When Todd Klindt buried his dad, he was stunned. Some of the mourners arrived not wearing masks - for the funeral of a man killed by the coronavirus.
Just days earlier, Klindt had held his father’s hand in a hospital intensive care unit. Now, watching people at the funeral - acting as if the world was not on fire, as if people were not dying by the dozen every hour of every day - he wanted to shout, “He’s right here!”
“I’m like, ‘Are you paying attention at all? Is any of this sinking in?’ " said Klindt, who lives in Ames, Iowa.
Death is now everywhere and yet nowhere in America. We track its progress in daily bar graphs. We note its latest victims among celebrities and acquaintances. Yet, in many parts of America, we carry on - debating holiday plans, the necessity of mask mandates, how seriously to take the virus, whether it’s all a hoax.
In the face of one of the biggest mass casualty events in American history, we are growing increasingly numb to death, experts say - numb to the crisis and tragedy it represents and to the action it requires in response.
Something happens in the brain when fatalities reach such high numbers, say psychologists who have studied genocides and mass disasters. The casualties become like a mountain of corpses that has grown so large it becomes difficult to focus on the individual bodies.
With the coronavirus in particular, experts say, the deaths have been hidden from sight even from friends and family - the human cost sequestered in hospitals and nursing homes.
“Sometimes I think, if only others could see what we see every day,” said Joan Schaum, a hospice nurse who has spent the past year caring for the dying in Lancaster, Pa.
“Other times,” she said, “I think, no one should have to see the amount of death and suffering going on right now. It changes you. It stays with you.”
The arithmetic of compassion
In 1994, hundreds of thousands in Rwanda were murdered in the space of weeks by soldiers and militias from a rival ethnic group. In response, the United States and much of the world largely shrugged. President Bill Clinton later called his administration’s failure to act one of his great regrets.
Puzzled by that apathy, a psychologist named Paul Slovic began conducting experiments to better understand people’s reaction to mass suffering and death. What he found was troubling.
In one study, his researchers showed people a picture of a 7-year-old girl dying of starvation and asked for donations to help her. He showed another group two starving children, then even larger sets of children. Slovic found people’s distress didn’t grow with the number of children in danger, but often shrank.
“In fact, the more who die, sometimes the less we care,” Slovic said in an interview. In greater numbers, death becomes impersonal, and people feel increasingly hopeless that their actions can have any effect.
“Statistics are human beings with tears dried off,” Slovic said. “And that’s dangerous because we need tears to motivate us.”
With the coronavirus - the death toll substantially exceeding 300,000 in the United States - many of our strongest impulses are working against us, experts say.
“Think about the disasters that have captured our national attention. . . . A hurricane like Katrina hits. News crews show the devastation, and people open their wallets,” said Lori Peek, who directs the Natural Hazards Center at the University of Colorado at Boulder. “But this pandemic isn’t a camera-ready event like that.”
Instead of a single discrete event - like the twin towers collapsing on Sept. 11, 2001 - the pandemic has unfolded as an invisible, slow-creeping, chronic hazard. Over time, our brains gradually tune out the danger.
Peek likened the effect to heat waves, which kill more people in America than all other natural disasters combined. “But you never hear that much about heat waves because it’s gradual. You don’t see people trapped on rooftops like Katrina. You don’t have homes going up in flames like in wildfires.”
Death up close
Without visual, physical manifestations of deaths, the alarm bells in our heads fail to ring, experts said. Because we don’t see the deaths, we fail to see their connection to us - including our role in preventing their growing numbers.
This is what death in the pandemic looks like up close: Patients often grow ashen as their body struggles for nutrients. Their skin becomes mottled with splotches of reddish purple as their heart pumps less and less blood to parts of the body that need it.
Often, the room is eerily empty, with nurses and doctors trying to minimize risk of infection. The only constant is the low, steady hum of an oxygen compressor piping air to the patient’s nostrils.
Amid the silent void, the patients’ dying breaths become magnified.
“The hardest thing about it is how alone they are in the end,” said Schaum, a nurse with Hospice & Community Care in Lancaster, Pa.
Schaum props up the feet of dying patients to take the pressure off their heels. She uses a gel to moisten their mouths, which grow uncomfortably dry once they stop eating or drinking.
