friday, april 3 , 2020. the washington post eZ re a23
T
he story of how the novel corona-
virus emerged in Wuhan, China,
has p roduced a nasty p ropaganda
battle between the United States
and China. The two sides have traded
some of the sharpest charges made be-
tween two nations since the Soviet Union
in 1985 falsely accused the CIA of manu-
facturing AIDS.
U.S. intelligence officials don’t think the
pandemic was caused by deliberate wrong-
doing. The outbreak that has now swept
the world instead began with a simpler
story, albeit one with tragic consequences:
The prime suspect is “natural” transmis-
sion from bats to humans, perhaps
through unsanitary markets. But scientists
don’t r ule out that an accident at a r esearch
laboratory in Wuhan might have spread a
deadly bat virus that had been collected for
scientific study.
“Good science, bad safety” is how
Sen. To m Cotton (R-Ark.) put this theory
in a Feb. 16 tweet. He r anked such a breach
(or natural transmission) as more likely
than two extreme possibilities: an acci-
dental leak of an “engineered bioweapon”
or a “deliberate release.” Cotton’s earlier
loose talk about bioweapons set off a
furor, back when he first raised it in late
January and called the outbreak “worse
than Chernobyl.”
President Trump and Secretary of State
Mike Pompeo added to the bile last month
by describing the coronavirus as the “Chi-
nese virus” and the “Wuhan virus,” r espec-
tively.
China dished wild, irresponsible allega-
tions of its own. On March 12, Chinese
foreign ministry spokesman Lijian Zhao
charged in a tweet: “It might be [the]
US army who brought the epidemic to
Wuhan.” He retweeted an article that
claimed, without evidence, that U.S. troops
might have spread the virus when they
attended the World Military Games in
Wuhan in October 2019.
China retreated on March 22, when Am-
bassador to the United States Cui Tiankai
told “A xios on HBO” that such rumors were
“crazy” on both sides. A State Department
spokesman said Cui’s comment was “wel-
come,” a nd Trump and Chinese President Xi
Jinping pledged in a March 27 phone call to
“focus on cooperative behavior,” a senior
administration official told me.
To be clear: U.S. intelligence officials
think there’s no evidence whatsoever that
the coronavirus was created in a laboratory
as a potential bioweapon. Solid scientific
research demonstrates that the virus
wasn’t engineered by humans and that it
originated in bats.
But how did the outbreak occur? Solving
this medical mystery is important to pre-
vent future pandemics. What’s increasing-
ly clear is that the initial “origin story” —
that the virus was spread by people who ate
contaminated animals at the Huanan Sea-
food Market in Wuhan — is shaky.
Scientists have identified the culprit as a
bat coronavirus, through genetic sequenc-
ing; bats weren’t sold at the seafood mar-
ket, although that market or others could
have sold animals that had contact with
bats. The Lancet noted in a January study
that the first covid- 19 case in Wuhan had no
connection to the seafood market.
There’s a competing theory — of an
accidental lab release of bat coronavirus —
that scientists have b een puzzling about for
weeks. Less than 300 yards from the sea-
food market is the Wuhan branch of the
Chinese Center for Disease Control and
Prevention. Researchers from that facility
and t he nearby Wuhan Institute o f Virology
have posted articles about collecting bat
coronaviruses from around China, for
study to prevent future illness. Did one of
those samples leak, or was hazardous waste
deposited in a place where it could spread?
Richard Ebright, a Rutgers microbiolo-
gist and biosafety expert, told me in an
email that “the first human infection could
have occurred as a natural accident,” with
the virus passing from bat to human,
possibly through another animal. But
Ebright cautioned that it “also could have
occurred as a laboratory accident, with, for
example, an accidental infection of a labo-
ratory worker.” He noted that bat coronavi-
ruses were studied in Wuhan at Biosafety
Level 2, “which provides only minimal
protection,” c ompared with the top BSL-4.
Ebright described a December video
from the Wuhan CDC that shows staffers
“collecting bat coronaviruses with inade-
quate [personal protective equipment]
and unsafe operational practices.” Sepa-
rately, I reviewed two Chinese articles,
from 2017 and 2019, describing the heroics
of Wuhan CDC researcher Tian Junhua,
who while capturing bats in a cave “forgot
to take protective measures” so that “bat
urine dripped from the top of his head like
raindrops.”
