Picture your name – first and last – written at the top of page one of a book. Now picture 249 more names after that, filling the white space down to the bottom. Keep going, adding names, until you have 2,000 pages. That’s a million. Or slip on your sneakers, tie the laces, walk outside at an even pace and count each step you take. To reach 1 million steps, you’d have to walk for nearly seven days without stopping. Or imagine if the Titanic, with 1,517 people still aboard, hit that fateful iceberg and sank not once but 667 times, for a total of 1 million deaths.

COVID-19 has claimed more than 1 million lives in the United States, President Joe Biden acknowledged on Thursday. But humans are so ill-equipped to process large numbers – nevermind large-scale suffering – that it’s nearly impossible to grasp that toll. What this milestone means for the many and growing number of Americans who are grieving cannot be expressed by statistics alone.

Research suggests that when one person suffers or dies, that yields the most profound sense of grief. But our ability to comprehend that suffering does not scale up with each additional person’s loss, said Paul Slovic of the University of Oregon. “As numbers increase, we lose feelings.”

Statistics about death and suffering, whether tied to COVID or war or famine, “[bounce] off of us while conveying little meaning or emotion, compared to when we know someone who has had the disease or we have first-hand information about individuals who are suffering,” a phenomenon called psychic numbing, Slovic said. 

The truth is we’ll never really know the exact number of human casualties – additional deaths caused by the virus aren’t captured by official counts – nor the exact day we hit any specific sum. We can’t truly calculate the web of emotional suffering, though experts estimate that for every one person who has died of COVID-19, nine close family or friends have been left behind. 

WATCH: How misinformation and the partisan divide drove a surge in U.S. COVID deaths

The grief has been spread unevenly, however. Some communities, left vulnerable by systemic racism, lack of accessible health care and other disparities, have borne a disproportionate weight. The losses that might be so obvious to some are fewer and far between for others. 

Some witnessed a family member’s final moments over an iPad, or said tearful goodbyes by phone. Others didn’t get that chance, instead receiving a call from a weary hospital staff that their person was gone. 

Sabila Khan’s father, Shafqat Khan, died of COVID on April 14, 2020, in “what I assume was a war zone of an emergency room during the peak of the New Jersey-New York pandemic.” 

A community organizer, Khan’s father worked to lift up the voices of fellow Pakistani Americans and Muslims, especially after the attacks on Sept. 11, 2001, and to nurture conversation across communities in New Jersey. Later in life, he was diagnosed with Parkinson’s disease, and when his rehabilitation facility went into lockdown in mid-March 2020 to prevent further spread of the coronavirus, Khan said she “assumed incorrectly that he was in the safest place possible.” But the virus was likely already inside the facility. Within days, Khan’s father became sick. On April 6, he was rushed to a hospital three blocks from her home. Despite being so close to him, Khan said COVID protocols forbid her from being with him, including his final moments. Even in death, she couldn’t be near him; she watched her father’s funeral, live-streamed through her phone. 

In life, Shafqat Khan worked to bring people through adversity. In death, he was alone, sick with COVID-19 and unable to have his family close by, due to pandemic protocols, on April 14, 2020. “My father died a death he did not deserve,” said his daughter, Sabila Khan, who went on to found a Facebook group to give people a community where they could grieve with others who had lost loved ones to the coronavirus. Photo courtesy of Sabila Khan

“My father died a death he did not deserve. He was a good man. He died traumatized, scared and alone,” she said. “I wish everyone could recognize that.”

Adrift in her grief, Khan looked online for communities of survivors. Finding none, she founded a private Facebook group to give families like hers a community. Today, there are 14,000 users. Members message to acknowledge their loved one’s birthday or death anniversary, and support each other as holidays and milestones serve fresh reminders that their person won’t be around to celebrate. 

Khan said that, in anticipating 1 million COVID deaths, many people who have lost someone worry that the country will go through the motions of mourning for a day and then return to business as usual, forgetting the families left unmoored by the pandemic.

“What the bereaved are currently going through is a bit of a nightmare,” she said. “The thing that killed our loved ones is still here.”

More must be done to support people who suddenly find themselves anguished by the loss of a loved one, said grief expert and author David Kessler. For much of the country, COVID restrictions have relaxed, masks have come off and signs of normal life are emerging in familiar patterns. But Kessler said grief must be witnessed, and “we’ve done a really horrible, horrible job at witnessing their grief.”

Those who are bereaved do not need or want to hear that their loved one is in a better place, Kessler said. They simply want to be heard without worrying if they will have to defend their loved one against questions implying that they somehow invited their own sickness and death.

Since the death of Charonda Johnson’s father, Kevin Taylor, a Vietnam War veteran and church leader in Dover, Delaware, she has lost count of how many times people have asked her about his age, underlying conditions or even behavior that might have caused to die of COVID in August 2020. Those questions offend Johnson, who went on to found COVID Survivors for Change, because they “minimize your loss and your experience and your grief,” she said. “Nobody says to someone who died of cancer, ‘Well, what did your loved one do to get cancer?’”

