WASHINGTON — The symptoms were more annoying than alarming: A dry cough, achiness and then sniffles developed a few days after Andrew Young, the American ambassador to Burkina Faso, met with government officials and aid organizations to discuss how to protect the West African nation from the coronavirus.
A week later, Mr. Young was sealed in an isolation chamber and loaded into an evacuation flight out of the capital, Ouagadougou, as the first United States ambassador to learn he had the virus.
He is unlikely to be the last. Already, 154 State Department employees worldwide have tested positive for the virus and more than 3,500 are symptomatic and in self-isolation, the vast majority of them serving in posts overseas.
The pursuit of diplomacy is mostly idealistic, if usually faceless and often thankless. But outside conflict zones, it is rarely deadly. Even the most placid assignments come with security guards and other protective measures.
The coronavirus has changed that.
Diplomats, whose very jobs are to interact with foreigners and to represent 20 million Americans who live abroad, have been highly vulnerable to the pandemic as it swept around the world and into countries that have been slow to acknowledge its threat, many whose medical facilities are less than adequate to start.
Three State Department employees have died from the coronavirus so far, all of whom were foreign citizens who were hired by the embassies in their respective home nations. One was from Indonesia and another from the Democratic Republic of Congo. The State Department did not disclose on Friday where the third person was from, except to say that he or she was not an American citizen.
On March 20, the day before Mr. Young tested positive, President Trump described the State Department as the “Deep State Department” — a jab at what he sees as a disloyal diplomatic corps. He delivered it during a coronavirus briefing as he stood next to Secretary of State Mike Pompeo, who minutes later said of the president, “I know how much he values the people that work on my team.”
It was left to Representative Eliot L. Engel, the chairman of the House Foreign Affairs Committee, to defend the State Department staff. “These men and women aren’t a ‘deep state,’” Mr. Engel, Democrat of New York, said later. “They’re our leading edge in working to protect Americans in the farthest corners of the world.”
At the start of last week, there were only 43 kits available in Burkina Faso to test for coronavirus infection, Mr. Young said. The country currently has one of the highest numbers of infections in Africa — as of Friday, there were at least 288 confirmed cases and 16 deaths.
Mr. Young was evacuated on March 25 on a flight that was chartered by the State Department to bring him and 120 healthy passengers home from Burkina Faso and Liberia. As soon as the plane landed at Dulles International Airport in the Virginia suburbs of Washington after a 29-hour journey, he was suited up in full biohazard gear and whisked off to a hospital for several days of treatment.
He considers himself lucky. And he wants to return to Burkina Faso as soon as the State Department will let him.
“My treatment is not the same treatment that your average Burkinabe will receive in the coming challenges, because the situation is going to get more difficult in the couple of weeks ahead of us,” Mr. Young said in an interview this week as he recovers at home in the Washington area. “So I carry that.”
So far, the State Department has brought back more than 38,000 citizens and their relatives — many of them tourists, students or Americans who live overseas. That includes about 6,000 diplomats and family members.
Another 22,000 American citizens are still waiting, frustrated by the dwindling number of available flights, foreign regulations and other complications that have slowed their return.
At both ends of the process are American diplomats who either are working abroad to get necessary departure permits from foreign governments, or are part of a Washington-based task force focused on lining up transportation and health services for stranded citizens.
In some cases, that has meant renting buses to pick up Americans in remote locations and take them to the nearest international airport. In others, it has involved negotiating with foreign officials to approve the flights when public airports are closed, or to allow cruise ships with U.S. citizens among infected passengers aboard to dock.
Some State Department employees in Washington have voluntarily reported to the task force operations center, to take over the night shift, after completing their daily diplomatic duties.
“It’s an incredibly fast-paced, fluid challenge,” said Robert W. Forden, the deputy ambassador to the American Embassy in Beijing, who is now running the department’s coronavirus global response team in Washington. “The reaction, the responses have been shifting almost hourly. So it’s a constant struggle.”
