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The coronavirus might not be the worst of it
The Washington PostDemocracy Dies in Darkness

Coronavirus has infected 100,000 people in D.C., Maryland and Virginia

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On Friday, 85 days after the novel coronavirus appeared in the Washington region, the number of known infections in D.C., Maryland and Virginia surpassed 100,000. That means six in every 1,000 residents have tested positive for the virus. At least 13,000 patients have been hospitalized, according to state data, and 4,284 have died.

This milestone comes as several of the region’s hardest-hit localities lift months-old restrictions, taking tentative steps toward resuming social and commercial life. The vigorous debate over reopening is a reminder that the virus has affected virtually everyone in the region. But these 102,059 patients have been touched by covid-19 in the most direct way.

“It’s surreal,” said Titou Phommachanh, 44, one of Northern Virginia’s first critically ill covid-19 patients. The father of two was admitted to Inova Fairfax Hospital, where his condition rapidly declined, in early March. After spending nearly three weeks in a coma, Phommachanh woke up to a different world, he said — “a covid world,” where what happened to him was no longer a freak incident but a familiar story unfolding across the region to hundreds of people.

“The shocking part of it all,” said Phommachanh, now recovered and at home with his family, “is how quickly it’s been able to spread.”

As case numbers mounted over the past 11 weeks, so did pressure on government agencies to release more data on infections and deaths. Health departments started publishing demographic information, then added Zip codes and localities, providing a partial portrait of who these patients are, where they live, and how they contracted the disease.

Slightly more women have tested positive than men, but ⁠ — as is the case nationally — more men have died. In Maryland and Virginia, residents above the age of 40 make up about 60 percent of cases. In the District, 72 percent of infections were found in residents 35 and older. But that does not mean children have been spared from the disease: Across the three jurisdictions, at least 7,000 patients have been younger than 19.

Communities of color have been disproportionately affected by the virus, mirroring national trends.

Of 931 Zip codes in Maryland and Virginia analyzed by The Washington Post, the highest infection rates per capita were found in communities that are predominantly African American and Latino. In the District, about 58 percent of known infections were in communities where African Americans are the majority. The three neighborhoods with the highest rates per capita — Stadium-Armory, Brightwood Park and Saint Elizabeths — are predominantly African American.

In the Stadium-Armory neighborhood east of Capitol Hill, which is 83 percent African American, 356 of every 5,000 residents have tested positive for the coronavirus, marking the highest rate in the District. This is partially because the neighborhood is home to the D.C. jail, where more than 200 people have tested positive.

Two black men died of covid-19, five days apart. This is what was lost.

Patients cluster around densely populated areas. Of the known infections, 79 percent were diagnosed in urban and populous suburban areas, including the District, Baltimore, Northern Virginia, Virginia Beach and Richmond. The Washington metro area makes up 60 percent of infections in the District, Maryland and Virginia.

The virus first appeared in the region on March 5, with three Montgomery County residents who were infected while traveling overseas. Within days, cases emerged in Virginia and in the District, including the city’s patient zero, the Rev. Timothy Cole of Christ Church Georgetown. Health officials urged calm, pointing out that all the early cases were linked to travel or known contact with an existing patient. But by the second week of March, the evidence of community spread was clear. Schools were shuttered and large gatherings banned.

The number of known infections spiked most sharply in April, increasing from 4,000 to 40,000 in 30 days. The region went from adding roughly 500 new patients a day to 2,000 before the figure started to plateau.

The pandemic’s spread was fueled in large part by outbreaks in nursing homes, assisted-living facilities and jails — what government officials call congregate settings. Despite early lockdowns at these facilities, the virus was passed along by asymptomatic carriers, infecting more than 17,500 staff and residents and accounting for nearly a fifth of the total caseload in the three jurisdictions.

