The New Yorker Radio Hour

Episode: The Shock Wave of COVID-19
Date: March 20, 2020
Host: David Remnick (The New Yorker / WNYC Studios)

Overview

This episode captures the early shockwaves of the COVID-19 pandemic in March 2020, as experienced across America. Host David Remnick speaks with frontline medical professionals, individuals affected by isolation and visitation bans, public health ethicists, economists, and essential workers. Through intimate stories and expert insights, the episode illustrates the profound disruptions—medical, personal, and economic—wrought by the virus, exploring the uncertainty and emotional toll of the crisis as it unfolds.

Key Discussion Points & Insights

1. The Strain on Hospitals and Healthcare Workers

Guest: Dr. Aria Neshat, ER Doctor, Portland, Oregon
Timestamps: 01:10 – 06:46

• State of Preparedness:
  • The calm before the storm: Oregon ERs are bracing for a surge seen in neighboring Washington.
  • Limited testing: Only the acutely ill are tested due to shortages.

    "We are expecting the rush to come in probably in the next five to ten days. Right now it feels very much like the calm before the storm." — Dr. Neshat [01:21]

• Equipment Shortages:
  • Nationwide lack of masks, gowns, and PAPRs (powered air purifying respirators); only 10% of federal requests for gear filled.

    "You're asking frontline docs...to take care of a highly infectious disease...without having the right gear to protect ourselves and our colleagues." — Dr. Neshat [02:12]

• Personal Anxiety:
  • Balancing duty with personal risk—as a single parent with asthma, facing the prospect of falling ill is traumatic.

    "I can’t put myself in a position where I orphan my children. And that's a really tough place to be." — Dr. Neshat [04:25]

• Evolving Guidelines & Leadership Frustration:
  • Confusion from rapidly changing protocols and federal missteps.

    "Obviously, the federal government has failed miserably in preparing the country for this pandemic, and for months was saying, this isn't a problem." — Dr. Neshat [05:27]

• Community Response:
  • Frustration at neighbors’ lack of seriousness about social distancing.

    “I was pretty mad when I got home last night, and I had observed in my own neighborhood a group of approximately 10 people congregating...it almost feels oblivious.” — Dr. Neshat [06:19]

2. Isolation, Vulnerability, and Unbearable Goodbyes

Guest: Jiayang Fan, New Yorker Staff Writer
Timestamps: 06:53 – 15:44

• Personal Story of Visitation Ban:
  • Fan's mother with advanced ALS is locked down in a care facility—no visitors allowed.
  • The emotional agony of being separated, possibly permanently, and relying on aids and technology (alphabet blinking chart, FaceTime with the help of private aide) for basic communication.

    "If I don't get to see her again...I should try to write something good." — Jiayang Fan, relaying her mother’s message [12:38]

• Coping Mechanisms and Guilt:
  • Fan describes the weight of missed opportunities and the surreal transformation of daily routines.
• Lingering Uncertainty:
  • “I never thought that I would not be there to say goodbye to her, that I wouldn't be holding her hand at her bedside when she goes.” — Jiayang Fan [13:18]
  • Balancing how much to communicate the outside crisis to her mother, given her mom’s physical isolation and vulnerability.

    “Her entire life has been a hospital bed she hasn’t left for years...when I tell her the world is coming apart outside her bedroom, I’m not sure if she’s fully able to grasp the significance.” — Jiayang Fan [13:55]

3. The Ethics of Scarcity and Triage

Guest: Dr. Philip Rossoff, Professor of Medicine and Bioethics, Duke University
Timestamps: 17:13 – 32:28

• Nightmare Decisions:
  • Hospitals in Italy are forced to ration ventilators, confronting “who shall live and who shall die.”
  • The need for institutional triage guidelines—choice should not be left to on-the-spot judgement.

    “The way not to make this decision is...arbitrarily, capriciously, unilaterally, and at the bedside in the moment.” — Dr. Rossoff [18:27]

• American System Unpreparedness:
  • Guidelines exist but are inconsistent state-to-state, creating disparities.
  • The US medical system, run on "just-in-time" logistics for cost efficiency, is fundamentally unprepared for a surge.

    "Our healthcare system is a $3 trillion business, and I want to emphasize business." — Dr. Rossoff [24:57]

• Emotional Toll on Caregivers:
  • Extraordinary “moral distress” for those who must decide on withdrawing care.

    “We need to put into place support systems for people in those situations.” — Dr. Rossoff [23:10]

• Lessons from Scarcity:
  • Calls to avoid exacerbating existing inequalities; allocate resources openly and based on clinical benefit.
• Vaccine Caution:
  • Dr. Rossoff warns against assuming a vaccine will provide a quick resolution; interim planning is critical.
• Hope and Shame:
  • Cites the duality of past crises: the potential for both “medical and moral victories” or “shame.”

