The Washington Post National Weekly. May 3, 2020

SUNDAY, MAY 26, 3, 2020 SUNDAY, APRIL 2020

SUNDAY, MAY 3, 2020

. IN COLLABORATION WITH

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States and cities face devastating cuts BY

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n Michigan, some unstaffed highway rest stops are shuttered. In Santa Barbara, Calif., local librarians are out of a job. Dayton, Ohio, has ordered furloughs at nearly every agency, and in Arlington, Tex., police officers and firefighters may soon see painful cuts.

Facing an urgent financial crisis, these and other cities and states nationwide are eyeing dramatic reductions to their workforces, threatening critical public-sector employees and first responders at a time when many Americans may need their local governments’ help the most.

Even as President Trump and top Republicans contend that only what they depict as bigspending, liberal-leaning states are to blame for mounting budget woes, a Washington Post review found that the economic havoc wrought by the coronavirus is far more widespread — saddling Democratic and Republican mayors and governors alike with souring finances and major revenue gaps. Some local governments have already started laying off or furloughing thousands of their workers, and the numbers are likely to grow markedly in the absence of federal aid.

Among municipalities, the new budget cuts could be profound: Between 300,000 and 1 million public-sector workers could soon be out of a job or sent home without pay, according to a new estimate from the National League of Cities. The steep reductions in staffing levels could affect education, sanitation, safety and health, local leaders warn, potentially leaving critical public services in utter disarray.

For governors, mayors and other top local officials, their economic troubles stem from the precipitous drops in revenue that have come as a result of shuttered businesses and sharp decreases in shopping

Nick Hagen For The Washington Post

Budget shortfalls, layoffs pose threat to education, sanitation, safety and travel. The extent of the disruptions are poised to reach a level not seen since the Great Recession more than a decade ago, a reality that has prompted many city and state leaders to plead with Washington for help.

But their public quest for federal cash has been met with staunch political resistance from Republicans, including Senate Majority Leader Mitch McConnell (R-Ky.), who at one point suggested states should have the option of falling into bankruptcy. Top Trump administration officials have echoed that skepticism and signaled that any aid would come with conditions: On Tuesday, for example, the president said he

would only approve money if states cracked down on immigration policies in “sanctuary cities.”

The recalcitrance on Capitol Hill and at the White House has sparked a lobbying blitz on the part of local governments, which have had no choice but to make painful cuts as they await action in Washington.

In Dayton, for example, Democratic Mayor Nan Whaley said the city has already furloughed 470 of its 1,900 employees, about a 25 percent reduction in staff that has affected public services including the city’s water department. Whaley said officials may have to institute an additional 18 percent acrossthe-board reduction in the next

Between 300,000 and 1 million publicsector workers could soon be out of a job or furloughed, the National League of Cities estimates.

In Detroit, above, that could mean a reduction in available first responders.

Michigan this past month laid off 2,900 municipal employees.

fiscal year if they don’t see federal support soon — a move she said would affect police officers and threaten residents with “slow response time.”

“It will fundamentally change how we do business long term,” Whaley said.

For many cities and states, their public push for federal aid reflects the urgency of their need: Many have argued that Washington’s intransigence threatens to exacerbate the deadly coronavirus, which has already killed more than 58,000 Americans nationwide. That’s because tax revenue typically helps fund first responders, and there’s only so much governments can do amid the downturn to shield public safety

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from withering cuts.

In doing so, many mayors and governors have sought to argue that they are economic engines in their own right, employing more than 19 million municipal employees in the United States, or about onetenth of the country’s workforce, according to federal data from March. Local leaders say they are just as deserving of federal support as major businesses, which have captured the lion’s share of coronavirus aid dollars authorized by Congress in March and April.

“They understand and know this would be a disaster if they didn’t get the kind of aid from the federal government they need,” said Lee Saunders, the president of the American Federation of State, County and Municipal Employees, AFLCIO, whose union represents public-sector employees. “They need to be a priority just as the corporations and small businesses were.”

In March, Congress extended $150 billion to cities and states as part of the $2 trillion coronavirus aid package signed by Trump. Quickly, though, local leaders discovered the funds came with significant caveats.

Only large cities, for example, received direct payments under the legislation, known as the Cares Act. The money also was limited to coronavirus-related expenses that governments did not anticipate in their most recent budgets, according to the Treasury Department, narrowing its use considerably.

In practice, cities and states could not tap their federal allotments to close revenue gaps, even though some of their shortfalls are the result of the coronavirus pandemic. The limitations greatly frustrated officials in states such as New Jersey, where Gov. Phil Murphy (D) on Thursday wagered that he might have no choice but to return some of the money.

Democratic and Republican governors say they realistically need $500 billion to help close the enormous budget holes they face — or else they risk debilitating cuts. Already, the bleak financial picture has led Pennsylvania to furlough thousands of state workers. Ohio has implemented a hiring freeze.

Jahi Chikwendiu/The Washington Post

Top: A police officer patrols West Baltimore on April 17. The city has considered about $11 million in total reductions that could affect first responders.

Right: New Jersey Gov. Phil Murphy visits an alternatecare facility at Bergen New Bridge Medical Center in Paramus, N.J., on April 22.

Michael Karas/POOL/The record/Associated Press

Scores of additional states are anticipating revenue gaps that may leave them no choice but to reduce their labor forces, either temporarily or for longer.

Michigan this past month laid off 2,900 municipal employees, a giant, early cut that reflects the dangers of its looming $7 billion shortfall. More than half of its Department of State, which handles driver and vehicle transactions, is out of work for at least the next two weeks, though local officials insist the staff reductions won’t

affect operations.

The National League of Cities, meanwhile, has sought $250 billion on behalf of municipalities around the country, nearly all of which anticipate slashing spending and staff to deal with unexpected shortfalls. The NLC came to its dour prediction — perhaps 1 million layoffs or furloughs in cities and towns nationwide — in part by extrapolating data from jurisdictions that have announced major reductions in their workforces.

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Los Angeles has eyed furloughing 15,000 workers, according to NLC, and Tulsa has sent home 1,000 people without pay, representing a third of the city’s labor force. Other cities including Allentown, Pa., and Boulder, Colo., are starting with cuts to temporary or seasonal employees, joining many communities that have targeted staff at parks and other public staples closed because of stayat-home orders.

Some of the cuts directly threaten police officers and firefighters. Baltimore has considered about $11 million in total reductions that could affect first responders, which could result in wage freezes or furloughs. The idea has sparked concern among labor unions, which fear it would harm response times.

Oklahoma City anticipates its broader austerity measures won’t be enough to spare public safety agencies in the end, either. “We’ll do the best we can to limit the impact on services we provide as we prepare for a new economic reality,” the city’s budget director said in a statement.

In Arlington, Tex., one of the state’s largest metropolitan areas, Republican Mayor Jeff Williams said it is bracing for budget trouble, too. In a normal year, professional sports, local amusement parks and an influx of college students help round out the city’s finances, infusing much needed revenue derived from shopping and tourism.

But such spending has ground to a halt, imperiling the city’s balance sheet — and potentially its workforce.

Arlington’s leaders already have asked local government agencies to plan for reductions in spending between 10 to 25 percent, according to Williams, who described the potential for layoffs or furloughs as a worst-case scenario that residents would feel immediately.