And then there’s the Chinese study that
was curiously withdrawn. In February, a
site called ResearchGate published a brief
article by Botao Xiao and Lei Xiao from
Guangzhou’s South China University of
Te chnology. “ In a ddition to origins of natu-
ral recombination and intermediate host,
the killer coronavirus probably originated
from a laboratory in Wuhan. Safety level
may need to be reinforced in high risk
biohazardous laboratories,” t he article con-
cluded. Botao Xiao told the Wall Street
Journal in February that h e had withdrawn
the paper because it “was not supported by
direct proofs.”
Accidents happen, human or laboratory.
Solving the mystery of how covid- 19 began
isn’t a blame game, but a chance for China
and the United States to cooperate in a
crisis, and prevent a future one.
Twitter: @IgnatiusPostdavid ignatiusHow did the
pandemic
start?
A
t one food pantry in Central Te x-
as, the queue of cars waiting to
pick up boxes of food stretches a
quarter-mile. In Dayton, Ohio,
the line extends about a mile.
In P ittsburgh, it’s m iles, plural, as fami-
lies wait hours so they won’t go hungry.
Across the country, one of the less
visible parts of the social safety n et — t ens
of thousands of food pantries and food
banks — is starting to fray. The federal
government must do more before it un-
ravels.
Unsurprisingly, demand for food assis-
tance is surging.
Nearly 10 million Americans lost their
jobs in just the latter half of March,
according to initial unemployment bene-
fits claims, and many of those workers
are struggling to pay their bills. Children
are stuck home from school, which
means parents who had relied on free or
reduced-price school lunches are scram-
bling to assemble or pick up additional
meals during the week. Grocery stores
cannot stock products as quickly as peo-
ple want to purchase them, and many
households with vulnerable family mem-
bers fear cramming into crowded super-
markets.
And so Americans who never saw
themselves at risk of food insecurity are
turning to private nonprofits that distrib-
ute free meals.
In surveys of food banks conducted
from March 19 to 23 by Feeding America,
the nation’s largest organization for do-
mestic hunger relief, 9 2 percent reported
increases in demand for food assistance.
The size of the increase varies by location,
with some reporting doubling or even
septupling their usual distributions. Day-
ton’s The Foodbank Inc. served about
175 to 200 households per day before the
crisis; one day last week, it distributed
food boxes to 667 households through its
limited-hours, drive-through-only ser-
vice.
“I’m worried about running out of
food,” s ays chief executive Michelle Riley.
Just a s demand has s urged, donations
from local grocers and supermarkets
have plummeted. Understandably,
many have little inventory left over to
donate. About two-thirds of food banks
surveyed n ationwide have experienced a
decline in food donations, Feeding
America reports.
Meanwhile, these organizations’ other
expenses have gone up.
About two-thirds have reported a de-
cline in volunteers — partly because
volunteers tend to be retirees, older peo-
ple who are more vulnerable to the coro-
navirus. Some organizations, such as
ECHOS in Houston, have been offering
their paid staff temporary raises in grati-
tude for their willingness to continue
working under stressful conditions.
ECHOS and other organizations have
had to buy new software and supplies to
adapt to social-distancing measures that
require some staff to work remotely, and
others to implement new food-delivery
logistics on-site.
And as the economy sinks into reces-
sion, many worry that the private dona-
tions they rely on will dry up.
“No crisis has ever strained our ability
to serve those in need as much as corona-
virus,” says Derrick Chubbs, president
and chief executive of the Central Te xas
Food Bank. His organization did not have
money set aside in its operating budget t o
purchase food needed to replace disap-
pearing grocery donations. The cancella-
tion of a major Austin music festival,
which usually raises about $200,000 for
the food bank, has intensified the finan-
cial strain.
The federal government has taken
steps designed to beef up food assistance.
These include funding for additional
commodity purchases from farmers, for
emergency food programs; and allowing
states to temporarily give more house-
holds the maximum food-stamp benefit.
Much more needs to be done.
First, the Agriculture Department
needs to reduce cumbersome paperwork
requirements for food banks and food
pantries. It u sually does this after natural
disasters, when the goal is to serve as
many people as quickly as possible. The
measure seems doubly important during
a disaster caused not by a hurricane but
by an infectious disease, when trading
pens and paperwork back and forth is
risky.
But USDA officials have dragged their
feet on waiving such requirements.
Second, Congress needs to pass “phase
four” coronavirus relief legislation that
increases the maximum value of food-
stamp benefits, as it did in response to the
Great Recession. (The Families First Cor-
onavirus Response Act allowed states to
give more households the maximum ben-
efit but did not raise the ceiling for
benefits.)