    “My hope is that when we come out of this, we will have medical and moral victories rather than medical and moral shame.” — Dr. Rossoff [30:46]

4. The Economic Shockwave

Guest: John Cassidy, New Yorker Staff Writer
Timestamps: 33:47 – 42:49

• Unprecedented Contraction:
  • Economists predict consumer spending may drop by a third; unemployment could hit 20% within months—faster than during the Great Depression.

    “...the economic impact of the COVID-19 virus is likely to be bigger than the Great Depression in the initial stages, at least.” — John Cassidy, quoting historian Barry Eichengreen [34:14]

• Sectors Most at Risk:
  • “Consumer-facing” workers (gig workers, airlines, hotels) hit first and hardest.
• Comparison to Previous Crises:
  • 2008 was a financial crisis—this is a government-mandated economic shutdown for public health, an unprecedented maneuver.

    "I think it's a sort of economic life support operation. It's what we need." — John Cassidy [37:48]

• Government Response:
  • Initial response was inadequate, but government pivoted to a $1 trillion stimulus including direct payments to citizens and loans to businesses.

    “What the Federal Reserve did over the weekend was very important just to prevent a full-on financial crash.” — John Cassidy [37:57]

• Universal Basic Income Proposal:
  • Cassidy advocates for a temporary universal basic income to provide support equitably and win political buy-in for other measures.
• Corporate Bailouts, Controversy, and Conditions:
  • Acknowledges airline bailouts are necessary, but should be structured to protect taxpayers with secured loans, echoing approaches from the Great Depression.

    “The loans should be secured on the assets of the companies…if they can't repay these loans, the taxpayer would then seize the...assets.” — John Cassidy [42:43]

5. The Dignity of Essential Work

Guest: Aaron Meyer, San Francisco Sanitation Worker
Timestamps: 44:00 – 47:30

• Daily Life on Lockdown:
  • Meyer’s tweet goes viral, highlighting the quiet perseverance of essential workers who cannot “shelter in place.”

    “Right now I am feeling an extra sense of pride and purpose as I do my work. I see the people...peeking out their windows at me. They're scared. We're scared. Scared, but resilient.” — Aaron Meyer (quoted from tweet) [44:00]

• Risks and Routines:
  • Fear of bringing the virus home to immunocompromised family; extra sanitation steps after each shift.

    "When I get home...I go straight into the garage and just strip off my...uniform...because I don't want to bring anything into the house." — Aaron Meyer [46:20]

• Community and Camaraderie:
  • Pride in work, camaraderie with colleagues, and a sense of unity and optimism.

    "I'm just one person, but there's a lot of other people out there who are in the same situation as me...we'll pull together and we'll get through this." — Aaron Meyer [47:30]

Notable Quotes

• Dr. Aria Neshat:

  “Just like you wouldn’t ask a fireman to run into a building without protective gear, it’s feeling very uneasy for us...we have a really good chance of getting [the virus]” [02:12]

• Jiayang Fan:

  "I never thought that I would not be there to say goodbye to her, that I wouldn't be holding her hand at her bedside when she goes." [13:18]

• Dr. Philip Rossoff:

  "Having empty hospital beds is a waste of money...we have cut the system to maximum efficiency. Bone." [25:21]

• John Cassidy:

  “Effectively we've got a government-imposed shutdown of, you know, 50% of the economy. Maybe we'll go up to even more than that.” [36:35]

• Aaron Meyer:

  “We’re scared. Scared, but resilient. Us garbage men are going to keep collecting the garbage. Doctors and nurses are going to keep doctoring and nurserying.” [44:00]

Timestamps for Important Segments

• Intro and context: 00:16 – 01:10
• ER perspective (Dr. Neshat): 01:10 – 06:46
• Family separation (Jiayang Fan): 06:53 – 15:44
• Triage and healthcare ethics (Dr. Rossoff): 17:13 – 32:28
• Economic crisis (John Cassidy): 33:47 – 42:49
• Essential workers (Aaron Meyer): 44:00 – 47:30

Tone & Takeaways

The episode weaves urgency, vulnerability, candor, and hope through firsthand stories and expert commentary. Listeners are drawn into the personal anxieties of healthcare providers, the heartbreak of family separation, the ethical calculations in resource scarcity, the economic unmooring of society, and the resilience of workers who keep cities clean and running. The stakes are immense and immediate, but the concluding voices offer reminders of collective strength and the possibility of rising to meet this unprecedented challenge.

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