“That would reduce our trash pickup less than what it is,” he said. “We would have to reduce the maintenance and reconstruction of some of our streets.” And public safety wouldn’t be spared, either. “We couldn’t help but affect our police and firefighters because of the deep cuts,” he said. n

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Sneeze guards and safe zones BY

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neeze guard” partitions.

“Safe zones” demarcating spots to stand in elevators. Contact-tracing apps to detect interactions between co-workers and infrared temperature readings.

As Colorado, Florida, Georgia, Texas and other states take steps to reopen their economies, including Boeing workers back on the job in Washington state after a three-week furlough, businesses, design firms, real estate developers and corporate advisers are starting to envision how a return to the office will work.

The transition is likely to be slow, uneven and cautious as employers navigate workers’ continued fears, government and public health restrictions, school and child-care closures, and — most of all — the prospects of a second, and possibly even more deadly, wave of the coronavirus.

Much depends on the availability — and accuracy — of virus and antibody testing kits. Antibody, or serological, tests might show who has developed an immune response to the disease and can safely return to work, but there are concerns about the tests’ accuracy.

Even so, companies are actively starting to prepare for the eventual return of at least some office workers who have been working remotely — rethinking floor layouts, staggering work schedules and making changes that could fundamentally shift relationships with employees, such as scanning temperatures.

Other firms have borrowed from their experiences in Asia or from managing essential workers during the shutdown, relying more on adapting social distancing to the workplace.

At their most transformative, some tools could help businesses quickly identify the co-workers whom an infected employee has encountered at the office. PricewaterhouseCoopers has had conversations with more than 50 clients about a new contact tracing tool for businesses it plans to

Illustration by Vidhya Nagarajan for The Washington Post

Companies are forced to reimagine the workplace — perhaps for good launch in early May. The tool adds a new app or line of code to business apps that workers already have on their phones, then runs in the background, using Bluetooth or WiFi signals to catalogue other coworkers’ phones that come near.

When a worker reports a positive covid-19 test, authorized managers can quickly identify and notify any colleagues the employee has come into contact with to help avoid a wider outbreak, bypassing the lengthy process of interviewing workers and asking them to recall their interactions. The trac-

ing works only on corporate properties, doesn’t collect location data and can only be accessed by certain managers, PwC said.

Companies are also talking about mandating thermal scanners, said Tom Puthiyamadam, who leads PwC’s U.S. Digital practice. “Not every enterprise is going to command and control mode, but I think right now some of these practices are warranted,” he said. “I don’t think many employees are going to say no, because a lot of [them] are actually scared to come back in.”

Some companies are exploring

their own testing initiatives. Amazon chief executive Jeff Bezos, who also owns The Washington Post, wrote in an April 16 letter to investors that the e-commerce giant had moved a team of specialists from their day jobs to work on a testing initiative, assembling equipment to build its first lab and hoping to start testing “small numbers of our frontline employees soon.”

Goldman Sachs is considering adding infrared body temperature scanners to some offices, along with virus and antibody testing kits for employees once

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they become more available and front-line health-care workers have their needed supplies.

IBM, which has begun adding back workers in several locations in China and South Korea, has developed global standards for returning to the office. They include bringing back those who need access to on-site equipment or labs first, staggering arrival times so elevators don’t become too crowded, eliminating buffets and shared serving tools in cafeterias, and taking out furniture in other spaces to ease social distancing concerns in conference rooms.

“The more constraints you have in your office layouts, the less people will be able to adjust,” said Joanna Daly, a human resources vice president at IBM. At Intel, where manufacturing and some lab employees have remained on site in multiple global locations, the chipmaker is planning a three-phase return for employees who have been working from home. It may include distributing masks, screening for symptoms, closing on-site gyms, limiting seating in cafes and offering disposable plastic covers for shared keyboards. The company has already learned that adding more frequent and visible cleaning during the day, rather than the traditional night or weekend service, has helped the employees who have been on-site feel more comfortable.

“I don’t see that going away anytime soon, even as we get back to normal,” said Darcy Ortiz, Intel’s vice president of corporate services, referring to the enhanced cleaning. Nor will the idea of more people working from home, even at a place that has long been a “work-fromwork kind of company,” Ortiz said. “This has been a huge social experiment, and I think this will open that up.”

President Trump has unveiled broad guidelines for states to reopen after previously suggesting he had “total authority” to reopen the country, and some manufacturers have said they will soon restart production. But business leaders are expected to be circumspect about moving too quickly to bring back office workers who have been successfully working from home.

“We are going to be more con-

“I don’t think the open office is dead, but I think we may have additional barriers for comfort.”

Trisnadi/Associated Press

servative than the countries we are in,” said Intel’s Ortiz. “As they lift restrictions, we will lag behind them to make sure there is no second wave.”

In its Amsterdam offices, commercial real estate firm Cushman & Wakefield said it has developed a prototype where carpet tiles can delineate a six-foot radius around a desk. It offers disposable paper mats that employees can place on shared desks before laying down their laptops or keyboards. A circular “safe zone” sign on the floor of an elevator shows where to stand.

Through its joint venture with Chinese real estate developer Vanke, the company has already advised thousands of companies in Asia about returning to work.

Architecture and design firm Gensler has launched a tool called ReRun to help employers run occupancy scenarios so they can apply social distancing conditions to their current seating arrangements.

In the shorter term, companies are likely to adopt quick changes that involve limited cost. Seating may be roped off or removed from conference rooms to cut occupancy in half. Doors may be taken off hinges or propped open so employees can avoid touching handles. Signs are likely to point people in one-way traffic flows through hallways to help employees avoid passing each other close by — even if that means taking the long way to the bathroom.

One of the biggest changes office workers could see is the spacing of desks to maintain distance, “every other” seat arrangements (where employees are staggered

diagonally rather than directly across from each other) or possible snap-on desk partitions to give employees more of a sense of protection.

“I don’t think the open office is dead, but I think we may have additional barriers for comfort,” said Brent Capron, the design director of interiors for the architecture firm Perkins & Will. “I’ve been calling it the ‘sneeze guard effect.’ ” At The Motley Fool, the Alexandria, Va.-based investing and personal finance site, director of operations Shannon McLendon said the nearly 400-employee company would be pushing its desks — which are already five feet wide and on wheels — a few feet further apart.

She’s also looking into providing face masks and deeper office cleans, adding foot-pulls to the bottom of doors for hands-free access and developing hand signs or space markers for co-workers to remind others to keep their distance.

“We’re thinking through some sort of universal cue that says, ‘You’re too close to me, I need space,’ ” she said.

For offices where people have their own desks, designers expect to see more “clean desk” policies, requiring employees to put away picture frames, tchotchkes or other personal memorabilia. Traditionally, private desks haven’t been cleaned very often, says Kay Sargent, the director of workplace at the architecture and design firm HOK, as housekeeping services are warned not to mess with precarious stacks of papers.

“Most people’s desks are dirtier than a toilet.”

Brent Capron, the design director of interiors for the architecture firm Perkins & Will

People stand in designated areas of an elevator as a social distancing effort in Surabaya, Indonesia, last month. Precautions like this may become more common at offices as employees head back to work.

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Sargent thinks more companies will turn to shared desks — a concept known as “hotelling” or “hot desking” — albeit with ramped-up cleaning and sensor technology she believes is “going to explode.”

Over the last four to five years, companies have increasingly used motion- or WiFi-detecting sensors installed on ceilings or desks to monitor whether spaces were being underutilized. “Now it’s going to be used for the opposite — whether it’s appropriately utilized. Do we have the right spacing? Are there pinch points where there’s overcrowding?” she said, noting that sensors will be able to tell when people vacate a seat and alert cleaners so it can be cleared to use again.

