Dr. Lee Harrison, the former chairman of the Allegheny County Board of Health, speaks in March 2020 about covid preparations. Next to him is sign language interpreter Danielle Filip.

Five years ago this month, Pennsylvania's chief executive scrambled to manage a global health crisis for which no one in the world was prepared.

As leader of the nation's fifth most-populous state, then-Gov. Tom Wolf found himself winging it like everyone else. He had no playbook for covid-19.

"It looked to be pretty serious," Wolf recalled recently in an interview with TribLive, "but how to handle it was unknown."

The virus would quickly turn the world upside-down. Not since the Spanish flu outbreak a century earlier, which killed an estimated 50 million people, had death swept the globe at such a torrid pace.

Americans watched as faraway casualties mounted in Asia and Europe. Would this new disease cross the Atlantic?

Soon enough, America got its answer. By March 2020 -- the unofficial dawn of the pandemic in the U.S. -- the virus shattered any notion that thousands of miles of ocean could protect us from the dark side of an interconnected world.

Eric Klinenberg, a New York University sociologist who wrote the book "2020: One City, Seven People, and the Year Everything Changed," put that reality into context.

"Outbreaks of deadly infectious diseases were things that happened to other people, in other places, but not America, because we're strong -- covid proved that wrong," Klinenberg said in an interview.

When the virus finally arrived in Pennsylvania, it showed no mercy.

Nursing homes became death traps. Bodies piled up -- 54,000 dead in the commonwealth by the end of 2023, more than the population of Harrisburg. That tally would fold into the 1.1 million fatalities in the U.S. and the 7 million around the world.

As a desperate nation waited for scientists to invent a vaccine, Wolf acted. To thwart the virus' spread, he closed parks, schools and nonessential businesses -- and suffered angry backlash. The Democratic governor faced legal battles and threats of impeachment over his containment strategy.

Covid's impact rippled across the state.

Gregory Del Duca, a Harrison man who lost his mother to the coronavirus, felt its touch. So did Dr. Amesh Adalja. The Pittsburgh-based infectious disease expert watched with dismay as poor policy decisions created real-world consequences.

Thousands of office workers went home and never returned. And local business owners struggled to stay afloat. Aimee DiAndrea Anoia, co-owner of DiAnoia's Eatery in the Strip District, recalls the anxiety of that time. In addition, she became pregnant in the early months of the pandemic.

"When I was pregnant: We were thinking, 'Are we gonna make it?' " said DiAndrea Anoia, who owns the restaurant with her husband, Dave Anoia. "I wouldn't say covid was good for us. It was tough on us. It was tough on our business. It was tough on our employees, and we had to get creative to make it through to the other end."

Looking back on the pandemic's fifth anniversary, Wolf reflected on the difficult decisions he had to make. Today, when asked whether his role in the pandemic will define his eight years in Harrisburg, he frets.

"One of the problems was there were no right answers. If you did something to help yourself here, you were hurting yourself over there," Wolf told TribLive.

"What happened, happened. And what we did, we did," he added. "But I'll be second-guessing myself for the rest of my life."

President Donald Trump launched Operation Warp Speed, the supercharged effort to create a vaccine. But he also eschewed masks, mused aloud about snake-oil cures and was criticized by many for his slow response to the catastrophe. As essentials disappeared from grocery store shelves and the country shut down, one thing became clear: In many ways, society was on its own.

"There was no magical cure from science," Klinenberg said. "We couldn't engineer our way out of it."

Millions of Pennsylvanians like Del Duca struggled to manage the consequences of the destruction wrought by the novel coronavirus. The pandemic had plunged him into a deep, dark hole. The virus killed his mother and shattered his psyche.

It took five years for Del Duca to climb out of the abyss. These days, he has a new job, a better outlook and a healthier frame of mind. Recently, he returned to his beloved routine of trekking to his favorite coffeehouse to sip a cortado.

He's not all the way healed, though. Del Duca knows the wounds of covid run deep. He is a different man today, possibly changed forever.

