1 The Virus

Rumors from Wuhan

December 2019–January 2020

Twenty-first-century Americans are used to scary headlines. Whether it’s nuclear war, sentient AI, climate change, or more lurid examples like murder hornets, Y2K, killer clowns, or a Mayan apocalypse, we are used to being regularly served with the inevitability of our impending doom. As such, the average person can be excused for failing to douse their hair in gasoline and ignite it whenever the AP or Reuters report something new to worry about.

In December 2019, one such story began circulating about an as-yet unknown illness in Wuhan, China. Early reports were aggressively banal compared to the examples above; one such brief referred to an “unidentified pneumonia outbreak” in Hubei province with 27 identified patients and no observed human-to-human transmission.1

SARS, MERS, H1N1 (“swine”) flu, and Ebola had all been serious, but none had materially affected the daily lives of average Americans despite the media frenzies that surrounded them. And so, as cases increased steadily in an ever-expanding crisis in Wuhan, the world remained unchanged. The question, then, is not why Americans did not see the pandemic coming, but when the evidence crossed the threshold from reasonable indifference to existential salience.

The news cycle droned on. Kobe Bryant’s death, the Harvey Weinstein trial, the U.S. killing of top Iranian general Qassem Soleimani, and the 2020 Democratic presidential primary peppered the headlines with a series of mostly ordinary, if sometimes gripping, news.

Even so, keen observers could notice a steady drip of details as scientists and public health officials worked furiously to get a handle on that novel respiratory illness, which was identified as being caused by a coronavirus on January 7 and initially named “2019-nCoV,” short for “novel coronavirus-2019.”2 The outbreak hit a meaningful milestone on January 14 when the World Health Organization (WHO) reported the possibility of human-to-human transmission; reports of cases in other countries, primarily in travelers coming from China, trickled into the news cycle.3

Americans first began seeing glimpses of the coming catastrophe in late January, with the first case of “coronavirus” in the United States on January 21, 2020, in a traveler who had returned to Washington State from Wuhan.4 While unsettling, this mostly prompted a sense of vague unease for the duration one spent thinking about it; it conjured memories of Americans returning from Africa with Ebola only a few years prior, and the leading expectation in the public imagination was still that the disease would be unceremoniously contained without too much trouble.

By January 21, that human-to-human transmission was confirmed. Up until that point, a casual observer could understand 2019-nCoV as an isolated cluster of illnesses likely of animal-to-human origin. Human-to-human transmission established that propagation of the virus beyond its initial source was possible, although not yet how efficient it was at achieving that end.

Yet another ominous murmur came from the Chinese government itself mere days later, on January 23. At only 444 recorded cases and 17 deaths, Wuhan authorities took unprecedented measures to suspend public transportation, close airports and train stations, and instruct residents not to leave without reason in an effort to contain the outbreak.5 Virtually overnight, eleven million residents of a modern metropolis were effectively shut out from the rest of the world. The scale of this disruption seemed surreal and wildly disproportionate to the raw case count, a fact that itself portended the scale of infection yet to come. Moreover, the restrictions began immediately before Lunar New Year, a significant event that was expected to precipitate large population movement and was also culturally difficult to disrupt.5

These measures were not in themselves a reason to panic; they functioned as a nudge that, in context, pointed to the disturbing possibility that the novel coronavirus might become something bigger. Increasingly severe restrictions in China combined with the revelation of human-to-human transmission and the recent history of SARS and MERS (which both had startlingly high mortality rates) elevated the concern from a faraway public health issue to a recurring media bugaboo that earned the attention of mainstream news outlets.6

Meanwhile, there was significant debate in the public health establishment about how to respond to the new pathogen. The World Health Organization (WHO) held an emergency committee meeting on January 22–23, though they failed to reach consensus about whether the situation warranted an emergency declaration. Barely a week later, on January 30, the WHO reconvened and this time issued that emergency declaration. Cases had risen sharply, more countries began reporting infections, and human-to-human transmission started appearing outside China. The outbreak was declared a Public Health Emergency of International Concern (PHEIC) that, while not yet calling it a pandemic, indicated to public health officials and experts worldwide that the pathogen likely posed significant risks to countries beyond China and that containing it would likely require significant international cooperation.3

