Though an inevitable milestone for months, its arrival is still breathtaking.
Deaths from Covid-19 exceeded 1 million people on Tuesday , according to a Johns Hopkins University database, the known toll of nine relentless months of a pandemic that has changed everything, from global balances of power to the mundane aspects of daily life.
The figure can only hint at the immeasurable grief of the friends, partners, parents and children of those who have died, many isolated in hospital wards, and buried or cremated without traditional funerals. In a year defined by loss, these 1 million people and their loved ones have lost the most.
The road to 1 million confirmed deaths started in December, with doctors in a central Chinese city noticing a pattern of strange illnesses surrounding a live-animal market. By the middle of January, people were dying every day. Since 18 March, the daily toll has not fallen below 1,000.
Behind every increase, there was a life.
In the final hours of 2019, health authorities in the Chinese city of Wuhan announced the discovery of a “pneumonia of unknown cause”. Within a month, the death toll was 131 people.
Chen checked in to a Wuhan hospital with a fever on 12 January.
It was the day after the newly discovered coronavirus had recorded its first victim, while Chinese authorities were still claiming there was no evidence the virus could spread between humans.
Chen, whose family asked that only her family name be used, was a warm-hearted, outgoing and friendly 65-year-old with a strong sense of justice, said her stepson Huang*. If she saw someone jumping a queue or a tour guide misbehaving, she would leap to act. Five years into her retirement after a career in hospital administration, Chen was fit and healthy, living with her disabled sister in Wuhan.
“If she had not been ill at that time in Wuhan, she was the kind of woman who would have enthusiastically helped to organise in communities when the city was under shutdown,” Huang says.
Instead, she was among the first of more than 31.2 million people to contract Covid-19.
Scans at the hospital showed Chen had developed white nodules blanketing her lungs. When she died on 15 January, in the presence of Huang’s father and brother, it was officially attributed to severe pneumonia. Huang said doctors privately told the family it was probably the virus.
But without documentation, Huang says, Chen’s death received no dignity. She is still not counted as a Covid-19 victim, he says, despite his calls to multiple departments. That means the family is still in debt to the hospital, ineligible for patient assistance and without the small comfort that confirmation could bring. It compounds their grief.
“Originally, we planned to hold a small farewell ceremony in October, but we didn’t have the energy and didn’t want to mention it. For all of us, it was a very difficult thing to accept.”
Huang has returned in Shanghai, where his father lives, but says they don’t talk much about his mother at home. His father does not think it is realistic to pursue accountability for Chen’s death. Huang has joined counselling sessions for people who lost relatives in the pandemic.
China is celebrating its response to the virus, but Huang says he feels conflicted. “No matter how successful the fight against the epidemic, the family is broken. For people in Wuhan, many families didn’t survive through and many ended in that winter.”
*Huang’s name has been changed
By 13 March, the death toll had crossed 5,000. The virus was ravaging northern Italy, where hospitals were running out of space to store the dead, and overwhelmed doctors were sounding alarms to the world.
Renato Federici and Ida Mattoni had been in good health, their annual check-up showed.
But on 17 March, a week after Italy became the first country to enforce a nationwide lockdown, the husband and wife both started to develop symptoms of Covid-19. Federici died on 21 March and Mattoni died four days later, leaving behind their sons, Diego and Pietro.
“For two people of their age, they were in perfect health,” said Diego, 35. “They didn’t have diabetes or problems with their heart, nothing.”
Diego lost his parents at the height of Italy’s pandemic and as their home province of Bergamo was emerging as the country’s ground zero.
“Until 17 March, they never had a symptom. Then practically overnight their health degenerated. They were both hospitalised the next day – my mum was struggling to breathe, my dad had a fever.”
The couple, who would have celebrated their 49th wedding anniversary on 9 August, died in separate hospitals.
“The feeling I had when I first heard that my dad had died is with me every day – a feeling of helplessness, and that my superhero had vanished,” said Diego. “Mum was already dying on the 18th, she couldn’t breathe, they never tried to cure her. I couldn’t do anything to help them. They died alone – they didn’t deserve that.”
Amid the grief for their parents, Diego and Pietro, 48, were also suffering from coronavirus.
Federici, 72, from Bergamo province, and Mattoni, 73, who was born on the southern Italian island of Lampedusa, had worked for a textiles company. They have a three-year-old grandchild through Pietro.
“They were wonderful people, unique in every sense,” Diego said. “They worked hard all their lives to give their sons everything, we never went without.” Diego moved out of his family home five years ago but would have lunch with his parents every day.
“Now I go to visit them in the cemetery every day,” he said. “That’s how much my life has changed.”
Diego is a member of Noi Denunceremo (We Will Report), a committee established in April by relatives of coronavirus victims which is driving an investigation into alleged errors by Italian authorities at the beginning of the pandemic.