Every single food bank, food pantry
and anti-poverty organization I’ve spo-
ken with pleaded for this. Not because
more generous food-stamp assistance
would put more money into their coffers.
It w on’t. But it would put more funds into
the hands of low-income Americans, en-
abling them to purchase more groceries
through commercial retailers. This
would reduce some of the burden on food
pantries and, moreover, serve as effective
fiscal stimulus.
The hours-long lines at food pantries
around the country are an early indicator
of the hunger to come. Better to get ahead
of the problem now.
[email protected]catherine rampellA sign of
the hunger
to come
BY DANIELLE STANSKYM
y patient dialed his wife on
the cracked iPhone he
barely knew how to use. I
grabbed the phone from
the 74-year-old’s shaking hands as it
rang, keeping one eye on his mouth,
chest and face and the other on the
monitor as his oxygen saturation
dropped.
“Hi, I’m Dr. Stansky,” I said. “I am
with your husband.” My stomach
turned as I tried to find the right
words. How do you tell someone over
the phone that this might be the last
time they ever speak to their spouse?
These past few weeks have been
some of the most heart-wrenching in
my life. Coding a patient before I
even knew her name. Te lling families
they can’t be with their loved ones.
Watching a healthy 28-year-old man
with covid- 19 become so sick that
only machines keep him alive. It is
exhausting, and by no means does it
feel heroic.
People often ask me, “Should I
really be worried?” The answer is yes.
I wish I could make them a fly on the
wall. Maybe then they would under-
stand this disaster. I am scared for
my patients. I am scared for my
colleagues. I am scared for my f riends
and family. And as much as I don’t
like to admit it, I am scared for
myself.
I call my parents on FaceTime
every day. I try to smile and make
jokes. I try not to remind them of my
co-workers who have contracted the
virus. I try not to feel guilty that I
cannot see them or help them gro-cery shop because I have been ex-
posed. I watch my m om tear up at t he
end of our conversation. My eyes
barely open from exhaustion. Her
eyes scream the words “I wish you
didn’t have this job.”
It w as 9:55 p.m. — five minutes left
in my shift, one of the worst yet. I
heard a nurse calling my attending’s
name. Knowing he was outside
speaking with a patient’s family, I
went to see if I could help. Behind the
workstation I saw a new patient and
snapped into resuscitation mode. ER
doctors are drilled on how to identify
who is sick and not sick. She was sick
— minutes from death if we didn’t
help her.
The patient was breathing
60 times a minute and within sec-
onds could no longer answer my
questions. I rushed to grab a plastic
gown. There were none left. But we
needed a breathing tube fast, and
putting one in even with gear on puts
everyone around me at risk. I ran to
the metal racks, grabbed a yellow
patient gown and put it over my
head. I looked down at my arms,
exposed from the elbow down to my
glove. Better than nothing. I threw
one at the nurse and a co-resident
and ran into the room.
We began to resuscitate the pa-
tient, pounding on her chest, insert-
ing a breathing tube, pushing epi-
nephrine, guiding a crash femoral
venous line into her leg. Anything to
keep her alive. This woman died in
front of me and came back. I left my
shift that day, walking past her dis-
traught family standing on the curb
worrying about their mother whowas fine just hours earlier. She was
hanging on by a thread. I held back
tears, got in the car and drove away.
Hours later, she died.
I think back to the phone call with
my patient’s wife. “I am with your
husband,” I said. “I believe he has
covid. His breathing is worsening,
and I think the only way to help him
is to place a breathing tube. He won’t
be able to speak, and he will be
sedated. He will be kept comfortable,
and we just have to hope in time his
lungs will recover.” My patient began
to gasp for air as his wife asked if she
should come see him. Knowing this
was impossible, he took the phone
and said to her, “No, sweetheart, I
want you to be safe.” His wife begged
me to make sure people call and
update her daily. I promised to pass
this message along, knowing all too
well the intensive care unit will even-
tually become so inundated with
patients that it may not happen. They
said “I love you” and hung up.
My patient looked up at me and
said, “I trust you. Do what you have to
do.” This man, who has so much more
life experience than I but who likely
didn’t have the same understanding
as I did about what putting a breath-
ing tube down his throat meant, gave
me mixed feelings. Pride and grati-
tude that he could trust me after just
a few hours of knowing me. But also
shame and sadness that I knew I did
not have much to offer him and that
from what we know, his most likely
outcome was death.The writer is an emergency medicine
resident physician in New York City.If you could visit my hospital,
you would see covid-19’s horror
david dee delgado/bloomberg News
Fire Department of New York EMTs bring a patient to the Montefiore Hospital in the Bronx on Thursday.pended animation.
