthma are not more likely to catch COVID-19 , but they are more likely to fare poorly if they do .
Asthma and similar health conditions cause the lungs to have trouble exchanging air , a situation that viruses such as the flu and the coronavirus exacerbate by filling the lungs with inflammatory cells , Chu said .
Read : What you can do right now about the coronavirus There ’ s no hard cutoff for when a crowd becomes too risky for an asthmatic or elderly person .
It ’ @ @ @ @ @ @ @ opera is definitely off-limits but work meetings are guaranteed to be fine .
Chu said she recommends that people who have asthma or a lung disease or are otherwise immunocompromised start thinking about telecommuting from work right about now .
For everyone else , decisions depend on what Amesh Adalja , a senior scholar at the Johns Hopkins University Center for Health Security , calls personal “ risk preference.
” That is , how worried are you about catching COVID-19 ?
If you ’ re relatively young , healthy , and traveling to @ @ @ @ @ @ @ countries relatively soon , you might decide that the risk of catching the disease is worth whatever it is you ’ re doing .
Adalja told me that he has not canceled any of his public appearances .
Two other experts told me that it ’ s still too premature for healthy people living in areas without a large number of cases to avoid gatherings or otherwise change their plans .
Instead , says Henry Wu , the director of the Emory TravelWell Center , in Atlanta , the advice is the same @ @ @ @ @ @ @ of day-to-day life : They should just wash their hands often , cough into the crook of their elbow , and avoid touching their face .
Of course , for some people , staying inside for a few weeks would be easier than going a single day without a good face-touch .

Information about the novel coronavirus is rapidly changing. As a result, some of the information or advice in this article may be out-of-date. You can find The Atlantic’s most current COVID-19 coverage here
In a time when a novel virus is still spreading quickly, a gathering of friends can now look more like a mob of disease vectors. Many of us are wondering, How many people is too many people to be around? The larger the crowd, after all, the greater the chance that someone in it will have the coronavirus.
Tokyo has already canceled its marathon for all but professional runners. (More than 37,000 runners took part last year.) The March meeting of the American Physical Society in Denver has been canceled. (Organizers anticipated 10,000 attendees.) Workday canceled a sales conference in Orlando, and Google and Facebook have also scrapped multiple events. (Last year, one of these, F8, drew 5,000 attendees.) Seemingly overnight, the coronavirus has people rethinking concerts, vacations, and even getting to work on public transportation.
Read: The official coronavirus numbers are wrong, and everyone knows it
This is not an unreasonable conversation to be having with yourself about COVID-19, the disease caused by the virus. “There are people who are walking around who must have it, or have had it very recently, or are about to have it,” Helen Chu, an infectious-disease professor at the University of Washington, told me. For that reason, she added, canceling major public events, such as marathons and conferences, is a “wise choice.”
A surprising number of people with a wide array of health conditions—including diagnoses as common as asthma—should be more cautious than usual. But most Americans shouldn’t necessarily be avoiding crowds and airplanes at this point, experts say. Instead, some risk assessment, both on an individual level and a societal level, is going to be required..
Read: You’re likely to get the coronavirus
Currently, the Centers for Disease Control and Prevention recommends that all Americans avoid nonessential travel to five countries: China, Italy, South Korea, Iran, and Venezuela. Some companies, including Twitter, have suspended all employee travel. But beyond that, there are weddings, conferences, vacations, and funerals to get to by plane. COVID-19 is transmitted through coughing or sneezing, so staying six feet away from people will help minimize the risk that someone else’s cough droplets will land on you. If you’re getting on a plane, however, that won’t be possible. And the closer you’re sitting to a fellow passenger who’s sick, the likelier you are to get COVID-19 from that person.
On a more typical day, the average American city dweller might take a crowded train to a packed, open-plan office, then go to a bustling PTA meeting after work. According to Chu, people who already have a chronic illness or are at risk of getting one should avoid these types of crowds as much as possible. This includes people with cancer, people over the age of 65, and people with respiratory diseases such as chronic obstructive pulmonary disease, emphysema, or even asthma.
People with asthma are not more likely to catch COVID-19, but they are more likely to fare poorly if they do. Asthma and similar health conditions cause the lungs to have trouble exchanging air, a situation that viruses such as the flu and the coronavirus exacerbate by filling the lungs with inflammatory cells, Chu said.
Read: What you can do right now about the coronavirus
There’s no hard cutoff for when a crowd becomes too risky for an asthmatic or elderly person. It’s not that, say, the opera is definitely off-limits but work meetings are guaranteed to be fine. Chu said she recommends that people who have asthma or a lung disease or are otherwise immunocompromised start thinking about telecommuting from work right about now.
For everyone else, decisions depend on what Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, calls personal “risk preference.” That is, how worried are you about catching COVID-19? If you’re relatively young, healthy, and traveling to a place other than the five restricted countries relatively soon, you might decide that the risk of catching the disease is worth whatever it is you’re doing. Adalja told me that he has not canceled any of his public appearances. Two other experts told me that it’s still too premature for healthy people living in areas without a large number of cases to avoid gatherings or otherwise change their plans. Instead, says Henry Wu, the director of the Emory TravelWell Center, in Atlanta, the advice is the same as it has been for the rest of day-to-day life: They should just wash their hands often, cough into the crook of their elbow, and avoid touching their face.
Of course, for some people, staying inside for a few weeks would be easier than going a single day without a good face-touch.


