The boat motored up the Nile River, a capsule of gaiety beneath a spotless February sky.
Bonnie Lippe figured the aches and fever she and others in her tour group experienced were related to the rich food or the drinking water. A month later, she became the first person in the Washington region confirmed to have the coronavirus.
By December, hundreds of thousands would be infected in the region, including a Virginia widow who placed her late husband’s ashes in a church portico on a recent sunny day; a D.C. nursing home aide who struggled to climb the steps of her apartment building that same morning; and a priest in the Allegheny Mountains who was tethered to an oxygen machine, grateful for friends who help with the laundry.
The march of the virus through the District, Maryland and Virginia has exposed cruel disparities influencing who gets sick and who survives. But at each stage of the pandemic, the virus has also shown that anyone — from the poor to the powerful — can become a victim.
At first, just a smattering of travelers tested positive, triggering work-from-home orders and panicked searches for masks.
Then the virus burrowed into elder-care communities and devastated blue-collar Black and Latino residents, many of whom live in crowded apartments and could not afford to stay inside.
By summer, cases were plummeting, especially among the more affluent. But beach communities became the centers of a new surge.
As mask-wearing became politicized, the virus took root in rural parts of Virginia and Maryland. College students brought it to their campuses and surrounding towns, and case rates among White residents grew to match those among Black residents — though in the District and its suburbs, sharp disparities remained.
Now, in a new year, vaccinations are here, though not yet widely available. And the virus is thriving in every corner of Virginia and Maryland, with reports of new and more dangerous variants.
LEFT: Pastor Tom Montgomery presides over a December interment service for John F. Uncles at St. Andrew Lutheran Church in Centreville. (Amanda Voisard for The Washington Post) RIGHT: Signs are set on seats to ensure social distancing at the December service at St. Andrew. (Amanda Voisard for The Washington Post)
“We know that we’re not in this alone,” Tom Montgomery, pastor of St. Andrew Lutheran Church in Centreville, Va., said in his sermon at the December service for John F. Uncles.
But lonely is exactly how it feels.
Uncles’s wife, Cindi Uncles, had waited months to inter his ashes on his 70th birthday. She sat in the church with their daughter, Christine, and about 30 loved ones, many of whom had not seen one another since before the pandemic. After the service, they exchanged awkward, masked hugs near “Stop the coronavirus” signs that urged them to keep their distance.
“This is not right,” Montgomery had said in his sermon. “In the seasons of John’s life, this should be a time of laughing and dancing and continued traveling, after he waited for Cindi to finally retire.”
Lippe and her mother-in-law flew to Egypt on Feb. 7, when the virus was just a remote threat concentrated in central China. Nobody seemed gravely ill, Lippe said, though a cabin boy wore dark circles of exhaustion under his eyes. “I will sleep tomorrow,” he promised her.
She returned to Bethesda on Feb. 21, puzzled by her loss of taste and smell. For 10 days, she went about her normal life, including attending a Jewish shiva gathering at a Rockville retirement community.
Then came a call from the Maryland Department of Health, telling Lippe she was probably exposed during the cruise. She later learned that several crew members were infected and that a man in her group had died.
Lippe tested positive, followed by a Bethesda couple she had met on the boat. On March 6, Gov. Larry Hogan (R) announced the results, providing details about the cruise and the shiva. Lippe worried she had infected others. She also feared for her safety, as people on social media called the three travelers callous and irresponsible and as media outlets scrambled to find her.
“I didn’t want to go outside. I didn’t want to talk to people,” said Lippe, who has since moved to Nevada with her husband. She donated blood plasma twice, hoping to aid others who become infected. She volunteers as an online peer counselor for Maryland residents who have tested positive.
“I felt like I needed to do something,” she said. For those now battling the virus, she offered this message: “Don’t give up hope. You’ll feel like yourself again.”
Cindi Uncles, 67, wonders when that day will come. She and her husband, a former government contractor and teacher, were probably infected in Australia, where their son lives with his husband.
The Centreville couple flew to Singapore on Feb. 9 to join the younger couple on a cruise. They saw people wearing masks and wondered whether they should do the same. “And we all decided: No. You see that more with Asian countries,” Cindi Uncles said. “We really didn’t think it was a big deal.”
The cruise was canceled after reports of outbreaks on other ships. So they flew to Australia and visited wineries outside the coastal city of Adelaide. Nobody wore masks. They began using hand sanitizer in Sydney, their last stop, where actors Tom Hanks and Rita Wilson had just been diagnosed with the virus.
