Chapter Three

ITEM “R2”

With hindsight, given the upheavals that would soon follow, the March 10, 2020, four-hour-long board of supervisors meeting in Shasta County, part of northern California, more than six hundred miles to the south of Sequim, was shockingly sedate.

For the previous three months, the COVID virus had crept inexorably toward the United States. First there had been the stories in December 2019 about Wuhan, China—and the images of hospitals inundated with patients who couldn’t breathe. Then there had been the shocking scenes in Italy—where the virus swept through the north of the country, killing off thousands of elderly and immunocompromised people within just a few days. In the city of Bergamo, so many people died in that opening act of the pandemic that the local crematorium was overwhelmed. Army vehicles had to be brought in to transport the sealed coffins of the victims, the bodies treated as hazardous materials, to other parts of the country for disposal. Whole regions had been placed under a rigid lockdown in a frantic effort to slow the spread of this new killer virus, and then, the day before the Shasta board meeting, the entire country had been placed under emergency pandemic restrictions. Seemingly overnight, Italy had gone from being one of the largest economies on Earth to being a frozen-in-place death zone with all nonessential businesses shuttered and the population mandated to shelter in place. Modernity had, in the blink of an eye, been replaced by the unfathomable terrors of the medieval plague years.

In February and March, a few cases began being identified in the United States, many of those early infections tied to people who had traveled to China or Italy or some other hotbed and had then returned stateside, others related to cruise ships, but some additional ones seemingly caused by community transmission. It was those cases that caused public health workers and epidemiologists the most grief. For these cases meant that the disease was already among us, a silent, stalking killer, establishing beachheads in nursing homes and hospitals, in prisons and in public gathering spots, among families and in workplaces. It was only a matter of time now before the case numbers would begin to explode and then, a few weeks later, the deaths would escalate.

Public health officials, from the CDC through local officials at the county level, were frantically scrambling to isolate new patients, to identify people who had been exposed to the virus, to set up mass testing systems for COVID, and to purchase protective gear for medical personnel. And ordinary residents were rushing to grocery stores, where the shelves were increasingly empty of basic staples, to stock up for the unthinkable—a twenty-first-century pandemic lockdown, a quarantine that would shutter businesses, mandate that people stay in their homes, and keep children away from schools for months, maybe even years, into the future. It sounded impossible, but the impossible had already happened in China and in Italy. Borders were starting to be closed to noncitizens. Air travel was being restricted.

Six days before the March 10 meeting, California governor Gavin Newsom had declared a state of emergency in response to the developing crisis. Six days after the meeting, seven Bay Area counties would coordinate to declare a local lockdown to try to slow the spread of a disease that showed every sign of being likely to rapidly swamp health-care systems. A couple days later, Newsom would extend those lockdown restrictions to the entire state. Soon, similar restrictions would be implemented across most of the nation. By April, much of the rest of the world would be locked down, with draconian penalties imposed in many places for people who ventured into the streets without permits or did previously everyday things like hold birthday parties or attend funerals for departed friends and relatives. On television (could one bear it) one could tune in to images of once-vibrant cities from London to New York, from Shanghai to Mexico City, largely shuttered, their streets eerily empty, their skies denuded of airplanes, the noise of ambulance sirens providing an otherworldly soundtrack to an unthinkable catastrophe. In Venice, Italy, the waters in the famed canals would clear as pollution from boat traffic vanished. In Paris, Rome, Moscow, and other vast metro areas, millions of commuters would stop using public transport almost overnight, and large cities would become akin to a collection of autonomous villages, their residents hunkered down in their homes or venturing out for exercise to walk the streets only in their immediate neighborhoods. Descriptions of life on the other side of town would become as exotic as centuries-old travel journals written by adventurers exploring far-off lands.

That retreat into the hyper-local wouldn’t just be a result of personal preference; it would also be official government policy. In many countries in Europe, by the mid-spring of 2020 residents would need passes to travel more than a few miles from their home, to be outdoors for more than a certain number of hours a day, or to be on the streets after curfew—passes that would generally be granted only for medical emergencies or vital work needs. These pass-based travel restrictions would be as coercive as any issued on the Continent since the end of World War II. In Australia, the states would impose rigid lockdowns, and the federal government would implement draconian, multiweek quarantine rules for anyone entering the country. By March, Hong Kong had already moved to a mandatory fourteen-day quarantine for travelers. Soon, other megacities would follow suit in locking themselves down: places that had until recently bustled with life and culture would enter deep freeze, with only “essential workers” allowed to attend their places of work. In India entire apartment complexes, in cities such as Bombay, would be locked down when a resident tested positive, sometimes with guards patrolling the streets below to ensure that residents didn’t break out. Stories would emerge of millions of destitute migrant workers in India trekking back home to villages, their jobs having vanished overnight.