It has also put State Department employees at risk of infection.
In Washington, some Foreign Service officers have questioned why they must report for duty at the State Department’s headquarters instead of teleworking, as the Centers for Disease Control and Prevention has urged most of the nation’s work force. Guidance issued on Wednesday, a copy of which was obtained by The New York Times, requests that State Department employees work from home “unless there is a critical mission need for you to be at the office,” but still allows senior-level supervisors to decide which diplomats qualify.
There are 171 U.S. embassies and 87 consulates around the world; all but two remain open. Those two — consulates in Vladivostok, Russia, and Wuhan, China, where the coronavirus originated — were shuttered this year because of the outbreak.
But 12 other American diplomatic missions are not fully staffed and many officials worldwide have returned to the United States as the pandemic spread. About two-thirds of the diplomats and contractors posted to the United States Embassy in Beijing and Consulates elsewhere in China, for example, have left. Several hundred remain.
Tests for the virus also have been unavailable in some posts to diplomats who worry they could be exposed — putting not just themselves, but also those around them in danger.
“People accept a significant level of risk in this career,” said Eric Rubin, a former ambassador to Bulgaria who is now the president of the union that represents career diplomats. But, he said, there is a need for clear, consistent guidance and the department largely has dealt with the coronavirus “bureau by bureau and post by post.”
None of the U.S. diplomats among the roughly 70 American and Chinese employees at the U.S. Consulate in Wuhan has tested positive for the virus, said Jamie Fouss, the consul general who led its emergency closing on Jan. 28.
A month earlier, diplomats there had become aware of a new, fast-moving virus in Wuhan that attacked the respiratory system, and alerted supervisors at the American Embassy in Beijing in late December. Mr. Fouss said he woke up one morning in mid-January to learn that the airport and some roads in Wuhan were closing, with more to follow in the coming days.
Emergency food supplies were checked; evacuation routes were debated.
Even after the State Department secured a flight to bring home the consulate’s American staff, diplomats had to negotiate with China’s Ministry of Foreign Affairs to reopen roads for the drive to the airport. The Chinese government also prohibited any people with Chinese passports from leaving, Mr. Fouss said.
Temperatures were taken before boarding and several times during the long flight home, which landed on Jan. 29 at March Air Reserve Base in Riverside, Calif. The plane was greeted by a C.D.C. officer, who informed all passengers that they would be held there under a 14-day federal quarantine — the first imposed in the United States since the 1960s.
“His hands are shaking, and you can tell he’s very nervous, because he’s expecting this huge uproar from us,” Mr. Fouss said. “And one of my officers said, ‘Well, will you set it up so we can watch the Super Bowl?’ And he said, ‘Yes, I think we can do that.’ And everybody laughed and cheered.”
So far, Mr. Young is the only American employee at the U.S. Embassy in Ouagadougou who has tested positive for the virus, although two local staff members have, and several others have gone into self-quarantine as a precaution.
More than half of the staff and all family members have been evacuated over the last few months, leaving only a few dozen diplomats and other employees. They are all either working from home in Burkina Faso or otherwise maintaining social distance from others.
Although he never ran a fever, his own diagnosis “was a wake-up call that people needed to be really serious about the type of tools that are available to everyone to slow down the spread of the virus,” Mr. Young said.
Over the last week, Mr. Young said, 10,000 coronavirus tests have been donated to Burkina Faso from one of China’s most prominent businessmen, the Alibaba founder Jack Ma. The World Health Organization has sent 2,000 more, he said.
Even before he tested positive, Mr. Young had worried about the virus’s effect on Burkina Faso’s fragile democracy in the middle of a terrorist threat and a growing numbers of refugees. He said he was eager to return.
“I’m working with a really brave population,” he said “They sacrificed for their democracy and now they are fighting a horrific villain in Al Qaeda and ISIS. And they are stepping up.”
He added, “I want to be part of helping them succeed.”
Catie Edmondson contributed reporting.