Conor Friedersdorf

Conor Friedersdorf is a California-based staff writer at The Atlantic , where he focuses on politics and national affairs .
He is the founding editor of The Best of Journalism , a newsletter devoted to exceptional nonfiction .
• Why the War on Cocaine Still Isn ’ t Working U.S. policy continues to harm Colombia while failing to prevent immense quantities of cocaine from reaching American soil .
• Police misconduct is widespread , far beyond the countless examples that are captured on cellphone cameras and posted to YouTube .
• President Trump and Senator Tom Cotton want to use @ @ @ @ @ @ @ would be catastrophic .
• Police Reform Is Popular .
Rioting Is Not .
Once the fires are out , what is the best way to secure justice ?
• The president is supposed to protect and defend the nation ’ s supreme laws .
Shooting looters is unconstitutional .
• The Regulatory State Is Failing Us Tyler Cowen suggests how to address some of the biggest obstacles to fighting COVID-19 .
• Why Are So Many Republicans Remaining Silent ?
Not a single congressional Republican from Florida was willing to comment about @ @ @ @ @ @ @ former colleague Joe Scarborough .
• The president does not seem to grasp the most basic aspects of the public-health crisis .
• Don ’ t Anguish Over Whom to Believe Pressure to pick a side in sexual-assault allegations can do more harm than good .
• Take the Shutdown Skeptics Seriously This is not a straightforward battle between a pro-human and a pro-economy camp .
• Food Banks Can ’ t Go On Like This Demand is spiking .
And meeting it is costlier than ever .
Without more changes to federal @ @ @ @ @ @ @ quo is unsustainable .
• Lives will be lost if Americans allow the culture war to determine whether they cover their face in public .
• Even now , vehement Trump supporters seem to believe that most criticism of the president is explained by widespread TDS .
• Nothing says “ happy birthday ” like the zip codes , email addresses , and mobile numbers of 1 million Americans .