By January 31, the situation had become much more serious: 9,826 confirmed cases, of which 9,720 were in China. 213 people were confirmed to have died of the disease, 106 cases had been reported in 19 countries other than China, and the United States stood at a total of six confirmed cases. At this point, the trajectory was clearly disturbing, but much was still unknown; it was not yet known how readily the virus spread, for example, or its true severity. But to the average American, containment still seemed more likely than a global pandemic.7

The Numbers Start Moving

January–February 2020

There is evidence that officials and concerned onlookers were alarmed by the novel coronavirus earlier than many of us remember. By January 31, the Trump administration had been sufficiently convinced of the threat to issue sweeping travel restrictions that took effect at 5 p.m. ET on February 2. These restrictions barred foreign nationals who had been in mainland China at any point in the previous two weeks from entering the U.S., though they did grant exceptions for returning Americans and some others. Americans returning from Hubei province were routed to specific airports and faced quarantine requirements.4

The coronavirus had something of a breakout cultural moment with the coverage of several coronavirus-infested cruise ships beginning with Diamond Princess in early February. The ship set off from Japan with some 3,700 passengers in late January, and by the first week of February the ship had become an uncontrolled natural experiment in the spread of coronavirus in a sealed environment. One passenger who disembarked on January 25 in Hong Kong tested positive on February 1; the ship nevertheless continued its itinerary through February 3, at which point it returned to Yokohama, Japan, after six stops in three countries. Initially, passengers did not disembark, though it was apparent the illness was rapidly spreading. By February 5, passengers were being confined to their cabins to prevent spread. By February 16, 355 cases had been confirmed, the largest known cluster outside of mainland China through most of February. All told, 712 of 3,711 passengers tested positive. 331 of those were asymptomatic.8

The Diamond Princess was important because it signaled to the public two alarming facts: coronavirus can spread quickly—and symptoms are not a foolproof way to identify infection. This largely set the stage for the Westerdam debacle. That ship, with some 2,257 passengers and crew aboard, spent roughly two weeks in early February sailing around East Asia trying to secure a port while being denied by Japan, Guam, the Philippines, Taiwan, and Thailand. Though Cambodia eventually allowed the ship to dock, the incident is noteworthy because the ship had no confirmed cases.9 Evidently, fear itself was rapidly becoming powerful enough to dictate political decisions with real social and economic consequences.

Judging its temporary designation of the novel coronavirus as “2019-nCoV” inadequate, the WHO renamed the disease “COVID-19,” short for “coronavirus disease 2019.” The virus itself was renamed “SARS-CoV-2” by the International Committee on Taxonomy of Viruses (ICTV), short for “severe acute respiratory syndrome coronavirus-2.”10 Until then, it had mostly been referred to just as “the coronavirus.”

By the third week of February, the newly christened COVID-19 began popping up all around the globe. South Korea was early to sound the alarm, reporting a major cluster in Daegu associated with the Shincheonji Church.11 Aside from the cruise ships crisscrossing the oceans, this was one of the first major instances of widespread domestic transmission—that is, most of the cases were not in travelers from China. Iran announced its first cases on February 19, the same day it reported its first fatalities; this was, unfortunately, suggestive that the virus had been spreading unchecked there for some time, given the incubation period and course of illness that precedes a fatal bout with the disease.11

Public anxiety steadily rose with each report from the Iranians and the South Koreans. Still, the eruption of cases in northern Italy in the fourth week of February seemed to mark a turning point in American media coverage. It is difficult to say why Italy was so psychologically jarring, but I will venture a guess that it was because it felt closer to home. China was a faraway country that felt alien to most Americans; Iran was a closed-off authoritarian backwater. South Korea was closer, but it could be hand-waved away by its proximity to China, no matter how silly that seems in retrospect. Italy, on the other hand, is European—it’s a vacation destination with a familiar culture, littered with landmarks whose likenesses adorn fridges, classroom walls, and picture books nationwide.

As WHO and European Centre for Disease Prevention and Control (ECDC) officials descended upon Lombardy and Veneto on February 24, the mood was mostly a drip-drip ratchet of increasing worry rather than panic.11 The outbreaks still had not been designated a pandemic, even as officials increasingly concluded that the disease had moved past the point where it was best explained by travel from China.