And it could take workers longer just to get in the door. As companies do temperature screenings at building entries and sharply cut down elevator occupancy limits, “you’re not going to be able to enter buildings very fast,” said Despina Katsikakis, head of occupier business performance at Cushman & Wakefield.

Over time, the coronavirus is expected to upend trends in office design that have been growing for more than a decade.

“Huddle spaces” with upholstered seating for impromptu meetings may get co-opted for workers’ desks in socially distant floor plans. Cozier finishes, such as wood surfaces, could get replaced as harsher cleaning solutions increase in use. Barista bars or beer taps that promote congregating may get temporarily shuttered while distancing guidelines remain.

“There’s been this great amenity war” in office design that encourage random meetups between workers, said Steve Smith, a principal with office design firm Cooper Carry. “Whereas before we were trying to script these collisions into happening, now we’re trying to do the exact opposite.”

One thing is certain: Many employees have proved they can effectively work from home, and companies are expected to continue letting many do so for a long time. “I think some people may never want to go back to an office setting,” said Travis Vance, who co-chairs the workplace safety group at the employment law firm Fisher Phillips. n

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VOICES FROM THE PANDEMIC

‘I’ve been busier than ever’ AS

TOLD TO

E LI S ASLOW

I’

m always driving, going back-and-forth between nursing homes, the hospital, and the morgue. All these roads should be empty if you ask me. But now I see people out running errands, rushing back into their lives, and it’s like: “Why? What reason could possibly be good enough?” Sometimes, I think about stopping and showing them one of the empty body bags I have in the trunk.

“You might end up here. Is that worth it for a haircut or a hamburger?”

You start to think that way as a coroner, especially now. I get fed up. I know the governor told us we could go ahead and reopen in Georgia. I understand businesses are hurting and people need to work. But I see these folks out and about and I wonder: “Is this another death I’ll have to pronounce?”

My work never shut down.

I’ve been busier than ever during all this. For six weeks now, I’ve been answering calls in the middle of the night, taking pictures at the scene, notifying families, trying to get those family members tested. We’ve had more deaths in the last month here in Albany than we normally have in six months.

This is a small community, but we’re ground zero for what they call community spread. Our greatest strength has been turned against us. We’re closeknit, social people down here.

We shake hands. We hug. We go to church and hold on to each other, and this virus takes advantage and keeps passing right along. Our hospital is full, and they’re opening up another emergency unit to create more space. We had 200 more people test positive just last week.

We’ve got so many sick in Albany that they’re shipping some to Atlanta to find space.

My cousin’s up there now on a vent with this virus, and it isn’t looking so good. Nothing’s look-

Photos bt Audra Melton for The Washington Post

Michael Fowler, Dougherty County coroner, on reopening Georgia ing so good. We’re right in the thick of fighting this thing, but all of the sudden this is the time to reopen? This is the moment for a tattoo or a trip to the gym?

I don’t believe in getting hysterical. It’s doesn’t do any good.

This is a numbers-and-facts job.

But we have numbers and facts that are screaming out by themselves.

I deliver an update to the town each week on the death toll. I put on a shirt and tie and a mask, and I go downtown to give a presentation. My whole refrain in this has been: “Let’s keep it below 100 deaths.” At first, people thought that number was impossibly high. Crazy.

One hundred is a lot in a place where it seems like everybody knows just about everybody.

But when I gave the update three weeks ago, we were at 49 deaths. The next week it was 67.

Then 84. I gave my last presentation a few days ago, and we’d hit 102. By the time I got back to my office, the phone was ringing again, and within a few hours, we were at 107.

It’s been so bad for so long that some people here say they’re starting to lose count. Maybe so.

But I never lose count. We have less than 90,000 people in this county, and close to 1,500 have already tested positive. All I do is keep counting.

Michael Fowler says getting a haircut is not worth the price of ending up in one of his body bags.

I’d like to lie and say we were perfectly trained and prepared for something like this to hit — that all of us on the front lines in Albany were waiting and ready. I’m no rookie. I’ve counted and examined the dead and done forensics after all kinds of major disasters. I’ve had three back surgeries from moving bodies. You get your floods and your tornadoes down here in south Georgia. But we’re 30 miles from the nearest highway, and our airport has maybe two or three flights a day back-andforth to Atlanta. You feel a little removed from what’s happening in China or Rome or even New York.

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The first alarm started going off in Albany on March 15. It was evening time. I got a call at home about a new case, and I went out to the residence. This was a 43-year-old black female.

At first, the process was routine. Usually, when the first responders are done, it’s my job to pronounce the death and take a look at the body. I take pictures, look for any medications, talk to the family, fill out the paperwork, and decide if we need to do an autopsy. Sometimes, the body gives away secrets. With an alcoholic, you might see a little clubbing of the fingers, and heart disease can show up as a swollen leg. But this time, I couldn’t see anything. There was no evidence of foul play or anything suspicious. I went out and talked to the family. I prayed with them a bit and then asked all my questions. I’m a pastor, and I like to put hands on people when we’re talking, listen to their concerns, really get to know them. This family kept repeating her symptoms: high fever, aches, coughing, lots of trouble breathing. It sounded straight out of what I’d been hearing on the news. I said: “Have you heard about the coronavirus? I think we better get her tested.”

It was a hunch, really. Right away, I had this bad feeling.

There were 20 people coming and going in that house, grieving and paying their respects, and who knows how many of them were already infected. There was a rumor going around at that time that maybe black people couldn’t get this virus. We were dealing with all kinds of confusion and misinformation. Nobody in that home was wearing a mask or gloves or doing any social distancing. At that point, neither was I. I sent her body to be tested, went home and tried to get back to sleep, but I got two more calls later that night. One was at a nursing home, and the other was in the ER. Same symptoms.

Both suspected cases. In one night, we went from zero deaths up to three, and that’s how it’s been going ever since. It explodes outward in waves like a bomb. One person has it and goes to church, and pretty soon half the pew is testing positive.

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“It’s a lot harder when the body you’re zipping up is a face you know or a face of someone you love.”

Coroner Michael Fowler said he originally hoped that the coronavirus death toll in Albany, Ga., would not surpass 100.

I console people on the death of their relative one week and end up pronouncing them the next.

I never thought this job could give me nightmares. I’ve been lucky that way, and it’s probably why I’ve lasted so long. I worked at a rubber factory here in town until it closed in 1986, and as part of the layoff, they offered a few of us free tuition to school for mortuary science.

It started off as kind of a joke.

I’d never seen or touched a dead body. They had us living in a funeral home in Atlanta, and that first night we got called to a wreck on I-20. A girl had flipped her car. It was a decapitation. We searched the highway with a flashlight, and after we finally found everything, I went home and I slept okay.

That’s when I first starting thinking this must be what God wanted of me. You see a lot of haunting things doing this work. I believe it has to be a calling. Most of the time, you’re seeing natural causes, but an average week might have homi-

cides, suicides, drug overdoses, car crashes, child deaths, drowning. Bodies get cold and harder to move. Muscles start to stiffen. We had a flood come through and wash out more than 503 graves a while back, and I spent months sorting bones and skeletons. I’ve worked 23 international disasters, from a plane crash in Guam to the tsunami in Thailand to nine weeks sorting remains at the World Trade Center. I try not to remember individual cases. I do my examination and write down the circumstances and the cause of death, and then I tell myself: “Okay. It’s gone.” I pray on it and I move on. I trained myself to do that.