Why does empathetic leadership mat-
ter in this kind of moment? At the most
basic level, it tries to redeem hardship
for some greater good. When President
Abraham Lincoln spoke at Gettysburg,
in the midst of so many fresh graves, he
was making clear that those deaths were
not random or purposeless. He dedicat-
ed unimaginable sacrifice to a transcen-
dent purpose — the survival of self-
g overnment. By feeling and expressing
grief, Lincoln could give it enduring
meaning.
Two days after the Sept. 11, 200 1,
attacks, President George W. B ush spoke
to then-New York Mayor Rudolph
W. Giuliani and New York Gov. George
Pataki by phone in the Oval Office. Bush
expressed his sympathy for those who
were mourning (“I wish I could comfort
every single family whose lives have
been affected”) and urged people to treat
Arab Americans with respect. He c ontin-
ued with barely controlled emotion:
“I don’t think about myself right now. I
think about the families, the children.
I am a loving guy, and I am also someone,
however, who has got a job to do, and
I intend to do it. And this is a terrible
moment. But this country will not relent
until we have saved ourselves and others
from the terrible tragedy that came upon
America.” Channeling the nation’s emo-
tions allowed Bush to direct them in a
proper direction — away from domestic
bigotry and toward a foreign enemy.
Empathic leadership also serves the
purpose of reassuring vulnerable people
that someone is on their side. President
Franklin D. Roosevelt’s fireside chatsS
omeday presidential historians
will fully explore the defects of
heart and character that led Presi-
dent Trump, in the midst of an
unprecedented national crisis threaten-
ing hundreds of thousands of deaths, to
brag that the television ratings for his
afternoon briefings rivaled the “Bache-
lor” f inale or “Monday Night Football.”
This is not mere pettiness. It is clinical
solipsism. Exploiting this type of tragedy
in the cause of personal vanity reveals
Trump’s spirit to be a vast, trackless
wasteland. Trump seems incapable of
imagining and reflecting the fears, suf-
fering and grief of his fellow citizens. We
have witnessed the total failure of empa-
thy in presidential leadership.
So far, frankly, it hasn’t mattered very
much. The main focus has been, appro-
priately, on the president’s lack of com-
petence. We clearly have a medical and
scientific A-team being supported by a
White House D-team. Trump’s initial
failure of urgency wasted weeks that
could have been used in lifesaving prepa-
rations. His long holiday of denial hurt
the country badly.
But the United States is now on the
verge of events that will demonstrate the
need for empathetic leadership. So far,
many of the sacrifices imposed by the
coronavirus crisis have been theoretical
(except in the most dramatically affected
areas). But even under the best-case
scenarios, we are entering weeks of
mounting fatalities. Before it all ends,
many Americans will know someone
who dies or faces severe illness. At the
same time, we will start counting and
feeling the costs of an economy in sus-convinced people in t he bread lines of the
Great Depression that an aristocratic
president had their back. Following the
March on Selma in March 196 5, Presi-
dent Lyndon Johnson spoke to a joint
session of Congress. He compared Selma
to the sacrifices of the American Revolu-
tion and the Civil War. A nd he concluded:
“Their cause must be our cause, too.
Because it is not just Negroes, but really it
is all of us, who must overcome the
crippling legacy of bigotry and injustice.
And we shall overcome.” I n that moment,
Johnson assured the civil rights protest-
ers that the American “ we” e ncompassed
their cause and that the president him-
self would be their advocate.
This is the type of unity that Trump
endangers when he accuses his oppo-
nents of wanting to tank the economy, o r
ties presidential attention to the grati-
tude of governors, or throws out xeno-
phobic gibes, or dedicates his briefing to
the praise of flunkies, or accuses health
professionals of stealing protective gear.
There is a hole at the heart of Trump’s
rhetoric where empathy belongs. How
must the marginal in our society —
prisoners, migrants, the homeless and
destitute — view a president who seems
most excited by stock market gains and
welfare for big corporations?
It is not particularly helpful to urge
the president to grow a soul. But empa-
thy in times of crisis is not some altruis-
tic add-on. It is the manner by which a
nation’s s uffering is given purpose, and a
method of assuring the vulnerable they
won’t be forgotten. If the president can’t
feel it, he needs to fake it.
[email protected]michael gersonAn empathy shortage