A foreboding cloud descended upon Wall Street the week of February 24–28 as a global stock market selloff began; it would rapidly become the worst week for the markets since the housing bubble burst in 2008. More than five trillion dollars evaporated worldwide—all before most major restrictions were implemented, before the death toll began climbing in earnest, and before anyone knew how long a ride we were in for.12

The selloff intensified after February 25, when Nancy Messonnier, then the director of the National Center for Immunization and Respiratory Diseases at the CDC, issued the strongest warning from an American official yet. Her admonition was curt and firm: prepare for disruption. This was the first time many Americans were given a preview of what the next couple of years would look like: school and workplace closures, cancelled large gatherings, and other measures that could severely disrupt everyday life.13 It also marked a stark turning point with respect to the rhetoric U.S. officials were using to communicate about the virus.

The next day, the first recognized case of community transmission was reported in a California patient with no relevant travel history and no known contact with an infected person. Importantly, this was only the first known community spread, almost certainly not the first. Barely seventy-two hours passed, and by February 29, additional likely cases of community spread were identified in Oregon, Washington, and elsewhere in California. Concurrently, a man in Washington State that day became the first reported U.S. death from COVID-19 (though later analyses would reveal the actual first death occurred much earlier).14

The month had begun with 9,826 confirmed cases; it ended with 85,403. It began with cases reported in 20 countries; it ended at 54.7,15 It would not stop there.

Rupture

March 2020

The beginning of March had a faintly airy, uncertain, unreal quality to it. COVID-19 was clearly a problem, and it appeared to be an increasingly local one, but very few in the public had yet come to appreciate its magnitude. We knew something was happening, but not how big or how important that thing was. The period leading up to the rupture of March’s second week felt as though the pandemic was slowly inching closer to everyday life. It was there in January, but it’s only in Hubei. It was there in early February, but it’s only in East Asia…well, now Europe too… It was in the United States, yes, but only on the West Coast. Surely it won’t make it all the way to me.

On March 1, New York State confirmed its first case, foreshadowing the early disastrous spread in the state.16 Around the same time, Americans got their version of the Westerdam and Diamond Princess; yes, we had our very own death-cruise spectacle. The Grand Princess had recently completed a cruise to Mexico, returning to San Francisco; on March 4, health authorities in California learned that some of the passengers from the previous voyage had developed COVID-19, including one man who had died. The implication here was that the disease was probably still circulating on board, because most of the crew and some passengers had remained.8 The ship was ordered to return to the United States but was initially not allowed to dock. The hulking white lump remained afloat conspicuously outside San Francisco, encircled by news helicopters and gawked at by a nation feeling both fascination and horror.

The Grand Princess drama unfolded over the course of several days. As the ship was held offshore, the California National Guard delivered tests for the virus, which, unsurprisingly, yielded several positives—21 of the first 45 tested had it.8 Meanwhile, a national debate percolated over what to do with the passengers. Contemporaneous reports said that Donald Trump’s advisors favored bringing them to the mainland for quarantine, but Trump disagreed. “They would like to have the people come off,” he said on March 6. “I’d rather have the people stay, but I’d go with them. I told them to make the final decision. I would rather—because I like the numbers being where they are. I don’t need to have the numbers double because of one ship.”17 Trump’s admission was startlingly blunt, though perhaps less so for him than it would be for another politician.

On March 9, the Grand Princess was finally allowed to dock in Oakland. Over the ensuing five days, passengers and some crew disembarked in staggered batches, each one greeted by a small army of health officials clad in respirators, face shields, and hooded white Tyvek coveralls. The episode finally ended with foreign passengers repatriated, Americans transferred into quarantine arrangements on military bases, and nine deaths from COVID-19 complications.18

Meanwhile, case numbers continued growing. On March 7, worldwide confirmed case counts surpassed 100,000, with the true number certainly much higher.3 The WHO finally declared COVID-19 a pandemic on March 11, noting 118,000 cases and more than 4,000 deaths across 114 countries. Cases outside China had, in the preceding two weeks, increased by more than an order of magnitude.19