But what I’m learning lately is, it’s a lot harder when the body you’re zipping up is a face you know or a face of someone you love. I’ve lived here my whole life. At least 30 of these victims are people I knew by name or considered friends. Six of our preachers have died.

Probably at least seven or eight more from church. Two neighbors. Three school friends. The probate judge who had the office next to mine at the courthouse. These are my contemporaries. I’m 62. We’ve had 36 people here die in their 60s, and at least a dozen more who were younger than that.

I try not to count down the days or make projections about when all of this is going to be over. The truth is, it’s starting to become routine. I always stand six feet away from the families. I always wear my space suit whenever I’m anywhere near a body. I always take off my clothes and have my wife spray me down with Lysol as soon as I get home.

The chamber of commerce has gone ahead and given me a tractor trailer with shelves to store extra bodies, which I might need depending on how reopening goes and how many more cases we get.

The phone calls used to wake me up at all hours of the night.

Now, I’m usually up waiting. n

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A month had passed since the first-

‘What happens if you and Daddy die?’

Children of doctors and nurses have kept anguished journals, written parents goodbye letters and created detailed plans in case they never see their moms or dads again BY

J OHN W OODROW C OX

grader last saw her dad, and her mom hadn’t stopped by in nearly a week, but now, from the kitchen, she heard a tapping on the front window. Tamina Tracy looked over, and when she saw the woman in a blue surgical mask standing outside the Northwest Washington rowhouse, the girl’s hazel eyes widened.

“Mama! My mama is here!” said Tamina, 6, as she hopped into the air and sprinted barefoot toward the door, her pigtails bouncing.

She wasn’t expecting her mother, Leah Lujan, that April Saturday. When her parents, both nurse practitioners, started treating patients with a scary new virus, they’d sent Tamina to live with her cousins. Her dad, Jimmy Tracy, also left their Adams Morgan home, moving into a relative’s empty apartment. Tamina didn’t know he’d developed a fever a few days later or that her parents feared he had the virus until his test came back negative, allowing her mother to visit the day before Easter.

Tamina, an only child, had struggled with the move, at times finding the separation unbearable, so they didn’t tell her Jimmy was sick. She understood it could happen, though. Before schools closed, a classmate explained that everyone who gets infected with the coronavirus dies. Then she overheard her parents talking about how they both expected to catch it, and she thought that meant they would die, too.

No, Leah told her daughter. That wasn’t true. Most people who get sick recover. But Leah didn’t lie, either. Some people, she acknowledged, do not make it.

That terrified Tamina, one of thousands of children across the country who have suddenly confronted the possibility that their parents’ jobs — to care for the ill — could cost them their lives. Already, more than 9,200 health-care workers have tested positive for covid-19, according to the Centers for Disease Control and Prevention. The illness has killed at least 27 of them, the CDC says, but the true number is much higher. National Nurses United found that more than 50 registered nurses, alone, have died.

Some health-care workers have moved away from their families, and many others have isolated in spare bedrooms or basements, trying to explain to their kids that they can no longer hug them because the consequences of even a single touch could be dire.

Most of all, parents have wrestled with how much to divulge, because what their children do and don’t know about the pandemic could consume them. In many cases, it already has: Kids have endured nightmares and recorded their anguish in journals, written parents goodbye letters and created detailed plans of what they’ll do in case they never see their mom or dad again.

Tamina’s anxiety seldom relented. Nearly every time her mother visited, the girl asked the same questions.

“When can I come home?”

“Why can’t Daddy be here, too?”

“When is this going to be over?”

This time, though, Tamina was distracted.

“I brought you all kinds of stuff,” Leah said

as she opened a shopping bag packed with toys and clothes.

Tamina pulled out her green Easter dress and decided she didn’t want to wait until the next day to wear it. She was excited for the holiday, but also worried. Tamina wondered whether the Easter Bunny would realize she wasn’t at home.

“Does he know that you guys work at a clinic so I have to live somewhere else?” she asked her mom.

That’s what her young life had become — glimpses of normalcy abruptly interrupted by reminders that nothing was normal. While Tamina picked through the bag, she spotted a bottle of hand sanitizer and immediately squirted a dollop on her hands, then insisted her mom do the same. Later, when she was zipping a toy boat across the red-brick porch, her 10-year-old cousin knocked a ball over the metal fence into a neighbor’s yard. Tamina stopped the boat and stared.

“Don’t catch anything over there,” she said.

Even the lightest moments were tinged with sorrow.

“I wanna dance,” she announced, yellow tulips blooming in pots all around her.

“Should we put music on?” Leah asked, and Tamina said she wanted to hear “Budapest.”

“Oh, Papa would be so happy,” Leah said, because that was one of Jimmy and Tamina’s favorite songs. Before all this, the two of them would play it in their house a few blocks away and shimmy together, hand in hand.

Now, Tamina danced alone.

On Easter, she put her green dress back on and hunted for eggs and ate the head off a chocolate rabbit. Tamina thought about her papa again, too, but still didn’t know he was sick.

That night, as she got ready for bed, he began feeling worse. Then his temperature spiked to 102.9. Then came a cough.

‘It could kill a lot of people’ In the other Washington, 2,800 miles away, where covid-19 first exploded in the United States, Keis Alagba-Green knew all about what the virus could do to people, and that’s why the boy was still awake one evening early this month when his mom went into his bedroom to check on him.

Niran Alagba is a pediatrician in Silverdale, Wash., and her husband, Lawrence Green, an Army veteran, manages her clinic an hour’s drive from Seattle. Niran knew she’d treated patients who were infected, and so did her four children.

“What happens if you and Daddy die?” Keis asked her as she lay next to him, two weeks before his 10th birthday.

At dinner soon after he posed the question, his parents answered it for him and his siblings.

Their close friends, they explained, had agreed to care for the kids if Niran and Lawrence couldn’t. In the days that followed, each child processed the reality that their mom and dad might not survive in starkly different ways.

Third-grader Laila, quiet and matter-offact, seldom talked about it, while the 8-year-

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COVER STORY

Daniel Berman For The Washington Post

Keis, 10, Laith, 11, Zade, 6, and Laila, 8, gather at home in Washington state with parents Niran Alagba, who is a pediatrician, and Lawrence Green, who manages her clinic.

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old’s oldest brother, Laith, 11, did all the time.

An aspiring paleontologist and Lego devotee, Laith liked to plan. Right away, he wanted to know how their new life would work.

The family’s friends also have four kids and they don’t live in a home big enough for four more. He decided that the other family should move into his house, then he mapped out where each kid would sleep.

Preparing for his parents’ absence made Laith sad — in a nightmare, he saw them laying in hospital beds — but the fifth-grader believed it was his responsibility to consider the “hardship things” his siblings wanted to avoid.

Those things troubled Keis the most. One afternoon in early April, the two boys contemplated what the virus might do in the coming months.

“It could clear up over the summer,” Laith said. “It could just keep going on —.”

“And kill everybody,” Keis interjected.

“No, not kill everybody, Keis. It wouldn’t kill everybody.”

“Yeah, but it could kill a lot of people.”

“It could kill a lot of people,” Laith conceded.

Keis could never hide how he felt. He hated visiting the hospital when a heart attack took his grandfather’s life two years earlier, and he hated the idea of his parents ending up in one now.

