This is part of Six Months In, a Slate series reflecting on half a year of coronavirus lockdown in America.
In recent years, many media outlets have dramatically shrunk their science coverage or gotten rid of it altogether. But over the past six months, it’s seemed like nearly every news story is a form of science writing. Science reporters are stars and Cassandras; our work graces front pages and tops most-read lists. We’re also, like everyone else, living through a pandemic; the very thing that makes our work so important is also unraveling our lives and threatening our health.
Now that we’ve been doing this for six months (or really, eight—a novel virus emerging in Wuhan was a big science story from the jump), I checked in with three people whose work has touched on all aspects of the novel coronavirus, from the nuances of how it spreads to its emotional toll on health care workers: Apoorva Mandavilli, a science reporter for the New York Times who began the pandemic as the editor in chief of Spectrum, an autism news site; Roxanne Khamsi, a freelance science reporter who has written for Wired, National Geographic, and Nature, among others; and Dhruv Khullar, a physician at New York–Presbyterian Hospital whose writing appears regularly in the New Yorker. Our conversation has been lightly edited for length and clarity.
Shannon Palus: For each of you, was there a particular moment where you realized that the coronavirus was something to take really seriously, and also that this was going to be with us for a long time?
Apoorva Mandavilli: I think it was in January. I was [socializing] with the New York Times science team, and we were all talking about the virus. By then, a few stories had come out, and I knew that the CDC had been holding press conferences. I was still full time at [the autism news site] Spectrum, so I wasn’t thinking about the coronavirus really intensively. The first coronavirus story I wrote was about how kids didn’t seem to be getting infected. When I started reporting that story and looking at the numbers in China, it really hit me how big this thing was. But I have to say, I didn’t think that it was going to be here forever until much later than that, probably like late February, I think, partly, because I was doing this on the side at first. It took me a while because there have been so many other viruses that have come and gone that I was, I think, hoping this would be the same.
Roxanne Khamsi: I saw [Stat news reporter] Helen Branswell’s tweet in early January where she’s like, Hey, there’s this unusual thing happening in Wuhan. And I thought, “Well, OK. No problem.” Well, not no problem, but you know, “OK, this will pass.” And then, as soon as I found out it was a coronavirus, I think it was like a couple weeks after that, I talked to my family on the phone, and I was like, “This is the real deal.”
There’s a virology meeting I used to attend every other year, and one year I had a conversation with a researcher who was studying MERS. It was this 40-minute conversation in the blazing sun. I remember how hot it was, and I was uncomfortable, but he really impressed upon me that coronaviruses are more airborne, and more transmissible and deadly, than we appreciate. [So] the moment I learned it was a coronavirus, something shifted in my head.
What doesn’t maybe get appreciated enough is there were a lot of journalists in China and Singapore and places on the other side of the earth who told some incredible stories from the early days of the pandemic. I was reading a lot of their articles and watching videos coming out of that region.
Dhruv Khullar: I probably came to it a little bit later, as I wasn’t steeped in science writing and virology before things started to really get bad in China, and then Iran, and Italy. So I think that’s when it started to dawn on me intellectually. But emotionally, it really wasn’t until the hospital started making some real changes.
Every doctor on staff was told, whether you’re part time, or full time, or three-quarters time, everyone needs to be available at all times. Clinicians from other specialties, pediatricians, and psychiatrists would be converted, like, called in. We were helping to train them. We were drawing up plans to expand on our ICU bed capacity by 100 beds, then 150 beds, then 200 beds. That’s when it became real-real.
After all these months, have you guys gotten bored of covering the coronavirus at all?
Khamsi: I mean, for me, it’s more the emotional exhaustion than the lack of curiosity. I think I could write about this pathogen the rest of my life as long as the science keeps coming out—which it does. From a science perspective, we’re learning new things about all viruses through this virus. That has made it engaging. I think it may be hard to write about this for the rest of my life, if we don’t vanquish it or at least mitigate its effect on our lives—it would just feel very hard, emotionally.
Khullar: I feel like, while it is one story and one bug, it touches so many different aspects of society.
Mandavilli: I would say, intellectually, I’m stimulated and overstimulated to an insane degree every week.
What’s something you thought or wrote about earlier in the pandemic that seems ridiculous now?
Khullar: I thought there would be a unified national response to this threat and that politics wouldn’t play as large a role as it has.