"We're still in the time of covid. All the pandemic's anxiety and stress? That's what had the effect," Del Duca, 50, told TribLive. "I don't know if I'll ever get back to my normal ever again."

Many might agree. The pandemic was much more than a public health crisis that led to more than 777 million reported covid cases worldwide to date.

The virus upended countless lives in countless ways. It changed how and where Americans work. It affected crime, education, mental health and local economies. To this day, some cities' central business districts, including Pittsburgh's, remain shadows of their former selves.

Covid forced many to embrace teleconferencing, telemedicine and at-home food or grocery delivery. It sped up the adoption of streaming culture. It triggered a home hobby craze, from baking bread to making music to exercising. Pro sports teams played to empty venues. And amid a vacuum of one-on-one interactions, the tumultuous period intensified Americans' relationships with cellphones and social media.

The pandemic, which straddled Republican and Democratic administrations, also deepened political divisions among an already-volatile electorate.

"It marks a real turning point for distrust and polarization and ideological conflict," said Klinenberg. "It was the moment every American started to become entitled to their own facts -- and 'team red' and 'team blue' decided they were going to live in different realities."

Klinenberg views the pandemic as more than an ailment of the body.

"We suffer from long covid as a social disease, not just a medical condition," he said. "In a lot of ways, we're still stuck in 2020."

'Really bad policy'

Adalja, a senior scholar at the Johns Hopkins Center for Health Security, first heard about the novel coronavirus in December 2019 through an email from ProMED, which bills itself as the world's largest surveillance system for infectious diseases.

He was not alone.

"Hopefully this is nothing out of the ordinary," Helen Branswell, a Canadian health journalist, posted to Twitter on Dec. 31, 2019. "But a @ProMED_mail posting about 'unexplained pneumonias' in China is giving me #SARS flashbacks."

By spring, the fears behind Branswell's social media post had manifested themselves -- and health officials like Adalja were calling urgently for more testing.

Adalja remains critical of Trump's approach to fighting the virus, what the scholar described as "the more you test, the worse you look."

"As an infectious disease, about 0.6% of people who got covid died -- and it killed 1 million Americans," said Adalja, 49, a Butler County native who has lived in Pittsburgh's South Side Slopes for 20 years. "That's not the virus doing that. That's really bad policy."

Health officials locally and nationally promoted masks. The term "social distancing" was quickly popularized; footprint-emblazoned stickers, each 6 feet apart, marked the floors of supermarkets, banks and doctors' offices.

Vaccinations rolled out en masse in 2021 as Anthony Fauci became a household name -- praised by some, cursed by others. That year, Allegheny Health Network delivered more than 400,000 vaccine doses. UPMC livestreamed nurses administering Pittsburgh's first covid shots; UPMC soon vaccinated 42,000 first responders and UPMC employees.

Within a year, 4 of 5 people in the U.S. had received a jab. The Commonwealth Fund, a private foundation that examines health care trends, estimated the vaccine prevented 3 million deaths and 18 million hospitalizations.

Lee Harrison, an infectious diseases expert, University of Pittsburgh professor and former Allegheny County Board of Health chairman, likened vaccination to wearing a seat belt.

"When you get into the car and put on your seat belt, you don't know for sure if you're going to be in an accident -- but the seat belt helps if you are. It's the same thing with the vaccines," Harrison said. "The covid vaccines aren't perfect, but neither are seat belts."

As debate swelled about the vaccine's effectiveness, potential side effects and the workplace mandates requiring it, hesitancy to get inoculated grew. In time, the percentage of Americans keeping up to date on their covid shots dropped.

Just 23% of American adults sought the covid booster last year.

As Americans spent more time indoors, telemedicine exploded.

Highmark Blue Cross Blue Shield processed 5 million telemedicine claims in 2020 online, said Dr. Timothy D. Law, its chief medical officer. That was a 2,000% year-over-year increase in physical medicine and an 8,000% spike for behavioral health.

Law was ahead of the curve. The former military physician, who joined Highmark in 2018, started practicing telemedicine 30 years ago.