He was convinced that both of them would eventually contract the virus, but he also knew his mom had access to hydroxychloroquine, the unproven drug President Trump touted as a potential cure. Niran explained to her son that the medication might not help, but Keis fixated on it anyway.

He needed to believe it would work, especially after the bad thoughts bubbled at night, when he would read books, concoct Dungeons & Dragons strategies, go give his parents’ hugs — anything not to obsess over losing them.

But his youngest sibling, Zade, who is 6, had decided he should do the opposite.

“I don’t want to stop thinking about them dying,” he explained, because Zade believed that if he forced himself to imagine his mom and dad being gone, he wouldn’t forget them when they were.

‘I can’t be without her’ Taylor Lindsey didn’t know when she would see her mother again, so the fifth-grader sat in the pink chair at her desk and picked up a pencil. To prepare for a potential surge of infected patients, Amber Lindsey, a registered nurse, was about to embark on a 10-day stint of overnight shifts at her community hospital in Olympia, Wash., an hour’s drive south of Silverdale. That meant Taylor, whose parents were divorced, would head back to her dad’s place.

“Dear Mom, I love you so much I have no idea what I would do with out you I would never forget you,” Taylor, 10, jotted on a sheet of paper. “Stay safe don’t get sick I be thinking about you everyday!”

She tucked the letter under her mom’s pillow, and soon, they said goodbye.

Taylor’s mother is her closest friend. They tended to their chickens and painted canvases

in acrylic and kayaked Puget Sound, always as a pair. They traveled together every summer, hiking in Central Oregon’s forest, sunning on Southern California’s beaches. Before the pandemic, each had given the other a beloved gift: for Amber, it was a heart-shaped necklace, inscribed with “BEST MOM EVER,” that she wore to work every day; for Taylor, a teddy bear dressed in pink scrubs that, when she squeezed its paw, played “I’ll Be There.”

On March 18, the night her mother returned to work, Taylor added an entry to her journal.

“Day 2,” it read at the top, next to “CoronaVirus.” “I really cried because I dont want her to get the Virus . . . I dont want her to get sick and be home alone. I cant be without her.”

The pandemic has instilled a sense of helplessness in children whose parents work in hospitals and clinics, but that feeling is especially acute for those like Taylor, the only child of a single woman living by herself while she treats sick patients. Her worries are not unique. Threequarters of those 9,200 covid-positive healthcare workers identified by the CDC were women, some undoubtedly raising children alone.

For Lexa Sterritt, 12, what might happen if her mother got sick was so unnerving that she tried never to think about it.

She and Elise Sterritt moved about six months ago from Chicago to Las Vegas, where the nurse practitioner took a job at a primary­-care clinic.

In March, the single mother developed a cough a few days after being exposed to two people who were later diagnosed with covid-19. Though she eventually tested negative, the episode shook her and Lexa.

What if Elise did get sick, and what if she was hospitalized? Would Lexa have to fly back to stay with relatives in Chicago, 1,700 miles away? Would she have to leave her mother?

Lexa didn’t let herself ask any of those questions aloud, and when Elise confided she might have to quit her job because the answers were too painful, her daughter assured her she understood.

Daniel Shum tried to understand when his mother explained things, too, but he was only 6.

“Mama has to take care of very sick people,” Lila Abassi, a physician, told her son on the day in March she dropped him off at her ex-husband’s place across town in New York City. She didn’t come back for Daniel the next week or the next or the one after that.

Daniel is smart. He reads at a fifth-grade level and can describe the differences among solids, gases and liquids in detail. He also wants to be a doctor, the kind “who save lives when people get very big boo-boos and is about to pass away.”

He grasped the immense risk his mother was taking, but Lila spared him from the worst of it — that nearly all of the patients at Mount Sinai Hospital in Manhattan, where she works, were coronavirus cases and that each time she admitted somebody new from the emergency room, Lila wondered whether this would be the one who infected her.

Daniel tried not to blame her for the separation during their FaceTime calls, but he couldn’t always help it. In his saddest moments, he closed

Daniel Berman for The Washington Post

Michael Noble, Jr. for The Washington Post

Top: Taylor Lindsey, about to turn 11, plays with her cat, Bruno, outside of her home in Olympia, Wash. Her mother, Amber Lindsey, is an emergency room nurse.

Above: Lila Abassi, who treats covid-19 patients, holds her son Daniel, 6, as they sit in Central Park in New York City.

his eyes and pictured the New Year’s Eve ball in Times Square.

After nearly a month apart, Lila told Daniel she was going to pick him up. The news thrilled him, at first, but then he overheard an argument between his mom and dad, who contended it was too dangerous for Daniel to see her. Lila insisted it wasn’t and that she’d taken every precaution and shown no symptoms. Eventually, her ex-husband relented.

When at last she picked Daniel up and they returned to her East Harlem apartment, he followed her everywhere, even when she took out the trash. At night, as he listened to his Harry Potter audiobooks, he fell asleep with both arms wrapped around her neck.

He was proud of his mom, but sometimes, Daniel wished he didn’t have a reason to be.

“I think why,” he said. “I think why did she pick the job to be a doctor?”

‘Why aren’t you crying?’

“Is it okay if I hold your hand?” Tamina Tracy asked her mother on a mild, spring afternoon.

It was the first time they had seen each

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The coronavirus pandemic

Max Whittaker for The Washington Post

Emily Elconin for The Washington Post

other in person since Tamina moved in with her cousins two weeks earlier. They decided to walk to Rock Creek Park, one of their favorite places. Tamina took her shoes off and waded in the cool water. She ate a Lunchables with two Oreos. She held her mom’s hand.

Tamina knew her parents were doing something important. Leah and Jimmy, who’d volunteered together in Haiti after the 2010 earthquake, both spoke Spanish and worked in D.C. clinics that treat many immigrants who lack insurance and are at a high risk of contracting the coronavirus.

Tamina often talked about wanting to help people, like her parents did, and now, they told her, she could. Her job was to stay healthy and not get anyone else sick, and to do that, she couldn’t live at home.

At her aunt and uncle’s house, she reveled in her role as the baby sister to her four cousins — all girls, all older — and embraced her newly assigned chores, aside from cleaning up after Crespa, the dog. Her aunt, Julie Lujan, set up a mattress in the living room and built a fort of sheets over it. Tamina

Top: Megan Babb, a physician, and her daughter Sophie Babb, 7, on the steps of their home in Folsom, Calif.

Above: Rana Awdish, a critical-care physician at Henry Ford Hospital in Detroit, and her son Walt Awdish, 9, in front of their home in Northville, Mich.

found a strung-together wad of faux dogwood flowers and decorated the wall next to her bed with them.

This wasn’t home, though, and she never forgot that.

Her mother painted a 12-by-8-inch portrait of the two of them and gave it to Tamina to keep while they were apart. She would lug it all over the house, then sit and stare at it.

She saw her dad only through FaceTime calls, but he’d also begun to write her letters, telling his daughter that she made him proud.

“So she doesn’t forget me,” said Jimmy, who wrote them even after the chills took hold and he couldn’t breathe for more than a few seconds without coughing. He ended each note with a request that his daughter send one back, and she did.

“I love you so MUCH,” she wrote him.

But she sometimes felt abandoned by her father and mother, and would refuse to accept the arrangement, throwing tantrums, demanding that things return to normal.