Mandavilli: In March, I wrote about a paper that was the first to clearly estimate how long the virus lasts on surfaces and in the air. I remember one of my editors asking me: “What about newspaper? And what about the blue plastic the paper comes wrapped in? Should we be warning our subscribers?” I said no even then, but still. The amount of fear we all felt then, and the manic attention we paid to scrubbing everything, including vegetables, seems ridiculous now. Perfectly understandable, but also ridiculous.
Khamsi: I thought that if I had enough toilet paper in the house I would be OK. That’s ridiculous. I underestimated how much this pandemic would involve fortifying my mental health rather than fortifying my toilet paper stockpile.
How would you say general media coverage has evolved over the course of the pandemic?
Khullar: The focus has shifted from reporting case numbers and describing a new illness to the pandemic’s broader social, economic, and political consequences.
Mandavilli: In the beginning, I think we were all in a mad scramble to report everything as fast as we could and to try to understand what this virus was and could do. Now things have shifted a bit. At least at the Times, we’re trying to take steps back more often to see how the pieces fit together and think ahead a bit more. I think many of us have also gone back to reporting from peer-reviewed publications more often than preprints. I still look at the latter, but only when I really trust the scientists to be careful in their analysis.
Khamsi: What I’ve found fascinating is how there’s a greater embrace of pretty deep scientific concepts relating to the immune system. I would never in a million years have thought that antibodies and T-cells would feature so largely in the evening news.
How do you—with the virus touching so many parts of life, and with general readers suddenly interested in the minutia of immunology—decide what to report on, and what your next story is going to be about?
Mandavilli: For me, that’s a little bit easier because I’m on a desk with a lot of reporters, and I’m at a paper with a lot of reporters, where tons of people are writing about the coronavirus. I mean, for a couple of months there, everybody at the Times was a coronavirus reporter. It’s easier to pick what I’m going to write about when I know that there are other people who will tackle things. I’ve been swimming in the geekiest of waters. I’ve been thinking about, What is something that none of my colleagues are going to be thinking about? What are ideas and stories that only I will find fascinating and chase after?, and trying to go after those.
Khullar: Some of that is similar for me in that there are stories that [the New Yorker] wants to know more about, particularly if they have some type of clinical bent. It’s helpful to have had clinical experience to bring a story to light.
Khamsi: For me, it’s changed over the course of the pandemic. The first piece I wrote was a piece saying we shouldn’t compare it to the flu. And then, like a month after that, I was like, it’s airborne, and we should pay attention to that. At the start of the pandemic, I was writing from a place of—I felt like a lot of people weren’t as concerned about the pathogen as I was. Now I feel that that’s a shared concern.
My stories have become much more, in a way, weirdly, more reflective on the past. I think I have gone from trying to think about just this one new pathogen to how does it fit in the range of viruses that we know about.
Roxanne, your airborne story came out in March, before everybody was talking about the possibility of the coronavirus being airborne. You’ve said before that, for the airborne story, the secret was picking expert sources who had super specific knowledge.
Khamsi: I went to engineering school. I’m the daughter of immigrants, and I’m Persian. So it’s like, you can be a dentist or an engineer. And love teeth. I definitely endorse flossing and a good toothbrush, but engineering was the better of those two options for me. So I went to engineering school for one year. And then I decided, I want to be a journalist.
But during that year, I started to really appreciate people in the applied sciences and engineers and that space. So I think it’s important, as reporters, to go to the folks who are the specialists in that thing. And I want to also recognize that Apoorva has done amazing airborne reporting too.
Mandavilli: I was able to do that because of Roxanne’s piece. She kind of broke it open and made us all aware that this is something people are not thinking about nearly enough. My story became more of an accountability story. I love doing accountability stories. I think that’s one of my strengths, so I’ve been leaning into that a lot during this pandemic. I started to look deeper into, why aren’t people [in power] acting on this information? What is stopping them from doing something about this? And that led me to WHO, and how they were resisting the idea of the virus being airborne.
Khamsi: I think the airborne story was, maybe, the hardest story I ever reported. I was going out on a limb. But I wrote it, and I was like: “Look, this is going to make an impact. People are going to stop and pay attention.” And I think some people started to notice, but it didn’t really have the impact that I was expecting. So it took Apoorva, and then other journalists, to do the accountability part. I had no idea about accountability. It still blows my mind.