Conor Friedersdorf is a staff writer at The Atlantic and the author of the Up for Debate newsletter.
Before joining The Atlantic in 2010, he was the features editor at Culture11 and a reporter for the Los Angeles News Group. He is the founding editor of The Best of Journalism , a newsletter devoted to exceptional nonfiction.
Photo-illustration by The Atlantic. Source: Hulton Archive / … Reader Views on the Role of Taboos “Taboos are illiberal mechanisms of enforcement and control,” one reader argues.
Hulton Archive / Getty The Role of Taboos in a Liberal Democracy Plus: free expression and social justice in the book world
Damon Winter / NYT / Redux 13 Readers on What Trump Voters Want “What really matters is whether a candidate gives a voter an identity,” a reader argues.
Michael Ho Wai Lee / SOPA Images / … A Progressive City Debates Crime Plus: One moment that could have weakened Donald Trump’s influence
Photo-illustration by The Atlantic. Source: Tony Bock / … Reader Views on Press Coverage of Race “Most of the time, I don’t think that negative reactions to observational, non-prescriptive pieces about race are the fault of the author,” one reader argues.
Haiyun Jiang / The New York Times / … Ignore the Histrionic Attacks on the Supreme Court Its most recent term was a credit to the institution, not the abomination its critics allege.
Everett How Comedy Movies Are Changing Plus: How to increase diversity at the top
Tony Bock / Toronto Star / Getty Why Is Tracy Chapman at the Center of a Country-Music Controversy? The response to Luke Combs’s cover of “Fast Car” raises questions about the relevance of race to certain news stories.
Illustration by The Atlantic. Source: Getty. 11 Reader Views on Affirmative Action “Affirmative action was always destined to be a Pyrrhic victory at best,” one reader argues.
Illustration by The Atlantic. Source: Getty. Readers’ Thoughts on Affirmative Action Responses from teachers, students, and others on educational equity
Illustration by The Atlantic. Source: Getty. The Hypocrisy of Mandatory Diversity Statements Demanding that everyone embrace the same values will inevitably narrow the pool of applicants who work and get hired in higher education.
Matthew Stockman / Getty When Sports and Politics Mix Plus: Share your thoughts on affirmative action.
Photo-illustration by The Atlantic. Source: Bettmann / Getty The Public Debates Worth Witnessing Readers weigh in on the topics and participants they would want to see.
Bettmann / Getty Joe Rogan, RFK Jr., and the Debates Worth Having Plus: Is the culture war upstream of politics?
Photo-illustration by The Atlantic. Source: Fox Photos / … The Gaps Between Media and Reality Readers share examples of media portrayals that are at odds with their own life experiences.
Ahmad Gharabli / AFP / Getty When Science Outpaces Ethics Plus: A ‘West Point for cops’
Illustration by The Atlantic. Source: Arnaud Chochon / … The ‘Single Greatest Hindrance’ to Learning Young people (plus parents and educators) reflect on the potential hazards of smartphones for children.
Arnaud Chochon / Hans Lucas / Redux The Battle Over Smartphones at School Plus: The decline of morality is an illusion.


Quinta Jurecic

Quinta Jurecic is a contributing writer at The Atlantic and managing editor of Lawfare .
• Three Plausible—And Troubling—Reasons Why Barr Tried to Force Berman Out Some are worse than others , though none represents what one would like to see from the Department of Justice .
• Despise Bolton , but Read His Book Anyway Americans need not validate or vindicate the former national security adviser .
But they should acknowledge that his story is worth hearing .
• Yet Another Week of Trump Failing to Be an Actual Authoritarian The president attempted to respond to protests with shows @ @ @ @ @ @ @ in the process .
• The president believes that those who oppose him should be punished , but that those who support him should be free to do as they please .
• ‘ Obamagate ’ Is Just Trump ’ s Latest Effort at Distraction From the very beginning of his administration , the president has sought to deflect attention from its original sin .
• What Judge Sullivan Should Do The Justice Department has requested that he dismiss the case against Michael Flynn .
Here are 13 questions the judge should ask @ @ @ @ @ @ @ Court Case That Could Destroy the Balance of Powers By accepting Trump ’ s argument for keeping his finances secret , the Court could strip Congress of its ability to hold this , or any , president to account .
• The Democrats Have No Good Options If they are successful in their cooperation with Trump , they potentially throw him an electoral lifeline .
But if they fail , the country will suffer .
• What ’ s So Hard to Understand About What Trump Has Said ?
A clarifying look at @ @ @ @ @ @ @ coronavirus , in his own words • Being an Actual Authoritarian Is Too Much Work for Trump The president doesn ’ t like constraints on his power , but he doesn ’ t exactly like using his power either .
• Trump ’ s Allies Know He Has Failed Defenders of the president seem to have settled on the excuse that the White House botched its pandemic preparations because it was too distracted by the drama on Capitol Hill .
• This Isn ’ t All Trump ’ s Fault ( But He @ @ @ @ @ @ @ with perfect leadership , the pandemic was always going to be bad .
But the president has caused the crisis to be far worse .
• Trump Seems to Be Missing His Old Scandals Why would the president , in the midst of an enormous public-health crisis , want to reignite the story of the Russian-collusion investigation that dominated his first two years in office ?