Once, she threatened to run away to her house and sounded so serious that her aunt slept that evening with her back against the front door.

Then came the afternoon of her walk through the park with her mom.

When they got back and Leah readied to leave, Tamina unraveled. She grabbed onto her mom and tried to wrap a hair tie around her wrist, imagining that it would keep her there forever. Tamina begged her to stay and screamed at her aunt when she pulled her away.

“I hate you,” Tamina said, weeping.

She looked into her mother’s eyes, peering back from above the surgical mask.

“Why aren’t you crying?” Tamina asked, and as her mother walked away, she did.

Leah returned the following day, because she’d promised to, but the goodbye was no easier. After that, they made a deal: When Leah left, Tamina could call her on FaceTime and stay on until she fell asleep.

Tamina didn’t want to be mad at her mom, just as Daniel, the 6-year-old in New York, didn’t want to be mad at his. But as the pandemic upends thousands of doctors’ and nurses’ lives, it’s left many of their children grappling with a rage they’ve never shown before and that their parents don’t know how to manage.

The bitterness in Sophie Babb, 7, emerged in ways her mother never expected.

Megan, a physician who treats infants in Folsom, Calif., was seldom exposed to infected patients — and told Sophie that — but the workdays had gotten longer, mostly because of her push for new health-care reforms in response to the outbreak.

It wasn’t the first time Megan’s job had left her with little time for her daughter. Only now, as Sophie became increasingly preoccupied with the virus, had she lashed out over her mom’s absence. She would ignore Megan when she came home late at night and snap at her when she apologized for going in early — “I know, Mom, you’re sorry.”

KLMNO Weekly

Googling fatality rates Walt Awdish wasn’t angry, and the third-grader tried not to feel afraid either, though he couldn’t always help that.

Usually, the more he grasped something, the better he felt, so Walt — a straight-A student who called his parents by their first names and repeated Simpsons jokes few 9year-olds would get — found out all he could about the coronavirus.

He learned that it started in China, ravaged Italy and hit his hometown, Detroit, harder than almost anywhere in the country outside New York. He learned how viruses spread when his mom, Rana, a critical-care physician, used tiny foam balls floating in slime to illustrate. He learned that nearly every patient where she worked, Henry Ford Hospital, was infected, and that helped him understand why his parents converted the laundry room into an off-limits space, marked by orange tape on the floor, for her to change clothes when she got home.

Not everything he discovered made him feel better, though. His mom told him she wore protective gear, but he knew it didn’t always make a difference. More than 700 people who worked for the Henry Ford Health System had tested positive.

He also suspected that on the days she came home with puffy red eyes, it meant she had been crying, and that meant she had seen something sad at the hospital.

Walt didn’t want to imagine her getting sick, but he needed to find out what could happen if she did. That led him back to his computer.

He searched fatality rates on Google and clicked on a chart. In his mother’s age group, 40 to 49, he saw 0.4 percent.

“Out of like a hundred, like that’s — that’s like very small,” he explained. “It would actually be four-tenths of a person for a death rate out of 100 people.”

Walt decided that was good news.

In Tucson, Kaya Dreifuss found her own way to cope.

The 10-year-old’s father, Brad, an emergency medicine physician, had launched an effort to aid people on the front lines in getting mental health support and finding comfortable housing away from their families. To help, Kaya, who’d just learned to sew, made fabric pouches — more than a dozen — and packed each with dried lavender. She gave them to her dad to sell so he could raise money for his project.

“Keep doing it,” he encouraged, because he knew that his daughter helping him would help her just as much.

She did keep sewing, and the work made her feel good, but the outbreak in Arizona soon intensified. Brad decided that he, too, needed to move away from his wife and daughter.

After he packed his car, Kaya, as usual, squeezed between her parents and pulled them toward her in a tight embrace, the “meat between the bread.”

Then she watched her father drive away. n

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books

The journey that introduced Lincoln N ONFICTION

l

REVIEWED BY

R ICHARD M OE

S Lincoln on the Verge Thirteen Days to Washington

By Ted Widmer Simon & Schuster.

606 pp. $35

o much has been written about Abraham Lincoln that it’s rare when a historian discovers an episode in his life that, if fully developed and interpreted, yields important new insights. Ted Widmer has done just that in his superb new book, “Lincoln on the Verge: Thirteen Days to Washington.” It’s ostensibly about the train trip the president-elect took from Springfield, Ill., to the nation’s capital; it’s in fact about how Lincoln and his fellow Americans came to know and trust one another.

In February 1861, Southerners feared that Lincoln’s election meant the end of slavery and their way of life; talk of secession and civil war was rampant. Northerners rejoiced at the election’s outcome, while fearing that it could lead to the country’s dissolution.

Widmer, a historian at the Macaulay Honors College of the City University of New York, spent 10 years applying his impressive talents as a researcher and storyteller to explain how our 16th president used a 13-day train trip to introduce himself to his fellow citizens and to prepare himself for the greatest crisis in the nation’s brief history.

The issue of slavery, most believed, would determine future events. Though his views were well known, Lincoln adopted a “strategy of silence” during the campaign and now through the four-month interregnum. But the Republican platform was unequivocal: Slavery must not be extended beyond the states where it already existed. “That was the rock that now loomed before the ship of state,” Widmer writes. As their next president, Lincoln believed he must calm anxious citizens — but the Constitution left him no means to do so.

Lincoln chose to use his train trip as the vehicle for connecting with those who elected him. He insisted on visiting the capitals of the five “essential” states that had

Photo12/UIG/Getty Images

President-elect Abraham Lincoln departs Springfield, Ill., on Feb. 11, 1861, to travel to his inauguration in Washington. The 13-day trip helped Lincoln connect with his fellow Americans.

elected him — Indiana, Ohio, Pennsylvania, New York and New Jersey; if hostilities broke out, he would need them to provide the manpower to deal with it.

On Feb. 11, an emotional Lincoln bid “an affectionate farewell” to 2,000 friends before the “Presidential Special” headed out. Hundreds and then thousands lined the tracks, trying to catch a glimpse of the man who embodied their hopes.

As Lincoln had plotted his route strategically, so too does Widmer with his writing; his creative structure and new research offer compelling diversions about some of the people and history the president-elect encountered. Included are past and future presidents, as well as the slaughterhouses of Cincinnati and the nauseating corruption of Albany.

The trip proved exhausting and at times frightening — with at least two assassination attempts.

Lincoln was often in pain, Wid-

mer says, “especially his hands, after the nightly ordeal of shaking hands with thousands of local well-wishers.” Nonetheless, “the trip was making a difference.

Even when the president-elect said nothing, the response was overwhelming.

Lincoln’s confidence grew as the Special entered New Jersey, where he told state legislators that, while he favored reconciliation, “I fear we will have to put the foot down firmly,” which he suddenly did, literally and dramatically — to the cheers of the astonished lawmakers. “This was the clear statement everyone was waiting for,” Widmer writes. “. . . He had found his footing, in every sense.”

The evening before, detective Allan Pinkerton had warned Lincoln that an armed mob would be waiting for him in Baltimore and that he must deviate from his course to evade the “death trap.”

Given a choice between continuing his journey with his dignity

and his purpose intact, or avoiding assassination by stealth and probably inviting ridicule, he quickly chose the latter.

“No one knew yet what a Lincoln presidency would mean, but the fact that he had survived the ordeal meant that his presidency would actually begin,” Widmer writes. “His odyssey was complete.” Days later, Lincoln arrived at the Capitol for his inauguration to speak of “the better angels of our nature.”