But when the Shasta County board of supervisors met, most of that was still in the future. On March 10 few people in attendance seemed to grasp the vastness of the changes that were about to befall them.

Board chair Mary Rickert opened with a few perfunctory comments, followed by a short invocation prayer by Pastor Dave Honey, of the Good News Rescue Mission. Despite it being a government meeting and thus supposedly nondenominational, Honey, his hair graying, wearing a black shirt, the top buttons undone, and a black sports jacket, made no bones about his Christian impulses. “In Jesus’s name we pray,” he concluded softly. Shasta was a conservative county; it was unlikely that anyone would make a fuss about the invocation.

After Honey, several minutes were spent on giving a young female county staffer an employee-of-the-month award. Only then, only after the ordinary, everyday business of politics in a small county had been dispensed with, did the meeting swing around to COVID. Dr. Karen Ramstrom had been asked by the board to come in and provide a public health briefing on what was happening and how the county was preparing for what might come. Standing at the dais, a low-cut purple blouse exposing the three thin necklaces around her neck, the doctor looked tired, even a little gaunt. She had been working flat-out in recent days, coordinating phone calls with the CDC and with state officials, getting travel manifests so that contact tracers in Shasta could reach out to people who might have been exposed overseas, setting up from scratch a new COVID-testing system for the county. Amid all of this, she had had to schedule time to work on this PowerPoint presentation.

On the projector hung behind the five supervisors, Ramstrom’s slides appeared. There was a dry, technocratic quality to the update, nothing to convey the earth-shattering enormity of what was starting to unfold. Eighty percent of COVID cases were thought to be mild or moderate, but that left 20 percent that were more serious—14 percent would likely be classified as “severe,” and 6 percent would leave victims critically ill and at risk of death. Ramstrom tried to contextualize: those numbers made the new virus far less lethal than other recent coronavirus outbreaks, such as MERS (with a 35 percent mortality rate) or SARS (with a 10 percent death rate), but far more lethal than many other communicable diseases. Measles had a 0.2 percent death rate, and seasonal influenza, which affected tens of millions of Americans every year, had a 0.1 percent rate. What was more worrying, though, was that no one had immunity to the disease, so once it got embedded in a community it would likely spread extremely quickly, via respiratory droplets, from one person to the next.

Ramstrom explained how even though scientists thought that asymptomatic transmission was not a big problem—a conclusion they would have to revise over the coming weeks and months—because it could happen, it still made social distancing particularly important. Moreover, because older people and those with weakened immune systems were particularly vulnerable, it was crucial, she explained, even if she had to admit that it “isn’t sexy,” for healthy residents to take the disease seriously and not to go to work or socialize with others if they were sick and therefore contagious.

The doctor ran down some more numbers. To date there had been 3,800 COVID deaths globally and 20 fatalities in the United States. California had confirmed 133 cases, 19 of which seemed to have been acquired by community transmission, and Shasta County had identified one case: a middle-aged man who had been infected while traveling overseas.

Ramstrom rapidly explained that the public health people were at this point in the pandemic trying to contain the spread of the virus but that at some point soon they would likely have to give up on that strategy and move to “community mitigation, which really has to do with social distancing.” They were strategizing how to keep hospitals functioning even as large numbers of staff got sick. And as she almost casually added toward the end of her presentation, “We are starting to have some conversations about consideration of a local emergency.”

As noted, it’s unlikely that many in the audience, including the board of supervisors members, fully understood either the magnitude of the situation or the import of those thirteen words. After all, a disease that had infected one person out of a county population of around two hundred thousand hardly seemed like something to fuss about. There were more immediate concerns—a spiraling epidemic of opioid drug use, homelessness, and poverty issues, not to mention all the physical, psychological, and economic impacts of years of massive wildfires throughout northern California.

One by one, the board members thanked her, and Rickert made small talk about how her own daughter had been in Milan when the outbreak there started but had come back to the United States and seemed not to have picked up the virus. Everything was calm, all the participants in the conversation civil. Less than half an hour after Ramstrom started speaking, the board meeting moved on to other, more immediate concerns: local power-grid problems, information about the county’s wellness clinic, conversations about how to respond to wildfires, a speech praising the work of a local children’s advocacy center, and so on. COVID had just been reduced to item “R2” on a crowded meeting agenda, on a par with all the other goings-on, all the other daily frustrations, of local governance.