That evening, the President delivered an Oval Office address whose content was so diligently, suspiciously obedient to his teleprompter that many of us were alarmed by the sheer lack of compulsive allusions to rat-bag Democrats, Crooked Hillary, or the Rigged Mueller Investigation. Even as he announced travel restrictions from Europe, blamed the Chinese, and labeled COVID-19 a “foreign virus,” Trump’s delivery was uncharacteristically restrained, almost somber, and he showed the visible discomfort of someone both aware that something was badly wrong and catastrophically unprepared—personally, as well as professionally—to handle it.20

Underpinning Trump’s unease were the beginnings of real disruptions to American social institutions. The same day, the NBA suspended its season after Jazz-Thunder player Rudy Gobert tested positive.21 Tom Hanks, one of the most broadly recognizable and reassuringly familiar celebrities one could name, announced he had it too.22 New York postponed its St. Patrick’s Day Parade—the first time it had not been held since the eighteenth century.23 Television shows began announcing tapings with no audience.24 Universities crossed a threshold—many, including my future alma mater, William & Mary, cancelled all in-person instruction and moved classes online.25

The next several days brought a rapid succession of state and local closures affecting schools, businesses, tourism, and social events. Between around March 12 and March 16, scores of seemingly disconnected institutions all seemed to reach a similar conclusion at the same time: shut down or prepare to be shut down.13 It was as if every hour, another pillar of American life collapsed, the beams buckling in sequence that inched, then crawled, then lunged at the throat of normalcy.

On March 13, the federal government formally declared a national emergency, finally signaling that COVID-19 was a real crisis unlikely to be contained and would require massive mobilization of attention and resources across local, state, and federal levels.26 By the time this emergency was declared, it was plainly obvious that it was justified; the whiplash came more from the Trump administration’s instincts to, over the preceding weeks, minimize its significance and wish it away into the category of routine public health annoyance.

The panic-buying that followed the recognition that reality itself had, in some sense, fractured read like a script I’ve often seen in the South, particularly when there is an approaching snowstorm. The event is so novel and so terrifying that, in addition to typical foodstuffs like milk, bread, eggs, and canned foods, shoppers start to fixate on specific items in a way that leads to a runaway sense of scarcity. The most memorable items from this cycle were typical flu-season infection control essentials like sanitizer, disinfectants, soap, paper towels, face masks, disposable gloves, and bleach. Slightly more bizarre was the obsession with toilet paper, which plenty of Americans evidently assumed would be necessary to stock by the ton if they were going to survive a prolonged viral siege.27 With masks, gloves, and disinfectants specifically, officials began worrying that hospitals and the healthcare professionals who staff them would be faced with shortages of personal protective equipment.28

By March 16, the White House announced its “15 Days to Slow the Spread,” which did not initiate the national response to the virus as much as it gave rhythm to the rolling, out-of-phase waves of local closures and social retreat. Though the implications of the message had not yet been absorbed completely, the federal government was beginning to tell the public that normal behavior was now itself dangerous. Gatherings should be avoided, travel skipped, and work and school reorganized or shuttered.29 The virus had thus completed its journey from obscure foreign concern to looming threat to the single governing fact of American life. What remained to be seen was whether the fear that so quickly reordered American life was proportionate to the danger Americans could reasonably have understood at the time.

What Was Reasonable to Fear?

As of March 2020

The initial response to COVID-19 has rightly come under immense criticism in the years thereafter. At the same time, there are limits to a fully retrospective account of policy decisions made under uncertainty. With that in mind, I ask the reader to set aside everything we have learned since mid-March of 2020 and ask what a sensible person and a competent government could have reasonably feared at the time.

The picture of the disease at that time was clear in some ways and yet more opaque than we might have hoped. We knew that the virus transmitted efficiently enough between humans to escape containment in China and establish runaway chains of infections in several countries.15 We knew that cases were increasing exponentially and that the virus could be carried by healthy people or the soon-to-be sick, and thus that cases were likely to be severely undercounted.8 We also knew from the outbreak in Italy that a modern Western healthcare system could come under severe pressure sufficient to threaten functional collapse.30 This last point was crucial—there was no vaccine, no proven treatment, and no population immunity to blunt the tsunami that could jeopardize our healthcare system.31

Yet much remained obscure. The true prevalence of the virus was unknown, though assumed to be much higher than the confirmed case count. This was especially a problem in the beginning when tests were in short supply, but it continued to be relevant because mild and asymptomatic infections had already been documented.32,33 Someone with a minor “cold” might not think of COVID at all, and someone asymptomatic might unknowingly spread the virus to others, all the while unaware of the bioreactor humming in their respiratory system.