I’m curious, for each of you, what’s one story you’ve written—or just one fact about the virus—that you wish the government, or a health organization in power, would be taking more seriously right now, and acting on?
Khullar: The thing that comes to mind, for me, is that story I wrote in May about essential workers and the disproportionate burden of COVID-19 that they’re bearing. In a normal week at the hospital, you might have one person who’s a food deliveryman or -woman, or you might have someone who worked at the MTA. But during that period, half your patients might be people who are essential workers. They have been keeping the world moving during this period. And they still don’t have the protections they need. They don’t have the access to testing and treatment that they need. They’re often the least well compensated in our society.
Khamsi: I think, initially, I was like, oh, testing, I wish they would do more testing. But if I can be honest, I’ve started in the past week or so wishing there would be integration of information, and more centralization and coordination—I’m just going to throw out a lot of words like that—both at the country level and then the international level. I think what I have started to dream of is a more coordinated response because I really feel like this is a kind of thing where, if governments don’t work together and listen to one another, support one another, then we can’t accomplish as much against this virus as we could together. I know that sounds a little “let’s hold hands and make things better,” and I shouldn’t say that because we shouldn’t hold one another’s hands during a pandemic.
Khullar: That’s a really good point. But it just reminds me of the RECOVERY Trial, as an example, in the United Kingdom, where they have been able to share information. They’ve been able to centralize a lot of data collection and analyze it. And they have probably generated three of the most important treatment-based insights in the world. You think about what they’ve been able to do and the disadvantages of a more fragmented system, in which we’re not able to collect data in that way, not able to pull in the same way and analyze it. I think, holding hands aside—
Khamsi: [hold her hands up, but a few inches away from each other]
Khullar: Yeah, exactly. That type of coordination is really important to move science forward.
Mandavilli: I’m really interested in testing. Roxanne has left testing behind, so now I’m going to look at it. I just wrote a story about how we have been using a kind of test known as PCR as a diagnostic, but really, a PCR is not just meant to be a test that people use to figure out whether you have the virus, or whether you’re infected. It actually delivers a very valuable piece of information called the cycle threshold, which tells how much virus somebody has. I was blown away, during my reporting, to find out that all of the public health labs in this country have just been looking at the yes-no and are not looking at the cycle threshold values, have not been tracking what it means, trying to figure out how does the amount of virus in a person’s body correlate with how sick they get or whether they die. I don’t want to say nobody has been doing that. Some people have. But just the amount of information that we have let go, without looking at it and really trying to see what we can find out from it.
Khullar: I mean, it seems like such an obvious thing to want to understand is how much virus is in a person and how infectious might they be. I know that when that first doctor died in China, a theory was that it was because he’d been exposed to so much virus. But we do it with HIV, for instance. We measure the ones that have viral loads, so why aren’t people doing this with this coronavirus?
Madevilli: I think there’s been a very reflexive way of thinking about PCR and testing—that we’re so focused on having enough tests that I don’t think we really thought about how to use [the tests].
We’ve obviously been bad at testing. What’s another thing other countries are doing that you wish we would do here in the States, or that you’re jealous of?
Khullar: I go back to something like RECOVERY. I think you can see some of the advantages of having a more nationalized system, in which they’ve made it really easy for clinicians to enroll patients in a single trial. They’re testing a number of different medications versus a common control group, and they have really created practice-changing insights out of that. So I think—given that the United States has more confirmed cases than any other country and, unfortunately, more deaths than any other country, and is biomedical powerhouse—it’s a little bit surprising and disheartening that we haven’t been creating these types of practice-changing insights, like the United Kingdom has and some other countries have.
Mandavilli: It’s hard to pick one because, honestly, we’ve done everything so poorly. We’ve done testing poorly. We’ve done contact tracing poorly. We’ve done treatment poorly. We’ve done collecting information poorly. We’ve done prioritizing people of color and communities who we know will be hard hit poorly. We’ve done schools poorly. We’ve done collecting data from children poorly. We’ve done just about everything very, very poorly, so it’s hard not to be jealous of everything. I recently wrote about the reinfection case from Hong Kong, and I talked to the scientist, who worked on the case. He said something like, Oh, when the guy was in the hospital, and I said, “Wait, wait, wait, I thought you said he didn’t have any symptoms.” And he said, “Oh, we put everybody in the hospital for two weeks, regardless of whether they have symptoms.” And I almost wanted to cry. Just the idea that you could have this under so much control that you could put a person who didn’t even have symptoms in the hospital and just keep them safe. It was just heartbreaking that we are so far from that. And in fact, we’re taking steps backward and saying, “We don’t have to test asymptomatic people.”