Cindi Uncles fell ill as soon as they arrived home. Her doctor suspected strep throat. John, wanting to be attentive, slept next to his wife until she grew worse and demanded he move to the guest room.
By then, he was burning up, too. They returned to the doctor’s office and found it closed. A note on the door read “Virtual appointments only.”
“We were like: ‘Oh, my gosh. This is what it’s got to be,’ ” she said.
Her last conversation with her husband came two days after they were hospitalized, text messages sent from separate rooms.
“Ventilator. Now,” he typed.
Crying, she responded, “Please fight.”
“I will,” he promised.
He did, for 13 more days, until the family decided to remove him from life support.
LEFT: Cindi Uncles holds her husband's remains at his December service in Centreville, on what would have been John's 70th birthday. (Amanda Voisard for The Washington Post) RIGHT: Cindi Uncles with daughter Christine. (Amanda Voisard for The Washington Post)
By then, the virus had killed 332 people across the greater Washington region.
Cindi Uncles said she does not know whether she or John passed the virus to anyone else, at the airport or during trips he made to buy food, each time without a mask.
“I think about it now and wonder: ‘Oh, my gosh. How many people did I infect?’”
Sabrina Mosley wasn’t used to the quiet.
Shops, restaurants and schools in Washington were closed, and the vast majority of residents had been told to stay home whenever possible. Trudging along empty pavement to the nursing home where she works in Northeast Washington, she struggled to shake the feeling of being alone — and exposed.
Mosley, 53, knew by this time that nursing homes were particularly vulnerable to outbreaks of the coronavirus, but her nursing-assistant job was her only source of income. Her managers told her she fell into the category of people too “essential” to stay home.
So Mosley kept talking to her Alzheimer’s patients, bathing them and helping them eat — all without masks or gowns. The week of April 7, she started hearing raspy coughs from inside patient rooms. Ambulances came more frequently.
Less than a week later, she tested positive.
LEFT: Mosley says that as coronavirus shutdowns took effect, the quiet in the streets as she walked to her job at a nursing home was unnerving. (Amanda Voisard for The Washington Post) RIGHT: Mosley tested positive for the coronavirus in April. Her recovery would be a difficult one. (Amanda Voisard for The Washington Post)
From April through June, the virus surged rapidly in the District, Maryland and Virginia, infecting vulnerable communities in large, relentless chunks: 64 residents at a nursing home in Maryland, 200 firefighters and police officers in the District, 100 workers at a poultry plant in Virginia.
People of color bore the brunt of the devastation.
Of the 25 Zip codes with the highest case rates in the spring, more than half were majority Black or Latino. Crowded apartments became hot spots as people came and left for work and those who fell sick struggled to find space to isolate.
After Consuelo Granados tested positive, so did her husband, pregnant daughter and son-in-law — all of whom have blue-collar jobs and live under the same roof in Springfield, Va.
Granados, 45, said the company that pays her $10.50 an hour to clean rooms at George Mason University did not provide its workers with masks. She was granted two weeks of paid leave when her symptoms became overwhelming.
It took her five months to return to work, she said. By then, a $670 hospital bill had gone to collection. A month later, her grandson was born prematurely and hospitalized for 13 days.
“I am working again. That’s the most important thing,” Granados said. “But I don’t know how I am going to pay my bills.”
The region’s response to those who were falling ill was haphazard, especially early in the pandemic.
When Joyce Shorter, 66, went to an emergency room in April with a dry cough, doctors suspected pneumonia and sent her home. Her managers at Sagepoint Senior Living Services in La Plata, Md., did not seem concerned, either.
The cough did not abate, even with medication. Isolating in her bedroom, Shorter felt more tired every day. Then came the intense headaches. On April 17, Shorter’s family watched from the yard as paramedics wheeled her into the back of an ambulance. It was the last time they would see her alive.
“I felt a piece of my heart leaving,” said her daughter, Stephanie Munson.
Shorter tested positive for the coronavirus posthumously. In the days after her death, Munson and three other relatives learned they had the virus, too.
Covid-19 deaths spiked in May across all three jurisdictions. But those infected were not dying at equal rates. Of the approximate 1,800 fatalities from mid-May to mid-June, 70 percent were people older than 70. Nearly half of those who died were Black, about twice the percentage of Black people in the population. In the District, deaths were concentrated in the poorest wards, even though wealthier parts of the city have higher populations of elderly residents.
Mosley was admitted to MedStar Washington Hospital Center on April 25, dehydrated and with her kidneys starting to fail. For five days she lay in bed, listening to other patients coughing, choking and flatlining.