Because of this, the actual fatality rate of the virus was not known, or knowable, at the time beyond the observation that it seemed to kill far more people who came down with it than ordinary seasonal viruses—the overwhelmed healthcare systems in northern Italy provided ample evidence for that.30 What we did know was a rough estimate of the case fatality rate (CFR), which needs to be distinguished from the infection fatality rate. The case fatality rate is the proportion of documented cases that result in death. The CFR was estimated at between 2% and 3%.34 That figure could not be directly compared with influenza’s estimated IFR because the true number of COVID-19 infections was still unknown. Health officials had only an observed CFR to work with, and its value was terrifying.

The attack rate of the virus was similarly unknown. “Attack rate” refers to the proportion of the population that becomes infected with a pathogen during an outbreak.35 The projected proportion of the population that might become infected would become a central justification for the mitigation measures that were implemented, and for good reason. In recent years, the American healthcare system has often been perilously close to surge capacity without an additional infectious disease on the loose. Immediately pre-COVID, around two-thirds of hospital beds were occupied at any given time; by 2023–24, that number was about three-quarters.36 Moreover, just because a bed exists does not mean it can be properly staffed. It does not mean there is a nurse to check vitals, a doctor to prescribe treatments, or a ventilator to keep a sick patient breathing.

The decision environment for health officials, politicians, and members of the public was thus asymmetric. Once COVID became a bona fide emergency, every incentive favored severe mitigation measures, because failing to slow the disease could trigger a cascading health disaster: patients would arrive too quickly and in numbers too great to treat properly, many would receive worse care, and many more would die—not to mention the routine care that would be displaced.37 Routine and preventive care would also be displaced: hypertension would go undetected, time-sensitive cancers would have more time to spread, strokes heart attacks, and other emergencies would compete for beds, staff, drugs, and attention.

The immediate goal, then, was not to stop infections but rather to slow them—to “flatten the curve” and protect the healthcare system from being stretched past its breaking point.37 Related goals were to buy time for the public health machinery to increase testing and surveillance, allow doctors to develop the first shreds of clinical intuition about how to treat the virus, and protect healthcare workers from unsafe conditions. The impulse to consider temporary disruption to daily life a worthwhile tradeoff was, then, eminently defensible. This is not to say that every restriction deserves to be validated, even from a contemporaneous perspective. Objectives, endpoints, and proportionality matter. It is only to say that from the perspective of America circa March 2020, severe caution with respect to COVID-19 was justified in exchange for the expected benefit of time and preserved healthcare capacity. How that bargain was implemented is another matter entirely.