Khullar: The other thing I would say is, just the lack of clear and consistent communication on a lot of these issues. I think one of the most important things in any public health crisis is just feeling like leadership knows what they’re doing, and is in charge, and is able to communicate effectively about new information as, inevitably, science creates new insights and things evolve. And the way that things have been communicated have has created such confusion.
Something struck me about a recent piece of yours, Apoorva, on how you decide whether to send your kids back to school. You’re a New York Times reporter. You’re a miniexpert in this stuff. You still called more experts. It seems like it was a really hard decision. And if it was hard for you—
Mandavilli: We’ve really let parents down in this country. I mean, one of the reasons I wrote that piece is because I get phone calls and texts from other parents I’m friends with, or people from school are asking, “What should I do? What are you doing?” And you’d think the answer would be a little bit more obvious to somebody who’s been reporting on this for months and months, but it really isn’t. The fact that we are letting individual school districts and parents just figure it out—I mean, we should let them figure it out, in the sense that they should have agency, but the idea that the federal government would not have very clear guidelines beyond just “We want schools open” is unfathomable. To Dhruv’s point, the communication piece: [I’m jealous of countries whose governments say] “Hey, this is how kids should wear masks” and have videos that are fun and engaging for kids to learn how to wear masks. And the government produces fun, colorful masks for all kids to wear.
Khamsi: Here in Quebec, masks are not required. I saw this story in March about how kids in Taiwan wear masks, and then they put up these little dividers at their desks so they have protection when they have their soup. It’s just like an adorable photo about how they’re doing with this terrible pathogen.
Each of us is now tasked with making all of these tiny decisions every day of our lives—about whether to take the subway, whether to go into the store, whether to eat at an outdoor restaurant, whether to, in some parts of New York state and the rest of the country, eat at an indoor restaurant. What sources do you all turn to? And how do you make each of those decisions and go through that thinking in your own lives?
Khamsi: Maybe the doctor can answer this question, first.
Khullar: These things are complicated, No. 1, because there has been a lot of confusion, because even the nation’s top public health agencies go back and forth and disagree with one another and don’t have clear communication on a lot of these things. No. 2, people with similar ages and similar risk profiles may have very different risk tolerances. Part of deciding what to do is a little bit of introspection around what is your personal risk tolerance. But making a reasonable assessment about when you’re willing to take a risk means knowing and having that information. That is kind of the communication failure I was talking about.
Mandavilli: I’m kind of lame. I don’t actually do very much. And it’s not always because I’m afraid. It’s just sometimes I’m so steeped in what I’m doing that I just don’t think to go out a lot. In my family, my husband has been the one who’s gone out to grocery stores. We try to really minimize that. He goes only once every two or three weeks, and we go to Costco and load up. One thing I have been saying a lot everywhere—and I will say it here too—is I do think that, for the next few weeks while we still have some warm weather, it’s important to keep socializing outdoors so that we can kind of build up our stamina for the winter ahead, because it’s going to be really hard. We do go to the beach because that is fine. To the point about public education being so poor—even newspapers and magazines are guilty of this. Every time they talk about crowding, they show outdoors areas, as if that’s wrong. And it’s like, that is the one thing that is probably OK.
Khamsi: My hobby has always been grocery shopping. My therapy, when I lived in Brooklyn, was just going to Trader Joe’s, I guess in addition to going to a therapist, but equally as productive and sometimes less expensive. So I have not ever ordered in groceries, like once, in this whole pandemic. I’ve always gone to the supermarket, but I go to the supermarket that has the most suburban feel, here in Montreal. It’s really tall ceilings, and it feels not cramped. A top-level answer I’d give to your question is that I’m trying to use the information we have about the virus combined with the cost-benefit of each action. My decision to go grocery shopping all the time is going to be different from that of my neighbors, who are older, like in their 70s.
Mandavilli: I mean, one key [consideration], right, for all of that, is community prevalence. You can look at 50,000 other things, but ultimately it’s how much virus is there in the community right now.