Quinta Jurecic is a contributing writer at The Atlantic, a fellow in governance studies at the Brookings Institution, and a senior editor at Lawfare.
She previously worked as Lawfare’s managing editor and as an editorial writer for The Washington Post. She is a co-host of The Lawfare Podcast’s “Arbiters of Truth” series on misinformation and disinformation, social-media platforms, and the online information ecosystem. Her writing focuses on politics, democracy, the rule of law, and the internet.
Drew Angerer / Getty The Triumph of the January 6 Committee Half a year after the House finished its work, the executive branch has taken the baton and started running.
Jim Watson / AFP / Getty; Alex Wong … The Court Eviscerates the Independent State Legislature Theory But bad-faith actors are still a threat to America’s elections.
Amr Alfiky / Reuters Trump Can’t Bluster His Way Through Court A courtroom is an inhospitable place for the former president’s efforts to define his own reality.
Ed Jones/ AFP / Getty This Is Actually Quite Bad The Manhattan district attorney’s charges underscore how profoundly unsuited Trump is for the office he is now again seeking.
Illustration by The Atlantic. Source: Brandon Bell / … An Astonishing, Frightening First for the Country The situation might be merely crass if not for the shadow of violence hanging over it.
Drew Angerer / Getty A Case That Even This Supreme Court Seems Torn Over A better version of the independent state legislature theory is proving difficult to figure out.
The Atlantic The Supreme Court Case That’s All About Donald Trump Even if it’s not explicitly about him at all.
Justin Sullivan / Getty Trump’s Terrifically Stupid Return to Twitter Two wealthy and self-involved men are seeking the attention they crave.
Olivier Douliery / AFP / Getty The January 6 Hearings Changed My Mind House investigators have come far closer than I anticipated to pinning both moral and legal responsibility for the insurrection directly on Donald Trump himself.
Jabin Botsford / The Washington Post / Getty The January 6 Committee Is Going to Have the Final Word By establishing an official record of the insurrection, the members are creating clarity in a political moment fogged with lies.
Stephen Voss / Redux The January 6 Committee Is Not Messing Around Its first two sessions have already made a powerful case for why this investigation matters.
Jeff Kowalsky / AFP / Getty The Great Rage Vicious political disagreement is seeping into every corner of life.
Stefani Reynolds / Bloomberg / Getty Why the January 6 Investigation Is Weirdly Static The House committee can still succeed, but success won't look like what a lot of onlookers are hoping for.
Illustration by The Atlantic* The Bobblehead Dilemma Liberals’ love for America’s bureaucrats stands in tension with the country’s deep need for institutional reforms.
James Devaney / GC / Getty The First Glimmer of Accountability The indictment of the Trump Organization and its CFO isn’t much—but it’s a start.
The Atlantic There’s No Good Way to Protect the Presidency Anymore The Department of Justice is banking on a future full of upstanding presidents who are committed to rule of law. But we may not be so lucky.
Science History Images / Alamy / Paul Spella … The Evolution of Trump’s Threat to America From Russiagate to the insurrection at the Capitol, Trump’s crises followed a clear trajectory.


Benjamin Wittes

Benjamin Wittes is a contributing writer at The Atlantic , the editor in chief of Lawfare and a senior fellow at the Brookings Institution .
• Three Plausible—And Troubling—Reasons Why Barr Tried to Force Berman Out Some are worse than others , though none represents what one would like to see from the Department of Justice .
• Despise Bolton , but Read His Book Anyway Americans need not validate or vindicate the former national security adviser .
But they should acknowledge that his story is worth hearing .
• Yet Another Week of Trump Failing to Be an Actual @ @ @ @ @ @ @ protests with shows of force , and revealed his weakness in the process .
• The president believes that those who oppose him should be punished , but that those who support him should be free to do as they please .
• ‘ Obamagate ’ Is Just Trump ’ s Latest Effort at Distraction From the very beginning of his administration , the president has sought to deflect attention from its original sin .
• What Judge Sullivan Should Do The Justice Department has requested that he dismiss the case against Michael @ @ @ @ @ @ @ judge should ask of government counsel .
• The Democrats Have No Good Options If they are successful in their cooperation with Trump , they potentially throw him an electoral lifeline .
But if they fail , the country will suffer .
• What ’ s So Hard to Understand About What Trump Has Said ?
A clarifying look at the president ’ s response to the coronavirus , in his own words • Being an Actual Authoritarian Is Too Much Work for Trump The president doesn ’ t like constraints on his @ @ @ @ @ @ @ exactly like using his power either .
• Trump ’ s Allies Know He Has Failed Defenders of the president seem to have settled on the excuse that the White House botched its pandemic preparations because it was too distracted by the drama on Capitol Hill .
• This Isn ’ t All Trump ’ s Fault ( But He Isn ’ t Helping Either ) Even with perfect leadership , the pandemic was always going to be bad .
But the president has caused the crisis to be far worse .
• @ @ @ @ @ @ @ Scandals Why would the president , in the midst of an enormous public-health crisis , want to reignite the story of the Russian-collusion investigation that dominated his first two years in office ?