In Montgomery County, 6 of 10 covid-19 deaths are linked to long-term care facilities. In neighboring Prince George’s County, such fatalities represent 40 percent of deaths. Prince George’s officials say a bigger driver of infections and deaths in the suburb of 900,000 is rampant community spread, particularly among residents who are working in essential services.

Covid-19 is ravaging one of the nation's wealthiest majority-black counties

In Maryland and Virginia, the most prominent jobs in communities with the highest cases per resident are tied to educational services, health care, waste management and social assistance, census data shows. That was followed by communities with high percentages of residents in construction and manufacturing.

In Montgomery County, at least 18 firefighters and trainees and approximately eight sworn police officers have contracted the virus. One of the earliest was Capt. Larry Lofland, 56, who tested positive in mid-March, along with his wife Kristie, a kindergarten teacher. Lofland is not sure when he was exposed; it could have been as early as March 7, he said, when his paramedic duties took him inside two hospitals.

“That was so early in all this,” said Lofland, who has since recovered and helped to treat other covid-19 patients. “One hundred thousand cases — that number is overwhelming to me."

In D.C., 239 firefighters and police officers have tested positive for the virus, including Assistant Fire Chief John Donnelly, 53, who learned on March 23 that he had contracted the disease that was beginning to terrorize his city.

“My initial reaction was, ‘Wow, this could be it,’ ” Donnelly said.

For nine days, Donnelly slept from sundown to sun up, and his appetite disappeared. Since recovering, Donnelly has used his experience to inform the agency and other colleagues, donating his antibody-rich plasma to research and corralling other firefighters to do the same.

Those who survive the disease say they feel tied by a bond similar to the one that connects first responders and civilians who survive major crashes, fires or tragedies like 9/11. Donnelly said he has received well wishes from strangers in his neighborhood and from his son’s Boy Scout troops. Phommachanh said he has heard from dozens of families, asking about his experience with the drug Remdesivir and seeking hope for loved ones in critical care.

“Everyone I talk to, there is a connection,” Donnelly said. “Even though we are isolated, I’ve seen our community come together.”

As government officials inch toward reopening, the virus continues to spread, with 8,955 new infections announced since Memorial Day. Some scientists say it may never go away, even with a vaccine.

Models from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington suggest that it may take till mid-June for new daily infections in D.C., Maryland and Virginia to drop to the levels they were in March, though experts have warned against relying too heavily on these projections. It is certain that there will be more patients, but the exact figure depends on how residents behave in the coming months.

Allison Rule, a 46-year-old lawyer from Chevy Chase and one of the first hundred Maryland residents to test positive, said she deleted the Facebook app off her phone after reading posts from people incorrectly calling the coronavirus a Democratic hoax.

“As someone who had it, I take it really personally,” she said. “It’s not make-believe.”

Rule didn’t end up on a ventilator or in the hospital but said she is still grappling with the stress that came from testing positive. She and her husband didn’t realize their 10-year-old daughter understood what had happened until one recent night, when the girl told Rule, “I stay up at night to make sure you’re not coughing.”

Even as parts of Maryland reopen, Rule said, her family intends to continue staying at home.

The impacts of covid-19 are lasting. Some patients suffer permanent damage to their lungs, which may make them more susceptible to future respiratory illnesses. Others emerge with weakened kidneys, hearts or livers, dulled senses, or other mysterious symptoms.

Lofland, the Montgomery firefighter, said that there are entire days from the period he was battling the virus that he cannot remember. Sharrarne Morton, a Prince George’s County resident, lost 25 pounds and two dress sizes during her five-week bout with the virus. Weeks after being discharged from the hospital, she still has not gotten her appetite back.

Phommachanh returned home nearly two months ago and still has some lingering nerve damage in his hand — a tingling, sometimes shooting pain from his ring finger to his pinkie finger. The sensation comes and goes, he said, a reminder of the virus’s mark on his body.

Clarence Williams, Dan Morse, Jenna Portnoy and Ovetta Wiggins contributed to this report.