Dhruv, you’ve written about how the pandemic feels exhausting for you as a doctor, and also exhilarating. I really like this line from a piece you wrote in April: “There is nowhere that I, or my colleagues, would rather be. There’s an odd sense in which the pandemic has made the practice of medicine into what many doctors hoped it would be.” Is that a feeling that has stayed with you since April?
Khullar: There was certainly a sense of adrenaline and meeting the moment. What I meant by that, really, was that a lot of the documentation and the burdens had kind of fallen away, as there was just this deluge of patients. And here it’s just a singular focus on what you had to do day in and day out. I think it looks very different over time. At the beginning, there’s this rush, and there’s this, like, “Let’s figure out what this virus is.” Obviously, it’s devastating and hard to see people suffering in that way, but there’s also this initial push to understand what’s going on and how to treat it. And then I spoke to a few doctors for a story that ran in July who said there’s a second phase there, which is like, everyone is just the same, and everything turns into a number and a lab value, and there’s this kind of fatigue that sets in of every day being the same. And at least what they did at their hospital was they asked patients, families to send in photos and letters, and they would hang them up on the ID poles and the ventilators. So when you’d go in and someone would be in a coma and ventilated, you’d see them at a barbecue, and you can reconnect with that humanity. So I think that there are certainly phases. I do think, as this wears on, it becomes harder for everyone, clinicians, patients, family members, to recognize that this is kind of a marathon.
Mandavilli: I tweeted recently asking people, Do you feel like you’re doing what you were meant to do? Because for me, there is such a proud feeling of purpose. This is exactly where I should be right now, during this pandemic. As Dhruv said, you do want to set boundaries after a while. I mean, initially, the working from home was just bad. I would just roll out of bed and immediately crack open my laptop and start working. But there was no break, and I would keep going until pretty late. But now I’ve been trying to get up in the morning and actually get dressed and have breakfast with my family and see the fresh air, and then go to work. Now I have better ergonomic stuff. I have a better desk. I have a better laptop holder. I have a better mouse at home and all this kind of stuff. I think self-care is super, super important. I watch very bad TV, and I let myself watch very bad TV with no guilt. I have not been reading as much as I was before the pandemic. I do a lot of crossword puzzles and the spelling bee every day. Basically, I do whatever lets my mind feel good when I’m not working.
Khamsi: I think what’s interesting to me is how my mental coping, my personal tools for coping, have changed during the pandemic. There was a good six-day stretch this spring where I needed to have a chocolate chip pancake every single morning when I woke up. I took photos. I really needed that. I just, I needed that to get me started every day. And I put on a little weight. Now my therapy for myself is going on long bike rides. So I’ve gone from being less in shape than usual to more in shape than usual. My pants don’t fit anymore because now I’ve got these biking thighs. I think we need to realize that not only are my coping mechanisms going to be different from other people’s, but they’re going to change, and we need to have them adapt and change.
Mandavilli: Twitter trolls actually motivate me, because I see people say things that are so far from the truth and it makes me think there’s still so much to do. There are still so many stories to write and so much information to get out there and so many minds to change about this pandemic.
Khamsi: Whenever I see the trolls, my response is like: “Everyone just needs to go back to high school biology and spend a year with Mr. and Mrs. Howard, my biology teachers in high school. And then we’ll all be good.”
Mandavilli: Mr. and Mrs. Howard.
Khamsi: Yeah. They each taught a class.
I think that’s a very generous view on trolls, that they could be lightly directed toward a high school biology class and have all their questions answered and therefore stop bothering everyone.
Have you all given thought to the kinds of stories you want to write when a vaccine finally gets produced and begins to be distributed?
Khullar: I think considerations around equity will be a central story—who gets the vaccine, when they get it, and why.
Mandavilli: I’ll more likely be thinking about the immune aspects of the vaccine and what we’ll see in terms of its longevity and chances of reinfection.
Khamsi: Equity without a doubt will be a question on my mind. And I’ll also be thinking about people who are older and immunocompromised and therefore unable to receive or respond as well to a vaccine. It’s harder for me to imagine what I will want to write about when this pandemic is behind us. In describing future pandemics, [the Atlantic’s] Ed Yong had mentioned a hypothetical SARS-CoV-3 in one of his articles earlier this year. Whatever the next thing is that I’m writing about after this pandemic is behind us, I hope it’s not SARS-CoV-3. I need a break.