America Didn’t Listen To COVID-19 Warnings
In the American South, the first year of coronavirus began with a party. As uproarious jazz celebrated a year not yet ruined, more than one million people packed the gritty streets and ornate balconies of New Orleans for Mardi Gras, an infamous carnival of excess. They chugged beers. They tossed beads. They ate king cake. They spread joy.
Two months later, sickness swamped the city. While the new coronavirus was still an intangible threat in most of the nation, Louisiana reported one of the fastest growing outbreaks in the world. Scientists warned Mardi Gras was the likely cause. The New York Times called it a "virus nightmare."
It was a lesson that the nation didn't learn.
Over the past 12 months of tragedy and turmoil, a pattern repeated like clockwork: Americans gathered to celebrate, many got sick and some died. In Nashville, Saint Patrick's Day parties at Vanderbilt University spread the virus across the campus. Memorial Day celebrations launched a summer surge in Alabama, Arkansas, Georgia and Tennessee. The United States saw its largest surge after Thanksgiving, and the viral winter swelled through Christmas and did not peak until after New Year's Day.
It happened over and over and over. While it is arguable Americans did not know better at first, eventually we did, and yet the cycle repeated anyway. A chorus of health experts, perpetually warning of a danger on the horizon, blurred into background static that was easily ignored or disbelieved. Denial spread as fast as death.
"We couldn't have imagined the cases rise that quickly," said Tennessee Gov. Bill Lee in December, as his state led the nation into a third wave of the pandemic. "Or, we certainly didn't want to imagine that."
It has been approximately one year since the novel coronavirus, known to most as COVID-19, began a long and slow assault that upended and ended more American lives than any event in generations. The virus spread both quietly and violently, killed slowly and quickly, and disproportionately preyed upon communities of color made more vulnerable by decades of poorer health and systemic inequality.
This story, a culmination of a year's worth of data analysis, experts interviews and news reporting on the pandemic, examines the arc of coronavirus across six southern states: Alabama, Arkansas, Georgia, Louisiana, Mississippi and Tennessee. Some statistics were obtained from the COVID Tracking Project, a volunteer organization that publishes state-by-state virus data from across the nation.
As of Feb. 21, these six southern states have reported more than 3.2 million coronavirus infections and about 60,000 deaths. In three of those states – Arkansas, Georgia and Tennessee – infections disproportionately impacted Latino residents, whom were at least 30% more likely to catch the virus , in part due to outbreaks in essential industries employing large numbers of immigrant workers.
The virus is now slowing in all six states, signaling a fragile end to the winter surge, but the pandemic is far from over. Less than 10% of residents of these states are fully vaccinated, and it will be months before enough are immune to ward off another surge.
As COVID-19 takes hold, shutdowns separate us all
They found the virus in Georgia first. On March 2, after weeks of wondering when and where it would inevitably strike, state officials said two Atlanta-area residents tested positive, including one who recently returned from virus-ravaged Italy.
Next it surfaced in Tennessee. Then Louisiana. Then Mississippi and Arkansas and Alabama. An outbreak across these six states grew from just one infection to more than 3,000 in less than three weeks.
As it became clear the virus was thriving out of sight, southern leaders begrudgingly accepted a federal recommendation to close all non-essential businesses. Louisiana, reeling from its early outbreak, shut down in March and did not open until mid-May. Alabama, Georgia, Mississippi and Tennessee closed in early April and allowed businesses to re-open in less than a month. Arkansas never closed.
The impact was clear: By the middle of April, the number of people no longer leaving their homes at all climbed by 12% across these six states, according to a database made public by SafeGraph, a cell phone location data company. Apple also reported the number of people using iPhones to look up directions – a likely sign of travel – fell by about 25% in the same states for the same period. Both companies showed the smallest change in Arkansas, where there was no stay-at-home order in effect.
While shutdowns were effective at reducing travel, they were devastating to state economies. Commerce was decimated, and the six states featured in this story lost about 1.5 million jobs in April alone. Governors rushed to stop the bleeding by reopening businesses, often with no precautions required.
But not everything could re-open. As restaurants and stores risked exposure to restart the economy, a cross-country network of nursing homes and assisted living facilities shut tighter than ever. Nationwide, millions of older, vulnerable Americans were isolated from friends and family during the most threatening year in decades.