Notes

  1. CIDRAP. (2019, December 31). Chinese officials probe unidentified pneumonia outbreak in Wuhan. University of Minnesota. https://www.cidrap.umn.edu/covid-19/news-scan-dec-31-2019
  2. World Health Organization. (n.d.). Coronavirus disease (COVID-19). Retrieved August 23, 2026, from https://www.who.int/europe/health-topics/coronavirus/taking-stock-of-the-health-related-sdg-during-covid-19
  3. World Health Organization. (2020, June 29). Listings of WHO’s response to COVID-19. https://www.who.int/news/item/29-06-2020-covidtimeline
  4. Patel, A., Jernigan, D. B., & 2019-nCoV CDC Response Team. (2020). Initial public health response and interim clinical guidance for the 2019 novel coronavirus outbreak—United States, December 31, 2019–February 4, 2020. Morbidity and Mortality Weekly Report, 69(5), 140–146. https://doi.org/10.15585/mmwr.mm6905e1
  5. Xinhua. (2020, January 23). China’s Wuhan suspends public transportation, outward flights, trains. https://www.xinhuanet.com/english/2020-01/23/c_138727567.htm
  6. Petrosillo, N., Viceconte, G., Ergonul, O., Ippolito, G., & Petersen, E. (2020). COVID-19, SARS and MERS: Are they closely related? Clinical Microbiology and Infection, 26(6), 729–734. https://doi.org/10.1016/j.cmi.2020.03.026
  7. World Health Organization. (2020, January 31). Novel coronavirus (2019-nCoV): Situation report—11. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200131-sitrep-11-ncov.pdf
  8. Moriarty, L. F., Plucinski, M. M., Marston, B. J., Kurbatova, E. V., Knust, B., Murray, E. L., Pesik, N., Rose, D., Fitter, D., Kobayashi, M., Toda, M., Cantey, P. T., Scheuer, T., Halsey, E. S., Cohen, N. J., Stockman, L., Wadford, D. A., Medley, A. M., Green, G., . . . Friedman, C. R. (2020). Public health responses to COVID-19 outbreaks on cruise ships—Worldwide, February–March 2020. Morbidity and Mortality Weekly Report, 69(12), 347–352. https://doi.org/10.15585/mmwr.mm6912e3
  9. Law, V. (2020, February 14). Nightmare holiday: Virus runs cruise passengers’ plans aground. Al Jazeera. https://www.aljazeera.com/news/2020/2/14/nightmare-holiday-virus-runs-cruise-passengers-plans-aground
  10. Kretchmer, H. (2020, April 22). Key milestones in the spread of the coronavirus pandemic. World Economic Forum. https://www.weforum.org/stories/health-and-healthcare-systems/coronavirus-spread-covid19-pandemic-timeline-milestones/
  11. World Health Organization. (2020, February 25). Coronavirus disease 2019 (COVID-19): Situation report—36. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200225-sitrep-36-covid-19.pdf
  12. Jones, M. (2020, February 28). Coronavirus crash wipes $5 trillion off world stocks. Reuters. https://www.reuters.com/article/global-markets/global-markets-coronavirus-crash-wipes-5-trillion-off-world-stocks-idUSL5N2AS3T4/
  13. Centers for Disease Control and Prevention. (n.d.). CDC Museum COVID-19 timeline. Retrieved September 4, 2026, from https://www.cdc.gov/museum/timeline/covid19.html
  14. Jorden, M. A., Rudman, S. L., Villarino, E., Hoferka, S., Patel, M. T., Bemis, K., Simmons, C. R., Jespersen, M., Johnson, J. I., Mytty, E., Arends, K. D., Henderson, J. J., Mathes, R. W., Weng, C. X., Duchin, J., Lenahan, J., Close, N., Bedford, T., Boeckh, M., . . . Starita, L. M. (2020). Evidence for limited early spread of COVID-19 within the United States, January–February 2020. Morbidity and Mortality Weekly Report, 69(22), 680–684. https://doi.org/10.15585/mmwr.mm6922e1
  15. World Health Organization. (2020, February 29). Coronavirus disease 2019 (COVID-19): Situation report—40. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200229-sitrep-40-covid-19.pdf
  16. Office of Governor Andrew M. Cuomo. (2020, March 1). Governor Cuomo issues statement regarding novel coronavirus in New York. https://www.governor.ny.gov/news/governor-cuomo-issues-statement-regarding-novel-coronavirus-new-york
  17. The White House. (2020, March 7). Remarks by President Trump after tour of the Centers for Disease Control and Prevention | Atlanta, GA. https://trumpwhitehouse.archives.gov/briefings-statements/remarks-president-trump-tour-centers-disease-control-prevention-atlanta-ga/
  18. Ng, R. A. C., Fonseca-Ford, M., Friedman, C. R., Tardivel, K., White, S., Murphy, R., Petersen, L. R., Attfield, K., Bower, W. A., Murray, E. L., Jain, S., Marlow, M., Wheeler, W., Stockman, L. J., Mead, P., Pesik, N. T., Rose, D., Weidle, P. J., Readhead, A., . . . Novak, R. T. (2025). Public health response to COVID-19 among travelers disembarked from the Grand Princess cruise ship, March 2020. Public Health Reports, 140(4), 316–324. https://doi.org/10.1177/00333549251321762