The group is not looking for financial compensation, but justice. “Those who made mistakes must pay,” said Diego.
Over the next week, the death toll doubled to beyond 10,000. Quarantines were being imposed across Europe, leaving the streets of many major cities deserted, and the French president, Emmanuel Macron, warned his country: “We are at war.”
As the UK debated whether to lock down, Birnham Roberts started feeling unwell.
Roberts, 82, was a well-known face in Birmingham’s city centre, where he had driven a bus for more than six decades, well past his retirement age.
Fearing he was having a stroke, his daughter Cherelle drove him to hospital. Roberts’s condition deteriorated quickly, but for the first days, Cherelle, a nurse, was still allowed to visit him. That suddenly changed one night. The hospital was going into lockdown and patients could no longer receive visitors.
Roberts had migrated to the UK from Jamaica in 1960. He did some carpentry and worked in a milk bottling plant until he settled into bus driving. He was a “fun, loving and open person”, Cherelle said, a driver that regular passengers came to recognise and would greet by name as they boarded.
As the virus was spreading across Britain, the fear in the hospital where Roberts was being treated was palpable. “Everyone was so scared to interact with the coronavirus patients,” Cherelle said, though she still made trips to bring him food.
Roberts died in hospital on 18 March, nine days after he was admitted. The fact she could not see her father in his final moments has made the grieving process all the more difficult, Cherelle said. “As a child, I always told my dad I was going to be there for him. I’d say, if anything happens, I’m going to be there, I’m going to care for you. And that didn’t happen in those last few days,” she said.
His death triggered a flood of messages from colleagues, passengers and other Birmingham residents. It helped Cherelle realise the impact Roberts had had on their community.
“As children, you don’t really get to know your parents as people, but over this period, people that knew him had contacted me and you find out they had this amazing other life going on.”
By 2 April, the death toll had surged fivefold to more than 50,000. About half of humanity was under some form of lockdown, and countries such as Australia were issuing unprecedented calls for their citizens to return home immediately.
Angelita Costanilla’s son-in-law rushed home to Melbourne.
But within a few days, Michael Rojales became critically ill, and was placed in an induced coma. His wife, Rachel, also became infected, and needed to be hospitalised. And then Costanilla, 84, who everyone called Gely, started showing symptoms.
Gely, too, was taken to hospital, even though her case seemed mild. “My mum wasn’t unwell during most of those six days,” Rachel recalled. “On the fifth day she was struggling to breathe, so they changed her nose oxygen tube to a thicker one.”
Rachel was stuck in an isolation ward, but her mother’s nurses would call her to help explain to Gely what was going on. It was during one of those, on the morning of 6 April, that Gely died.
“I was just telling her, ‘Mum, they changed your tube so you can breath better. People are praying for you. Everything’s gonna get better. We love you.’ Then I said, ‘Let me pray for you.’ As soon as I said that, she closed her eyes. The nurse said to me, ‘I think your mum passed away’.
“It was good in a way. Before she passed away she was able to hear the familiar voice of a person who loves her … the nurse was holding her hand, and when she closed her eyes to pray she opened them and she was in heaven.
“That’s the mental picture that will always stay with me and give me comfort.”
Rachel said she spent the next weeks in “survival mode”, unable to cry and terrified her husband could also die. “When Michael came out of the induced coma, that’s when I felt like a burden was lifted, I was able to grieve for my mum properly,” she said.
Born in the Philippines during the second world war, Gely had remembered being lifted over a fence to hide from Japanese soldiers. She married and raise two children in the archipelago, and migrated to Australia after her husband died.
“She was a very quirky person. She loved her fashion … the earrings always matched the necklace, the shoes matched her dress,” Rachel said. “She was very generous, she loved to give and was so kind.”
The global death toll doubled over the next week to more than 100,000 people, with a surge of fatalities in New York, including many health workers, some lacking sufficient safety gear to shield them from infection.
Marilyn Howard had started training to be a nurse in her mid-30s.
Many of the years since she had arrived in the US from Guyana as a teenager had been taken up helping to raise her five brothers. “She was a mother to many,” said her brother Haslyn.
When she did finally get to university, she steadily racked up four degrees, and at age 53, was studying again to become a nurse practitioner.
As a school nurse in Brooklyn, she regularly treated children with chronic illnesses associated with poverty. One day in early March, a fellow nurse came down with a fever and a cough. Covid-19 was already ripping through New York, especially its brown and black communities, way ahead of the public-health response.
A few days before New York city schools were ordered closed, Howard started coughing too. At first her symptoms appeared to be receding, but in early April, she took a sudden turn. Her heart stopped as her brother was driving her to hospital on 4 April. She was declared dead at the hospital.