In May, she moved to a skilled-nursing facility for rehabilitation. It took her two weeks to relearn how to walk, then two months before she felt ready to work.
By the time she put on her blue scrubs again, infections in the region were plateauing, and local officials in rural and beach communities were lifting restrictions.
Mosley ventured out with a mask and a new sense of wariness. This time, it wasn’t the empty streets that scared her. It was the crowds.
The temperature was swelling past 90 degrees.
It had been more than three months that Michael and Shannon Katz had been cooped up in their townhouse in the Maryland suburbs, more than three months since schools had closed and Michael had been furloughed from his job at Marriott Corp. and put in charge of explaining — almost daily — to Cecilia, 3, and Liam, 6, that the playground was not safe to visit.
The family’s annual beach trip to South Carolina, planned months before the pandemic, promised a week of escape.
Shannon, a speech therapist, was nervous about sharing a rental house with her in-laws flying in from Arizona, where the virus was surging. She had read about the way air molecules circulate inside a plane cabin, bouncing from one stranger to the next. But she also knew that her kids — and her husband — were counting down the days.
So in late June, as test positivity rates in Maryland dipped below 5 percent, the family headed to Kiawah Island. As the children skipped over the breaking waves with their grandparents, things almost felt normal again, Shannon said.
The symptoms started when they got home.
All six members of the Katz family tested positive for the coronavirus. Michael’s father was hospitalized for a week. Liam had a fever of 101 degrees. Struggling with body aches and fatigue, Shannon and Michael wrote their wills.
“It was like nothing we had ever felt before,” Shannon said. “It was just scary.”
Over the course of the summer, millions of D.C., Maryland and Virginia residents traveled out of their county or state, according to cellphone data analyzed by the University of Maryland.
Images of crowded bars and boardwalks exasperated public health officials as the virus crept from populated metro centers to beach towns, infecting visitors who then took it back to their communities.
After July Fourth, daily cases in Ocean City increased more than sixfold. In Virginia’s Hampton Roads area, case rates hit an average of 83 infections for every 100,000 residents, outpacing the more populous counties in Northern Virginia that until then had driven the spread of the virus in the state.
Officials had warily lifted restrictions, desperate to restart the economy. People under 40 became the main spreaders of the virus, accounting for 57 percent of cases between July and August. In Loudoun County, the number of infections among people under 30 more than doubled after dozens of teenagers and young adults attended a massive “beach week” celebration in South Carolina.
The Katzes kept mum about their condition for weeks, Shannon said, embarrassed that they had traveled. “I felt like we were at fault,” she said. “In hindsight, I know it wasn’t worth the risk.”
Others who caught the virus during the summer also felt regret.
A 19-year-old college student from D.C. tested positive after visiting friends in Atlanta, forcing his entire family to isolate for two weeks. A 58-year-old in Sterling, Va., still beats himself up for agreeing to remove his mask when his virus-denying nephew paid a surprise visit. A young couple from Baltimore who tested positive after visiting Bethany Beach, Del., said they continue to suffer from covid-19 symptoms.
“There are random days now, even periods of three to five days, where my breathing struggles come back,” said Perry Wheeler, 36. Since the beach trip, he has seen cardiologists about his lingering chest pains and finds himself fretting over “the unknown” of what other long-term side effects may emerge.
“It’s extremely frustrating because until that point, we did everything right,” Wheeler said. Before the Delaware trip, he and his wife did not eat inside restaurants, attend large gatherings or forget their masks.
They made just one small slip-up after what they described as months of “torturous” quarantine.
For the virus, that had been enough.
The virus pierced the Rev. Marsha Spain Bell’s social bubble in late October.
Since around Easter, she and her husband, Cecil George Bell Jr., had socialized exclusively with the Rev. Martha Macgill and her husband, Bryan Kelleher. They shared home-cooked meals, bottles of tequila and spirited games of canasta in their homes in mountainous Western Maryland.
Outside, the world went on. Many of their neighbors adhered loosely to mask requirements, attending backyard barbecues and school parties that seemed to be everywhere on warm days.
“I was angry at the people who weren’t complying,” said Marsha Bell, an associate priest at Emmanuel Parish of the Episcopal Church in Cumberland, Md., where Macgill is the rector. “The health department would not do anything about it or enforce it. They would not even call the police.”
In the spring, Maryland’s Allegany County was reporting just a handful of new coronavirus cases daily. But by the Tuesday before Halloween, when the two couples shared a chili dinner, 10 new people per day on average were testing positive, and 24 local residents had died.