Part of the phenomenon of psychic numbing traces back to how humans evolved, Slovic explained. In a given day, a person usually practices fast thinking (quick, intuitive decisions based on gut reactions to images and impressions) and occasionally slow thinking (analysis grounded in logic, reason and science). That reliance on fast thinking is a survival mechanism that “helps us get through our day,” Slovic said. But it erodes our ability to understand loss and human suffering in orders of magnitude.

Numbers that end in zero catch people’s attention, however briefly, Slovic said. One million deaths is huge, and he expected more people to pause and think slowly about who the country has lost, “but then it may not last very long.”

To counter the tendency to become desensitized to grim milestones, social worker and grief counselor Melissa Sellevaag said it is critically important to remember, “Every single one of these numbers is a person who was loved by somebody.”

READ MORE: Why Louisiana counseling centers are seeing a rise in kids with grief

People in mourning, often “feel like the world is moving on and [theirs] has stopped,” Sellevaag said. She tells them that when someone dies, you don’t get over it – you learn to live with it. You need to talk about your person and share your memories with others. Grief comes in waves, she said, and learning how to cope with that grief is a nonlinear process.

Grief is raw and fresh for preschool teacher Genevieve Larrañaga. She still struggles with talking in the past tense about her husband and father of their teenage sons, Edward Larrañaga, who died of COVID on March 3. They had saved for retirement and planned to travel with her tight-knit family, camping their way across the country. At home in Albuquerque, New Mexico, they loved to share laughs and time sitting together by a roaring fire. “We never do anything apart,” she said. She wasn’t ready to let him go.

Genevieve Larrañaga met Edward, the man who would become her husband and father of their two sons, in high school after their respective prom dates ditched them. From that night, they were inseparable for decades. Then, this winter, Edward got sick with COVID-19. He died on March 3. As the United States confirmed 1 million deaths from the coronavirus, Larrañaga said through tears, “This is not just a number. These are real people who had real lives and were thriving. They’re dearly missed.” Photos courtesy of Genevieve Larrañaga

Despite her begging, pandemic protocols prevented Larrañaga from being by her high school sweetheart’s side to hold him one last time while he was still awake. 

Was he in pain? Was he scared? No answers offer comfort. Now, whenever she and her boys walk past the dining table, where Ed had earlier set up his office, her heart breaks all over again because “it’s empty.” 

“This is not just a number. These are real people who had real lives and were thriving. They’re dearly missed,” Larrañaga said through tears.

It’s not too late to support these families, Kessler said. Government officials can do more to officially remember and recognize the people who died of COVID, as well as those carrying their memories. Permanent public memorials would create an open space for people to grieve. Grief counseling, especially for the 200,000 children under age 18 who have lost a caregiver in the U.S. so far during the pandemic, would help many learn how to find meaning again and move forward with their lives. 

In her own way, Jenny Clay is building a memorial for her daughter, Alexandra Chandler, who died in February at age 27. 

Chandler and her husband had struggled for years to have a child of their own, but on Mother’s Day last year, Chandler excitedly told Clay that she was going to be a mom, too. 

As a school teacher in Killeen, Texas, Chandler caught COVID shortly after returning from winter break to the classroom despite being vaccinated, Clay said. Chandler gave birth to a son, Beau, by cesarean section on Jan. 9. But while her condition continued to deteriorate, Clay said the hospital did not treat her daughter for COVID before sending her back home. Likely preoccupied by being a new mom, Chandler did not realize how sick she was and went to the hospital only when her son became ill, Clay said.

“She was unaware,” Clay said through tears. “She just downplayed it. She didn’t know she was that sick. She had never had a baby before.”

In the hospital, staff realized how far gone Chandler was, and COVID protocols prevented Clay from holding her daughter’s hand, even when her child “was crying for me,” she said. Desperate to bridge the distance of a hospital window, Clay took a pen and paper and made a sign for her daughter that said, “We love you,” pressing it against the glass. Then, she watched her child for the next 30 days until she died on Feb. 13, during the Super Bowl.

After that, Clay, also a teacher, quit her job and now works at a grocery store. In Texas, she said people act as if COVID-19 “doesn’t exist.” People rarely wear masks. Some people challenge Clay when she says her daughter died of COVID. 

Clay doesn’t have any option but to keep going, she said. To carry on, she is working, slowly, on a memory book, starting from the day Chandler was born. Clay wants to give it to her grandson when he is older so he knows who his mother was, why she mattered in life and why she must be remembered in death. 

“She’s gone, but she left us this present for us to enjoy,” Clay said, referring to Beau. “If there’s any healing, that’s what’s happening. I hold him and think of her.”

Above: Illustration by Megan McGrew

By Zeke Miller, Maria Cheng, Associated Press

By William Brangham, Ryan Connelly Holmes, Ian Couzens

Laura Santhanam is the Data Producer for the PBS NewsHour. Follow @LauraSanthanam

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