Even those interactions are limited: Schaum is supposed to keep direct contact to 10 to 15 minutes during her daily patient check-ins. So, from six feet away, she talks to them as much as possible, even when they are unresponsive, hoping they sense her presence.
“You do everything you can to make sure they don’t feel alone,” she said. “But it’s hard to convey just how isolated it is.”
Sometimes, a family member is present, allowed to visit during a patient’s final moments. But many patients are so elderly that their children fall within high-risk age groups.
In recent days, Schaum has been helping the adult children of a woman in her 80s decide whether they can safely see her. “There’s so much guilt, anger, hopelessness and helplessness.”
When families are unable to be there, Laura Carey, a social worker for Hospice & Community Care, sometimes sits with covid-19 patients during their last moments.
It’s frustrating, Carey said, trying to hold a patient’s hand while layered in goggles, masks, face shield, gloves and gown - unable to make skin-to-skin contact normally used to reassure the dying.
As patients’ hands grow cold and lose sensation, Carey often places her hand on their shoulder or head to make sure they know someone is there. She tells patients she has talked with their family and how much they are loved.
She sits quietly beside them as their breath slows and becomes increasingly shallow and irregular, until it stops.
“There’s something so incredibly sacred and powerful about that moment,” Carey said. “If only others could experience it, maybe things would be different.”
Roehl Empestan, 50, loved action movies and dancing with his wife.
Judith Hill, 70, was the type others were drawn to, full of stories about people approaching out of nowhere to talk.
Carol Brezen, 72, “never met a crossword puzzle she couldn’t finish.”
For months now - every few hours - a Twitter account called Faces of Covid has shared snippets like these about the lives behind the staggering statistics. Alongside the details are photos of those lost to the virus: people blowing out birthday candles, posing proudly by fish they caught, laughing with their children.
The tweets are an attempt to publicly mourn the dead and show the pandemic death toll in human terms instead of in numbers, said Alex Goldstein, who runs the account with a handful of volunteers.
“I started it in March when the deaths started spiraling out of control. I could feel it becoming more abstract for me,” he said.
Goldstein had worked as a press secretary for Massachusetts’s labor department during the height of the 2008 recession. He remembers how much it bothered him to send out monthly news releases announcing 20,000-some lost jobs - devoid of the human suffering represented by those numbers.
In the months since he began the Twitter account, hundreds of families have contacted him, providing photos and asking for relatives to be added to his queue. With large funerals banned, the tweets have served as a virtual receiving line for the bereaved.
“You can see in real time after a tweet goes up as the family goes through and replies to every single comment,” he said. “You can tell how much it means for them to have their loss acknowledged, even by complete strangers.”
With daily death counts soaring to record heights in recent weeks, some sociologists believe the deepening apathy and lack of outrage can be traced to who is dying.
The disease continues to ravage African Americans and other people of color far more than White patients. People 65 years and older account for roughly 80 percent of deaths. Many of the biggest outbreaks have occurred in prisons.
“There’s no question that the demography of who is dying plays a role in the level of empathy we’re seeing,” said Peek, the sociologist in Colorado.
Finding some way to spark that empathy will be crucial as the country enters its darkest stretch yet this winter. Without empathy, it will be impossible to persuade people to take the actions and make the sacrifices necessary to stem the surge of deaths.
In earthquakes, Peek noted, most survivors are pulled from the rubble in early moments by fellow survivors. Similarly, with the pandemic, it will be the actions of other Americans that will save one another.
“There are so many things broken in our country right now . . . but empathy is something we know can be cultivated,” Peek said. “You have to imagine yourself in the role of others.”
Since his father’s death, Klindt has struggled to reconcile his anger and grief with the apathy he encountered in the small Iowa town where he grew up.
At one of his kids’ soccer games, one player showed up even though a member of the immediate family had tested positive. “I had to leave,” Klindt said, “because I didn’t have the emotional strength at that point to deal.”
A friend whom Klindt grew up with has long argued the coronavirus is no worse than the flu. Klindt pointed out no one they know has died of the flu. Since his dad died, they haven’t talked much.
“I don’t trust myself to behave, to not let the emotion get the best of me,” Klindt said. “But I don’t want to lose that relationship . . . so I don’t want him to say anything.”