A leveling force was at work. Once barely touched, rural communities were experiencing multiple outbreaks, fueling a more than fivefold spike in infections that erased the racial gap seen until that point in the pandemic.
On the day of the chili dinner, Cecil Bell visited a home improvement store. Kelleher went to the high school where he taught math. Macgill attended meetings, and Marsha Bell had physical therapy for a damaged rotator cuff.
Less than a week later, all four were coughing and feverish.
Marsha tested positive first. Her husband drove her to the emergency room but refused to go in himself.
“He was being tough, like he is,” she said of the Texas-born man they knew as “Bubba.”
A few days after, Cecil had pneumonia and was hospitalized.
He texted Kelleher: “I’m sorry I gave you the virus.”
“Your job is to get better. Stop saying that,” Kelleher replied.
Cecil Bell died on Nov. 25, 15 days after his 73rd birthday. His wife and Macgill were there with anointing oil and a prayer book, their voices still raspy as they helped him let go.
“You feel God’s presence when you do that,” Macgill said. “Standing next to Cecil with all that protective gear on, we also understand what those doctors and nurses do every day.”
Across Maryland, Virginia and the District, the number of covid-19 patients in intensive care units had surged back to the peak levels of the spring, averaging 1,000 a day.
But now they were not concentrated in major hospitals in population centers. Instead, they were scattered in much smaller facilities, where even a half-dozen patients can overwhelm an ICU and it is hard to find replacements when nurses and doctors have to quarantine or fall ill.
In southwestern Virginia, hospitals serving the tiny towns near the Kentucky and Tennessee borders saw ICU admissions increase for 91 straight days between late September and the end of the year, far above the 14-day threshold that the state health department considers to be a red flag.
Ballad Health, whose 21 hospitals serve that region, temporarily stopped all elective surgeries and set up mobile morgues.
“Just about everybody is on a ventilator, which requires multiple pumps and multiple sedation,” nurse Allie Williams of Johnson Memorial Hospital in Abingdon, Va., said in December. “It’s just so, so hard to watch these patients and take care of them. Because they’re so sick and so critical and unstable, they need more than just one set of eyes.”
By late November, the virus had reached every corner of D.C., Maryland and Virginia. Nearly 2 out of 3 Zip codes hit record-high infection rates in December and the first week of January as people traveled or gathered in person for the holidays.
Residents under 40 continued to drive the bulk of the infections, and those above 70 still accounted for the vast majority of deaths — an average of 58 a day in December, which rivaled May as the deadliest month.
Case rates surged again in majority-Black and -Latino communities as the virus returned to diverse, metropolitan areas. Racial disparities widened — but not to the levels from the spring because the virus was still tearing through the majority-White, rural counties in Virginia and Maryland.
Zip code 24635, in Pocahontas, Va., reported its first five coronavirus cases on Dec. 5. Three days later, there were 107. By January, the town of about 1,430 residents had seen 243 infections.
“Quite frankly, we predicted this,” said Baltimore County Health Officer Gregory Branch, who was infected in July when community transmission in Baltimore spiked. “It was said over and over again that the winter months would be dangerous.”
From the start of November to the end of January, the number of coronavirus cases in D.C., Maryland and Virginia more than doubled, with 550,000 new cases. There was a 60-year-old Latina grandmother in Alexandria who tested positive along with multiple members of her household. A cautious, retired professor in Chevy Chase found himself exposed. A man quarantining with his son in Montgomery County was hospitalized two weeks before his 76th birthday.
All of them died, their relatives said, without knowing how the virus got to them.
While the arrival of the vaccine in late December was a reprieve, experts warn it will be months before it is available to enough people to counter the virus. In the meantime, more people will get sick.
Ron Harrison, a self-described “homebody,” had not traveled for the holidays or dined indoors at crowded restaurants. As an English and sociology teacher at a private school in Howard County, he had been meeting with small groups of students since the fall, staying masked and distant. He suspects that he caught the virus after talking to a fellow teacher who traveled out of state for Thanksgiving.
LEFT: A self-described “homebody,” Harrison had been careful before he got the virus. (Amanda Voisard for The Washington Post) RIGHT: Harrison teaches English and sociology at a private school in Howard County, Md. (Amanda Voisard for The Washington Post)
Harrison, 54, said he blames himself for taking off his mask while they chatted. “I dropped the ball,” he said.
Isolating in his bedroom in December, he made a plea to those weary of the pandemic.
“Please do what you need to do to keep yourself safe — please,” he said. “It’s not over.”