That's what happened to Dorothy "Dot" Hautman, a spunky, affectionate southern matriarch who couldn't abide lulls in conversation so she filled them with compliments. Hautman, 93, moved in 2019 to an assisted living facility in Dickson, Tennessee, to be close to her daughter's home in the waning years of her life.
Before the pandemic, Hautman saw her family almost daily. She'd sit in a rocking chair on her daughter's front porch watching hummingbirds, then would stay for Saturday dinner and Sunday worship. She was the oldest member of their church choir, where a little deafness and lots of spirit led her to sing her favorite hymns just a bit too loud.
The virus put an end to all that. By the spring, Hautman was stuck inside the assisted living facility, and the top priority was keeping residents in and the virus out. Hautman's family lived down the street, but they'd never been further away.
Her daughter, Cindi Brown, asked her to be patient. The virus would be gone soon, she promised.
"We just knew what we were told," Brown said. "So we kept encouraging mother to hold on just a 'few more months', or 'a few more weeks.' And that didn't happen."
Trump's promise: 'It's
going to go away'
Hautman and her family were not alone in their hope that the end was near.
As the pandemic spread across the United States in March and April, many scientists publicly theorized the virus might slow considerably in the warmer summer months, similar to the common flu. Scientists presented this as merely a possibility, but many Americans – yearning for good news – seized on it as a certainty.
This mindset was encouraged by then-President Donald Trump, no stranger to unscientific statements, who used the megaphone of the White House to insist the virus would vanish. Between February and May, Trump told Americans on at least 17 occasions the virus was destined to disappear, sometimes because of the change of seasons, according to reporting by CNN.
"It's going to go away, hopefully at the end of the month," Trump said on March 31, as the first wave of coronavirus began. "And, if not, hopefully it will be soon after that."
The virus did not go away.
But the caution southerners exhibited in March was gone.
In May, as the spread of the virus plateaued, Americans gathered in droves for Memorial Day, a holiday intended as a somber reflection on selflessness and sacrifice. Southerners traveled more in the week around Memorial Day week than any other week at this point of the outbreak, according to the data from SafeGraph and Apple.
Once again, the impact was clear: In the weeks after the Memorial Day, record surges were reported in most U.S. states, including Alabama, Arkansas, Georgia and Tennessee. In Louisiana, where businesses were only barely open, cases rose but did not didn't approach the peak after Mardi Gras.
Memorial Day was proof that a single holiday could undo months of progress, and there was every reason to believe a bigger holiday could do more damage. As the Fourth of July approached, it was believed a single infection on Memorial Day may have spread the virus to as many as 500 people, said Dr. James Hildreth, an infectious disease expert who leads Meharry Medical College in Nashville. Hildreth begged the public not to repeat its mistake.
"Let's do our part, especially over the coming weekend when there will be a temptation to go back to old habits. That's the worst thing we could do," he said. "Please don't be a vector."
Masks required as
virus spreads wide
As the summer surge grew, state leaders reluctantly embraced a strategy that once seemed unthinkable – mask mandates.
Scientists previously advised Americans not to wear masks, insisting they were only needed by health care workers, but new research suggested widespread masking was the best hope of preventing infections while a vaccine was developed. Most public officials started to promote masks as not just a defense but a neighborly responsibility. Results were mixed.
Governors in Alabama, Arkansas and Louisiana enacted mask mandates in July. Mississippi followed in August, then rescinded the mandate in September and made a new mandate that only impacted the most infected counties. Eventually, Mississippi's county-by-county mask mandate grew to blanket most of the state.
The holdouts were Georgia and Tennessee, where leaders were closely aligned with Trump, who downplayed the need for masks and rarely wore one himself.
Georgia Gov. Brian Kemp drew nationwide scorn in July when he not only refused a statewide mask mandate but issued an executive order explicitly forbidding local governments from requiring masks, invalidating mandates already in effect in 15 counties and cities. Kemp reversed one month later, allowing local mandates to return.
Lee, the Tennessee governor, rejected calls for a statewide mandate but empowered the state's 95 county mayors to create mandates if they chose. Most mayors did not, and the virus spread fastest in rural areas where masks were far less common.
This was the case back in Dickson, where the Brown family also grappled with masks.
