In March, when the new coronavirus prompted lockdowns around the world, many people felt it came out of the blue. There were plenty of earlier warnings, though, for those who knew where to find them. At the end of December, a low-tech news site beloved by infectious disease doctors relayed that the Wuhan Municipal Health Committee had sent out “an urgent notice on the treatment of pneumonia of unknown cause.” By January 4, STAT’s Helen Branswell was warning of a possible link to “a new virus, and perhaps even a new coronavirus.” As for me—a medical journalist who has been reporting on coronaviruses from time to time since 2004—the terrifying, revelatory moment of this pandemic came not from reading any sentence in a news story or by checking bulletins from overseas. It came from watching a woman’s scream.

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I first saw the scream at the end of January: A 14-second clip passed around on social media that showed a health care worker sitting in a chair in what looks to be a break room. She’s letting out one devastating howl after another, while most of the others in the room are doing what they can to ignore her anguish. (The woman just beside her noodles anxiously on a cellphone.) I do not know who these people are. I do not know where the clip was filmed. I don’t even know for sure that the footage is from Wuhan or that it was taken during the pandemic. But the rawness in her cries crystallized the possibility in my mind that this new viral outbreak was something far beyond the norm.

The screaming-nurse video is, at this point, rather hard to find. Other videos I remember watching at the time have completely disappeared, but some remain: a distressed woman pushes over signage in apparent despair at the new pandemic reality; bodies accumulate on a hospital floor; a patient films from bed as health care workers haul away a corpse across the room. There were also clips with better sourcing, such as the footage captured by Fang Bin, who did a short walk through a hospital ward to find a man struggling for breath as his father was dying before his eyes. But Fang Bin disappeared, as did other citizen journalists documenting the pandemic in China.

I wasn’t sure, back then, whether I should share the videos I’d seen that had murky sourcing—so for the most part I refrained. By April, I was regretting my decision. These clips had made it clear to me that the new coronavirus was far scarier than the flu, yet many in the US seemed to disagree. Then again, The New York Times had posted a compilation of some Wuhan videos—complete with an ominous soundtrack—on January 23, and that didn’t seem to make much difference: Americans continued to go about their lives mostly unperturbed. Maybe they would have to witness deaths on their home soil before they’d take the problem seriously.

When the pandemic finally did arrive, it brought shocking images of refrigeration trucks parked outside hospitals, and of graves being dug for unclaimed Covid-19 victims. Field hospitals were set up in Central Park. Documentaries showed overstretched emergency rooms. But even then, we rarely saw footage of the kind that showed up in the early clips from China. We rarely saw patients as they gasped for breath. We rarely saw the suffering up close. Surely that’s due, in part, to our culture of death denial; but the dearth of more intimate, macabre videos and images is also a function of our medical privacy laws, which prevent hospitals from disclosing data such as identifying information from a patient. (The appearance of someone’s face in a documentary would be exactly that, of course.) Hospitals also worry over the use of video in malpractice lawsuits, and the profound risk of retraumatizing families with a recording of a loved one’s death.

It’s not only that we’re shy of putting misery on tape. Spouses and children have been blocked from seeing patients in the hospital, for fear that such visits will infect them and spread the virus further. This makes sense, perhaps, as a measure in support of public health; but aside from all the other human costs that it imposes, it also stops us from bearing full witness to the tragedy. Other hospital rules that keep the shutters closed have far less reason to exist: some have even blocked their doctors from talking to the press—threatening to fire anyone who does.