Widmer has written a revelatory work about an important but underappreciated episode that placed Lincoln “on the verge” of developing the confidence and courage to become America’s greatest president. His book could also be on the verge — of becoming a Lincoln classic. n Moe is a former president of the National Trust for Historic Preservation and the founder of President Lincoln’s Cottage in Washington.

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For homeless kids, a story of humanity

Finding solace in a troubling life story

F ICTION l REVIEWED BY R ON C HARLES

N ONFICTION

I

shmael Beah’s 2007 memoir, “A Long Way Gone,” was hard to ignore and impossible to forget. News reports about children conscripted into Sierra Leone’s civil war had shocked the world, but then came this indelible testimony from one of the soldiers describing the horrors he had witnessed and committed as a teenager. Beah’s survival, his recovery and his eloquence made him an international symbol of hope, and he has worked passionately since then to bring attention and resources to saving children traumatized by wars.

Now almost 40 years old, Beah has published his second deeply affecting novel, “Little Family.” Although set in an unnamed African nation, the story speaks to the plight of extremely poor people in all countries riddled with corruption and violence. Distressingly, the experiences of Beah’s characters are the experiences of the powerless everywhere.

Inspired by his extensive travels and interviews, Beah has imagined a group of five homeless orphans living on the edge of a bustling city. As victims of abuse or calamity, they care for each other gently, warding off memories of better — and worse — times.

Given the necessity of remaining invisible, the five kids in “Little Family” have taken refuge in an abandoned airplane camouflaged by a maze of vegetation. The oldest boy, a bookish 20-year-old named Elimane, acts as their de facto leader. But there are no formalized lines of command. Knit together by love rather than by blood or authority, they form a natural commune in which everything is shared equally.

Tender as this is, Beah has no interest in romanticizing their little family. He means only to insist on their humanity, which the upper classes so aggressively deny.

The novel conveys the precariousness of their position with shocking clarity: Every day is a struggle for food and security for these

kids whom nobody wants.

What endows the novel with such stirring energy is the way Beah focuses on their remarkable skills. To work the streets as grifters, shoplifters and pickpockets, the five members of this family must be extraordinarily observant and disciplined. Without any formal schooling, they are psychologists, sociologists and economists — tirelessly attuned to the shifts in a shopkeeper’s voice, a guard’s eyes or a crowd’s murmurings.

Early in the novel, the two elder members develop their own special projects that require them to exchange the security of invisibility for the potential power of being seen. Elimane attracts the attention of a political fixer who quickly recognizes the young man’s dexterity and begins using him for mysterious black ops.

Meanwhile, Khoudi, the elder girl in the group, emerges as the novel’s central character. One day she’s noticed by a group of wealthy students who have no idea she’s homeless. Swept up into their glamorous social scene, Khoudi enters a realm of opulence funded by endemic state fraud.

Funded by despotism, these glittery folks are easy objects of disgust. But Beah’s approach is more nuanced, and even Khoudi, who suffers so much under this system, never hates her oblivious new friends. She understands that their lives have been designed to make them sophisticated about the world and ignorant about their countrymen.

“Little Family” is an empathyexpanding story without the heavy gears of polemical fiction. In a sense, Beah has written an African social novel that complements earlier novels by Dickens and Twain, but he conveys his unsettling assessment with a more delicate balance of tenderness and dread. n Charles writes about books for The Washington Post and hosts TotallyHipVideoBookReview.com.

A

Little Family

By Ishmael Beah Riverhead. 262 pp. $27

MISS ALUMINUM

By Susanna Moore Farrar Straus Giroux.

288 pp. $27

l

REVIEWED BY

M ARION W INIK

t 74, Susanna Moore has lived a life well worth recounting. Both privileged and marked by tragedy, she has moved through the world as a great beauty and also as a deep and careful thinker with an old-fashioned character.

Born in Hawaii, she left home at 17 and moved to Philadelphia then New York and Los Angeles; she modeled and became a script reader for Jack Nicholson and Warren Beatty. In her new memoir, “Miss Aluminum,” Moore dishes about her Hollywood days — including a shocking revelation about the designer Oleg Cassini — but the book is far from your typical debauchery-filled tell-all.

As readers of Moore’s fiction know, she is a brilliant storyteller and sentence-maker. “My Old Sweetheart” and “The Whiteness of Bones,” novels inspired by her youth in Hawaii, her mother’s sudden death and her coming of age in New York have been among my favorites since I read them in the early 1980s. Her 1995 erotic thriller “In the Cut” created a well-deserved sensation.

The latest addition to her oeuvre reminded me of everything I ever loved about her as a writer, and now, as happens with certain memoirs, I feel like she is my friend — a very elegant, accomplished grande dame sort of friend, to be sure, one who might loan you a pair of blue velvet Pucci bell-bottoms or a copy of “The Great War and Modern Memory” on your way out the door after tea.

Moore’s voice on the page is sometimes reminiscent of one of her mentors, Joan Didion, in its spellbinding rhythms and effortless transition between the physical and the intellectual. Her anecdotes range from breezy to chilling. On one end, you have her ludicrous two-day reign as Miss Aluminum (a modeling job for the Aluminum Association to help promote their products) and

her early confusion about sexual pleasure. “I had been more influenced than I realized by my prurient reading of such books as Peyton Place,” she writes, “drawing from them the inaccurate notion that orgasm was tantamount to a seizure of great intensity.” She may still have been a little confused about things years later when she had her less-thansteamy extramarital affair with Nicholson.

On the dark side, she was not much more than 20 when she says she was raped in a hotel room by her then-employer, the designer Oleg Cassini, a Harvey Weinstein prototype. Though she doesn’t mention the #MeToo movement, it may have emboldened her to share this story, about which she has remained silent until now. After the incident, Cassini went on to help her get a role as one of 10 “Slaygirls,” bodyguards to Dean Martin’s character in a ridiculous film for which he was the costume designer. To protect herself from Cassini over the months of shooting in Acapulco, she became the “girlfriend” of the associate producer, a man with liver spots, a wife and grown children. But Moore too was married, and eventually her husband showed up unannounced in her cottage at the Hotel Las Brisas. He beat her so badly that even months later the judge took one look at her face and awarded her an instant, no-waiting-period divorce.

Stories like these are grounded in her unflappable narrative tone and her conviction, shared on the last page of the book, assessing her prospects at age 30, that “it would be all right.” Given the luminous literary career she had not yet even begun at that age, it seems to be so. n Winik, a professor at the University of Baltimore, is the author of numerous books, including “First Comes Love,” “The Lunch-Box Chronicles” and, most recently, “The Big Book of the Dead.”

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Opinions

The case for allowing human experiments Peter Singer and Richard Yetter Chappell Singer is a professor of bioethics in the University Center for Human Values at Princeton University.

Chappell is an assistant professor in the department of philosophy at the University of Miami.

The pandemic has thrown previous moral assumptions into disarray. Most of us now accept restrictions on our freedom of movement and association that would have seemed unthinkable just a few months ago. Yet the research we are willing to do to combat the virus is still governed by assumptions developed in calmer times when less was at stake. ¶ Research ethics normally prohibits exposing human subjects to significant risk. The overriding aim is to prevent their exploitation by researchers whose interests may not coincide with those of the individual patient. But in a pandemic, the overriding aim must be to avoid a potentially catastrophic toll. We all face such heightened risk that restrictions on promising research (beyond the basic requirement of informed consent) could easily prove counterproductive in humanitarian terms.