Benjamin Wittes is a contributing writer at The Atlantic, a senior fellow at the Brookings Institution, and the editor in chief of Lawfare.
A specialist in law and national security, he is the author of several books. Most recently, he co-wrote Unmaking the Presidency: Donald Trump’s War on the World’s Most Powerful Office . He previously served as a member of The Washington Post’s editorial-page staff, where he focused on legal affairs.
Getty / The Atlantic Trump’s Self-Pardon Fantasy Will Meet a Harsh Reality The idea might sound good on paper, but in the real world it could backfire.
Alex Wong / Getty Can Democrats Stop the Nomination? Four questions that could determine whether Mitch McConnell can push through a Trump Supreme Court nominee
STR / AFP / Getty Lebanon’s Tragedy Is All Too Familiar Americans know what it’s like to suffer the consequences of negligent government.
Luke Sharrett / Bloomberg / Getty Trump Is Terrified of Losing His electoral prospects are slim—and he knows it.
MANDEL NGAN / AFP /Getty The Revenge of the Never Trumpers Conservatives who have repudiated the president are an essential part of the coalition that could elect Biden—and reshape American politics for years to come.
Rian Dundon / Economic Hardship Reporting Project Nothing Can Justify the Attack on Portland The question of whether these arrests are appropriate has a clear answer—at least in a nation that purports to live under the rule of law.
Getty / The Atlantic How to Corrupt the Justice Department Donald Trump has left his successors a playbook.
Getty Trump Is Campaigning on a Platform of Abject Failure The president’s argument for his reelection is not the kind of argument you make if you’ve done a good job.
Getty / The Atlantic Trump Is Boring Now, and He Can’t Do Anything About It Season 4 of the Trump show just doesn’t have the zest and sparkle of the previous seasons.
Oliver Contreras/SIPA/Bloomberg/Getty Three Plausible—And Troubling—Reasons Why Barr Tried to Force Berman Out Some are worse than others, though none represents what one would like to see from the Department of Justice.
Getty / The Atlantic Despise Bolton, but Read His Book Anyway Americans need not validate or vindicate the former national security adviser. But they should acknowledge that his story is worth hearing.
Shutterstock / The Atlantic Yet Another Week of Trump Failing to Be an Actual Authoritarian The president attempted to respond to protests with shows of force, and revealed his weakness in the process.
Debby Wong / Stephen Maturen / Getty / … The Law-Enforcement Abuses That Don’t Bother Trump The president believes that those who oppose him should be punished, but that those who support him should be free to do as they please.
Jonathan Ernst / Reuters Boring but Very Nasty Writing a column to prove the president’s tweet correct turns out to be more difficult than expected.
Mike Segar / Reuters Worse Than a Pardon The decision to drop charges against Michael Flynn implicates the whole justice system.
The Atlantic / Getty ‘Obamagate’ Is Just Trump’s Latest Effort at Distraction From the very beginning of his administration, the president has sought to deflect attention from its original sin.
Patrick Semansky / AP What Judge Sullivan Should Do The Justice Department has requested that he dismiss the case against Michael Flynn. Here are 13 questions the judge should ask of government counsel.
Bloomberg / Getty / The Atlantic To Trump, ‘Complete and Total Exoneration’ Is Always Right Around the Corner The president and his supporters continue to fixate on the Russia investigation, perpetually expecting redemption.
Chip Somodevilla / Getty The Democrats Have No Good Options If they are successful in their cooperation with Trump, they potentially throw him an electoral lifeline. But if they fail, the country will suffer.