"It took a pandemic to open everyone's eyes that there are other ways to practice medicine," Law told TribLive. "We learned under fire and ... now we're as ready as anyone can be for the next epidemic or pandemic."

Paying the price

Elected leaders in Washington, D.C., pushed back against covid with nearly $300 million in pandemic relief. Government-issued $1,200 rebate checks provided some relief to households.

Federal officials also funneled $953 billion to buoy payrolls and keep businesses open. But hundreds of thousands of businesses still closed -- a historic number, 330,000, in the second quarter of 2020 alone, according to the Federal Reserve.

Things turned around. It just took time.

In 2022, the U.S. economy created more than 21 million new jobs, 800,000 of them in Pennsylvania, census data shows.

When covid hit Pennsylvania, movie theaters shuttered and so did full-service restaurants. Three-quarters of the statewide restaurant workforce -- nearly 150,000 people -- quickly lost their jobs, according to the Federal Reserve Bank of St. Louis.

Pittsburgh fared better than Philadelphia. The Steel City lost about 10,000 full-service restaurant jobs. Philadelphia lost nearly half that in the pandemic's first two weeks.

DiAnoia's, the Strip District restaurant, weathered the pandemic by always being willing to try new ideas, co-owner DiAndrea Anoia told TribLive.

"We sat down early in the pandemic and said, 'Listen, we can't just sit here and wait for this to end,' " said DiAndrea Anoia, 40, a former Pittsburgh Ballet Theatre marketing and communications director who lives in the North Hills. "We kind of said, 'If they're not going to let people come to our restaurant, how we are going to keep our staff working? How are we going to keep making money?' "

DiAnoia's upped their food takeout game by building a fan base on Instagram. Their chefs created "partially prepared meal kits," sometimes themed around holidays like Mother's Day or Easter. When pandemic restrictions loosened, they served Pittsburghers outside, providing them blankets and hot toddies.

"We probably do 10 times more takeout now than we did before -- and we also have a full restaurant," said DiAndrea Anoia. "Now big events are back, and people want to celebrate. People want to go out again."

Political divide

Partisanship reigned -- loudly -- a trend that has outlived the pandemic. About three-quarters of U.S. adults say the pandemic did more to drive the country apart than to bring it together, according to a recent Pew Research Center survey.

The political divide left behind remains a gaping chasm.

In November, more than 8 in 10 Republicans told Pew surveyors that they would not get an updated covid vaccine. By contrast, more than 6 in 10 Democrats said they planned to get it or already had.

Political affiliation also appears to color voters' views of how health officials handled the pandemic.

Nearly 80% of Democrats called officials' responses excellent or good, Pew data shows. Just 35% of Republicans agreed.

When Trump was leading the pandemic response, 84% of Republicans had positive views of how public-health officials were fighting the virus. The percentage among Republicans fell to 26% in January 2022, during President Joe Biden's tenure.

Adalja, the Johns Hopkins scholar, said it's important to remember that covid didn't "end." The death rate just dropped. People continue to get infected. And people continue to die.

He thinks Americans will be seeking seasonal covid vaccinations, year in and year out, for the foreseeable future -- just like with the flu.

Adalja is bracing for the next pandemic, which he is certain will strike.

"It might not be this (bird flu). But an avian influenza will cause a pandemic -- that's a 100% certainty," Adalja told TribLive. "Anti-scientific thinking played a role in the covid pandemic. And it's going to play a role in the next one."

Klinenberg, the NYU sociologist, worries the U.S. will go into the next pandemic weakened by covid. He measures the damage done through "social solidarity," an academic term for the concept that "our fate is linked to the fate of our neighbors."

"2020 was important because it was a moment societies needed to build social solidarity to get through -- and the United States proved they were unable to do that," Klinenberg said.

"That's the glue that holds society together," he added. "What's striking about the U.S. ... is that, by the end of the pandemic, we ended up trusting each other, our institutions and our government much less."

Wolf isn't so sure those steering the American government will do better next time.

The covid pandemic "forced you to recognize you've got to be nimble and flexible and agile," Wolf said. "But there is no crisis that really prepares you for the next crisis."