For example, conventional standards require that new drugs be tested on animals before clinical trials with humans are permitted. For covid-19, sufficiently promising treatments should jump to human clinical trials as soon as is reasonably possible, bypassing the usual lengthy period of animal testing.

There is a precedent for this.

In 1986, when AZT first showed promising results in the treatment of AIDS, patients demanded that the drug be made available without going through animal testing. The Food and Drug Administration licensed it the following year, saving many lives.

AIDS had a much higher fatality rate than covid-19.

Even so, if we fully inform covid-19 patients about the risks of taking part in an experimental treatment trial, they may reasonably choose to take that risk. When we consider the broader humanitarian benefits of

confirming a treatment’s effectiveness much sooner than would otherwise be possible, not to mention the reduced animal suffering involved, there is a strong moral case for allowing patients to make that choice.

Similar arguments support allowing “human challenge” trials to speed development of a vaccine. Ordinarily, testing a candidate vaccine means waiting months to see whether injected subjects are less prone to infection.

Deliberately exposing vaccinated volunteers to the virus could produce results much more quickly. If you think no one would volunteer for such a trial, think again.

More than 3,000 altruists from 52 countries have already signed up.

Finally, consider research into low-dose controlled voluntary infection, or “variolation,” widely used to inoculate against smallpox before the discovery of vaccination. In the New York

Illustration by Rob Dobi for The Washington Post

Times, scientists Joshua D. Rabinowitz and Caroline R. Bartman note that people who receive a low dose of a virus are more likely to recover than those who receive a high dose, and that this holds for coronaviruses, too. But they then say: “It would be unethical to experimentally manipulate viral dose in humans for a pathogen as serious as the coronavirus.”

Does this ethical judgment make sense in a pandemic?

The seriousness of the coronavirus cuts both ways: more risk from the initial lowdose infection, but greater benefits if it does protect them.

If we can gain solid evidence that receiving a low dose of the virus leads to a mild case of covid-19, and that such mild cases then bring immunity to further exposure to the virus, we would have found a means of saving hundreds of thousands of lives — and millions of livelihoods. In these circumstances, it seems both reasonable and ethical to invite healthy young volunteers to receive a low dose of the virus, followed by quarantine and medical observation.

In fact, some individuals have already sought deliberately to infect themselves via uncontrolled “coronavirus parties,” despite

medical experts urging them not to do so. It would be better for everyone if such individuals instead had the opportunity to volunteer to receive a low dose of the virus as part of a carefully monitored trial. That would be safer for the participants than an uncontrolled infection, and the knowledge that we would gain from such a trial could, in the best-case scenario, lead to a quick end to the pandemic.

We are ethicists, not medical or biological scientists. When it comes to factual beliefs about the pandemic, we defer to expert scientific opinion, as everyone should. But what we ought to do with the facts we have, and how we should go about seeking facts we still lack, are ethical questions.

Ethicists have a crucial role to play in this debate.

There is too much that we don’t know about covid-19. The longer we take to find it out, the more lives will be lost.

(That’s why the website asking for vaccine volunteers is called “1 Day Sooner.”) If healthy volunteers, fully informed about the risks, are willing to help fight the pandemic by aiding promising research, there are strong moral reasons to gratefully accept their help.

To refuse it would implicitly subject others to still graver risks. n

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Five Myths

The gig economy BY

S HELLY S TEWARD

Shelter-in-place orders in response to the coronavirus pandemic have increased public awareness and scrutiny of the gig economy — from the DoorDash drivers who drop off ramen, to the Instacart shoppers who buy groceries, to the Amazon Flex drivers who deliver packages.

(Jeff Bezos, the chief executive of Amazon, owns The Washington Post.) But many other kinds of laborers — including domestic and agricultural workers, temp agency workers and freelancers — also piece together short-term jobs. Many are classified as independent contractors, which means they are not covered by laws that ensure a minimum wage, prohibit harassment or provide safety equipment.

As millions of these workers stay on the job so others can stay home, here are five common myths about the gig economy.

Myth No. 1 The gig economy is taking over.

The gig economy is here to stay, but it’s not replacing traditional work. While gig work is notoriously difficult to measure, most studies agree that about 10 percent of workers earn most of their income from the gig economy, a share that has remained stable for more than 20 years. At least as many workers engage in gig work on only a parttime basis, to supplement other income. Increasing numbers of workers have engaged in these “side hustles” in the past decade.

The JPMorgan Chase Institute estimates that the fraction of U.S. households that earned money through an online platform increased from 0.3 percent in the first quarter of 2013 to 1.6 percent in the same period in 2018. Many of these side hustlers become active on apps only after an income loss or an unexpected expense.

Myth No. 2 The gig economy has been driven by technology.

Just as the steam engine brought us industrial manufacturing, the story goes, smartphones brought us appbased work.

But the decisions of managers and policymakers shape the labor market more than technological development does. Beginning in the 1970s, corporations shifted their focus away from production and toward stock prices.

Employees came to be seen as a cost to be cut rather than a source of profit. The use of temp agencies, introduced in the 1950s, exploded in this era.

Shortly after the Taft-Hartley Act, which passed in 1947, excluded independent contractors from the National Labor Relations Act, taxi companies began experimenting with hiring independent contractors. Court cases ruled in favor of this practice, opening the door for its proliferation. Uber and Lyft expanded the independent contractor model, taking advantage of a regulatory framework already in place.

Technology can facilitate and accelerate change, but it doesn’t drive it.

Myth No. 3 Gig workers are mostly millennials.

The age distribution of gig workers is similar to that of the overall workforce, according to data from the Bureau of Labor

Cheney Orr/Reuters

An Instacart worker heads to his car after shopping at Safeway. Such gig economy jobs aren’t as flexible and reliable as companies claim.

Statistics. The youngest workers, those under 25, are more likely to have gig jobs, because young people have always engaged in gig work.

As a cohort, millennials tend to value job security — possibly because they came of age during the Great Recession — and are more likely than Generation X or baby boomers to say security is extremely important when considering a job, according to a Pew poll. Millennials also tend to hold jobs longer than the generation before them did at their age. These priorities make gig work unappealing to many millennials.

Myth No. 4 Gig work can be a backup option in a slow economy.

Gig work is not a reliable source of income during a recession. The number of jobs available depends on consumer demand: Though some companies, including the food delivery services Instacart and Postmates, have announced increases in work opportunities through their platforms, others, including Uber and Thumbtack, have reported steep drop-offs in demand since March, as consumers have stayed home.

The dynamic pricing systems used by Uber, Lyft and other platforms make the job availability and the rate of pay unpredictable.

Myth No. 5 Gig workers have lots of flexibility.

Not all gig work is created equal, though. Some contract work allows people to choose what they do, when they do it and what rates they charge: A freelance graphic designer with a respected portfolio, for example, may select her clients and set competitive rates. But several online platforms use variable pay, ratings systems and notifications to push people to accept certain jobs and work certain hours. These practices, called algorithmic management, limit the flexibility of work. Uber drivers report being monitored through their phones and deactivated without notice. Low, unpredictable wages and a lack of benefits can push people to work more hours than they would in a full-time job. n Steward, a sociologist and associate director of research for the Aspen Institute’s Future of Work Initiative, studies the changing nature of work in the United States.

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