Reflections on when the world changed For some, it was the realization that students would have to stay home. Or that trying to find hand sanitizer and toilet paper had become a scavenger hunt. Or that a substance abuse lifeline was closing its doors, even if temporarily. Whatever the sign or the moment, the gravity of the deadly viral outbreak revealed itself in different ways, but the message was the same: The world was about to change. Since the first case of COVID-19 was detected in Maine on March 12, 2020, there have been more than 46,000 cases and 723 lives lost. The death toll in the United States has topped 530,000.