  19. World Health Organization. (2020, March 11). WHO Director-General’s opening remarks at the media briefing on COVID-19—11 March 2020. https://www.who.int/news-room/speeches/item/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—11-march-2020
  20. The White House. (2020, March 11). Remarks by President Trump in address to the nation. https://trumpwhitehouse.archives.gov/briefings-statements/remarks-president-trump-address-nation/
  21. National Basketball Association. (2020, March 12). NBA to suspend season following Wednesday’s games. https://www.nba.com/news/nba-suspend-season-following-wednesdays-games
  22. Whitcomb, D. (2020, March 12). Tom Hanks, wife Rita Wilson test positive for coronavirus in Australia. Reuters. https://www.reuters.com/article/world/tom-hanks-wife-rita-wilson-test-positive-for-coronavirus-in-australia-idUSKBN20Z07T/
  23. Reuters. (2020, March 12). New York City’s St. Patrick’s Day parade canceled on coronavirus concern. https://www.reuters.com/article/world/new-york-citys-st-patricks-day-parade-canceled-on-coronavirus-concern-idUSKBN20Z0DA/
  24. Elber, L. (2020, March 11). Virus prompts late shows to drop audiences, “Survivor” delay. AP News. https://apnews.com/article/2073ff69c2cf0002b6dcf8fe8583001c
  25. William & Mary. (2020, March 13). W&M provides details on interim actions around COVID-19. https://www.wm.edu/news/stories/2020/wm-takes-interim-actions-on-instruction,-travel,-events-to-prevent-covid-19.php
  26. The White House. (2020, March 13). Proclamation on declaring a national emergency concerning the novel coronavirus disease (COVID-19) outbreak. https://trumpwhitehouse.archives.gov/presidential-actions/proclamation-declaring-national-emergency-concerning-novel-coronavirus-disease-covid-19-outbreak/
  27. Reuters. (2020, March 17). Shoppers rush to stock up as coronavirus spreads. https://www.reuters.com/news/picture/idUSRTS35ZLY/
  28. World Health Organization. (2020, March 3). Shortage of personal protective equipment endangering health workers worldwide. https://www.who.int/news/item/03-03-2020-shortage-of-personal-protective-equipment-endangering-health-workers-worldwide
  29. The White House. (2020, March 16). 15 days to slow the spread. https://trumpwhitehouse.archives.gov/articles/15-days-slow-spread/
  30. Remuzzi, A., & Remuzzi, G. (2020). COVID-19 and Italy: What next? The Lancet, 395(10231), 1225–1228. https://doi.org/10.1016/S0140-6736(20)30627-9
  31. World Health Organization. (2020, February 28). Report of the WHO-China Joint Mission on coronavirus disease 2019 (COVID-19). https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
  32. Mizumoto, K., Kagaya, K., Zarebski, A., & Chowell, G. (2020). Estimating the asymptomatic proportion of coronavirus disease 2019 (COVID-19) cases on board the Diamond Princess cruise ship, Yokohama, Japan, 2020. Eurosurveillance, 25(10), 2000180. https://doi.org/10.2807/1560-7917.ES.2020.25.10.2000180
  33. Sharfstein, J. M., Becker, S. J., & Mello, M. M. (2020). Diagnostic testing for the novel coronavirus. JAMA, 323(15), 1437–1438. https://doi.org/10.1001/jama.2020.3864
  34. Wu, Z., & McGoogan, J. M. (2020). Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72,314 cases from the Chinese Center for Disease Control and Prevention. JAMA, 323(13), 1239–1242. https://doi.org/10.1001/jama.2020.2648
  35. Centers for Disease Control and Prevention. (2012). Principles of epidemiology in public health practice: Lesson 3, Section 1—Frequency measures. https://archive.cdc.gov/www_cdc_gov/csels/dsepd/ss1978/lesson3/section1.html
  36. Leuchter, R. K., Delarmente, B. A., Vangala, S., Tsugawa, Y., & Sarkisian, C. A. (2025). Health care staffing shortages and potential national hospital bed shortage. JAMA Network Open, 8(2), e2460645. https://doi.org/10.1001/jamanetworkopen.2024.60645
  37. Ferguson, N. M., Laydon, D., Nedjati-Gilani, G., Imai, N., Ainslie, K., Baguelin, M., Bhatia, S., Boonyasiri, A., Cucunubá, Z., Cuomo-Dannenburg, G., Dighe, A., Dorigatti, I., Fu, H., Gaythorpe, K., Green, W., Hamlet, A., Hinsley, W., Okell, L. C., van Elsland, S., . . . Ghani, A. C. (2020, March 16). Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand (Report 9). Imperial College London. https://doi.org/10.25561/77482