Howard was the kind of woman who never missed a party, Haslyn said. A devoted aunt, godmother and friend, she tended to show up at family barbeques with a half dozen friends in tow. “She was literally everywhere, in so many people’s lives,” he said.
After her death, hundreds turned out on Zoom to mark Nine-Night – a days-long wake traditional to the Caribbean – where loved ones shared photos, sang gospel songs and recounted Howard’s impact on their lives.
About 800 New Yorkers were dying from the virus every day by that point. At least a dozen of Howard’s relatives were infected. Her death a cautionary tale, the family evolved into a sprawling triage team, monitoring one another’s temperatures, deploying pulse oximeters to measure oxygen saturation and mapping nearby hospitals. Relatives took turns delivering food. Everyone recovered.
Howard’s brothers are planning to start a foundation in her name to help women in the US and West Indies who decide to become nurses later in life. “The best way to honour her spirit and her memory is to bring more nurses into this world,” says Rawle. “We need more Marilyns around.”
By late June, social distancing and improved treatments had slowed the growth of daily fatalities across Europe, and temporarily in the US. But deaths were soaring in South America, especially in Brazil, pushing the global toll past half a million.
When the first cases emerged in his village, Fabrício Uprewa was the only health worker who stayed.
All the non-indigenous doctors left the indigenous land of São Marcos, in the Brazilian state of Mato Grosso, and the Xavante people had nobody else to turn to.
With no access to appropriate protective equipment, nurse Uprewa, 47, wore masks made in the village. With no ambulance available, he drove critically ill patients, including Covid-19 victims, for 37 miles (60km) to the city of Barra do Garças using a passenger car that all in his community shared.
“He knew the risk but didn’t want to stop. He dedicated his life to the Xavante people. He died defending our people,” said his brother, Francisco Hoimanatsiro, 26. “I told him to ask for leave because the government letting him work alone and without any safety was absurd. He knew the risk but chose to work ever harder, assisting people even in other villages.”
Many members of the Xavante ethnic group do not speak the Portuguese language that Uprewa, the older of six brothers, learned as a child in a school of religious missionaries. He accompanied patients in critical condition to the city to act as their interpreter too, because he knew white doctors could not understand them.
Uprewa soon went the way of his patients. After a few days with Covid-19 symptoms, he began to feel shortness of breath and asked his wife to take him to the hospital in the city.
“He was so sick he couldn’t talk. And his wife is not fluent in Portuguese. She sent us a message asking for help, but it was too late,” said his brother.
Uprewa was admitted to the hospital on 29 June. He went straight to the ICU and was intubated but died on the next day.
The same day, five members of his village also died of Covid-19. Since the start of the pandemic, more than 30 people have died in the indigenous land of São Marcos.
Uprewa is survived by his seven children. His brother, 21 years younger than him, regarded him as a father too. “My dream was to be like him. He was the most extraordinary man I ever met.”
In late September, the recorded toll exceeded 1 million deaths. Renewed mixing in summer months is leading to a resurgence in fatalities in parts of Europe as winter approaches. The US has lost more than 200,000 lives. In countries such as India, the first wave is still building up.
Talk of the virus on TV and WhatsApp never worried Ashutosh Upadhyay.
“He was a healthy guy,” said his sister Bhargavi Bhatt from her home in Vadodara, a city in India’s Gujarat state formerly known as Baroda.
For nearly two decades, bringing good fortune and warning of bad had been Upadhyay’s calling. After a few years working for a plastics manufacturing company as a young man, he had quit to become a spiritual guru, holding prayer ceremonies to purify homes, matchmaking and telling fortunes.
“He wanted to be close to God, and help people,” said Bhatt. “He wanted to warn people if they had something bad in their future, so they could handle it.”
When Covid-19 surfaced in Vadodara, Upadhyay’s younger sister, whom he lived with, developed minor symptoms. She received a positive test in August. Soon after, so did Upadhyay.
“Initially he just had a cold, and he was not diabetic or had a history of hypertension,” Bhatt said. But within a few days, a fever set in.
For days, the family’s efforts to get Upadhyay treated were fruitless. “The doctor at the hospital kept saying they didn’t have a bed,” she recalled.
When he was finally admitted, they found the hospital lacked the equipment to provide patients with oxygen. His condition worsened, and doctors at the first hospital said he would need to move to a better-equipped facility, Bhatt said.
At that stage, Upadhyay had still been strong enough to talk to his sister as he was being loaded onto the ambulance. “After that we never spoke to him again,” she said. “He was always wearing an oxygen mask.”
Upadhyay died on the morning of 31 August. His family were unable to place his remains on a funeral pyre. He was wrapped in plastic casing to prevent infection, and cremated in an electric machine as they watched from a distance.
Additional reporting by Kakoli Bhattacharya and Lillian Yang