Like many southern conservatives, the Browns viewed mask mandates as government overreach and applauded their governor's decision not to require masks. Meanwhile, Dickson County was counting new infections by the hundreds. Hautman remained in lockdown at her assisted living facility, stuck in a snare that grew tighter by the day.
Hautman's granddaughter, Kara Brown-Herr, 45, who said she initially viewed masks as "dumb," began to embrace them as the virus infiltrated Dickson. She soon realized every encounter was a risk, not just to her, but to her entire family.
By the summer, Brown-Herr wore her mask religiously, including during her interview.
"I wanted my freedom," she said. "But at some point I said, you know what, I need to be more careful."
In the end, careful wasn't enough.
A family mourns, a nation surges
On Nov. 10, Hautman sounded hoarse on a daily call with her daughter, Cindi Brown. Three days later, a local doctor confirmed their fears. One day after that, Brown tested positive too.
Their simultaneous infections mirrored a bizarre duality witnessed across the pandemic: Brown, 68, felt ill for just a few hours; Hautman, 93, got worse every day.
Seven days after her first symptoms, Hautman, dressed in animal print pajamas, was wheeled into an ambulance to be rushed to a nearby hospital and isolated in a COVID-19 unit. Brown, who faced no risk because she was already infected, was permitted to visit her mother while wearing enough protective gear to make a beekeeper suit.
Hautman died days later as her daughter sat by her side, thankful for face-to-face farewell available to few families. Instead of the large memorial she deserved, Hautman was buried in a small graveside ceremony, Brown said. Relatives said the funeral was the only time they'd ever seen Hautman without a smile on her face.
As the Brown family reeled from loss, so did the nation.
Hautman was one of at least 2,270 Americans to die on Nov. 25, which was one of the deadliest days of the pandemic at the time. That number, however, was quickly overshadowed as another holiday lifted the virus to new heights.
Despite numerous warnings, Americans crossed state lines and united households for Thanksgiving gatherings, popping the exposure bubbles that offered at least some protection in their daily lives. The virus surged, and as hospitals swelled to the brink, the Centers for Disease Control and Prevention warned of "the most difficult time in the public health history of this nation."
None of this was a surprise to Dr. William Schaffner, a prominent infectious disease expert at Vanderbilt University who'd watched all year as ill-advised gatherings spread the virus over and over.
Throughout the pandemic, Schaffner gave thousands of interviews to hundreds of news publications, offering expertise that was calm, polite and peppered with the folksy charm. But by December, faced with the same questions about yet another preventable surge, he'd finally grown exhausted of repeating himself.
"We paid a price after Memorial Day. We paid a price after July 4. The same thing happened, more or less, after Thanksgiving," Schaffner said. "I don't know how many lessons we need. How many times do we have to do this experiment to convince ourselves of the result?"
His answer came weeks later. In mid-January, as southern states braced for a post-Christmas surge of epic proportions, it simply did not arrive. The six states covered in this story each reported viral peaks in the earliest days of 2021, then a steady and significant decline in new infections, hospitalizations and test positivity. By the end of February, the southern outbreak shrunk to levels not seen since before Thanksgiving.
Schaffner and other experts struggled to understand the slowdown. Some settled on a wishful-but-plausible explanation – Americans had finally learned to stay apart.
Then again ... maybe they didn't. On Jan. 11, as many southern states were grappling with the most infections they'd ever seen, the Alabama Crimson Tide crushed the Ohio State Buckeyes in the last game of a bizarre and incomplete season of college football.
When final whistle blew, thousands of Alabama college students took to the streets of Tuscaloosa to celebrate amid the deadliest year of their lives. The crowd, mostly unmasked, packed shoulder-to-shoulder on a quarter-mile street called The Strip. The spread of the virus was far smaller than the Mardi Gras carnival that kicked off coronavirus 11 months prior, but parallels in behavior were obvious.
They chugged beers. They chanted cheers. They spread joy. And the second year of coronavirus in the American South began the same as the first – with a party.
Tennessean reporter Rachel Wegner, the Associated Press, Kaiser Health News and USA TODAY each contributed to this story.
Brett Kelman is the health care reporter for The Tennessean and the USA TODAY Network. He can be reached at 615-259-8287 .
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