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Letter from Select Subcommittee on the Coronavirus Crisis, James E. Clyburn, Chairman, to The Hon. Alex M. Azar, II, Secretary, Department of Health and Human Services and Dr. Robert R. Redfield, Director, Centers for Disease Control and Prevention
December 10, 2020

One Hundred Sixteenth Congress
Congress of the United States
House of Representatives
Select Subcommittee on the Coronavirus Crisis
2157 Rayburn House Office Building
Washington, DC 20515-6143
Phone (202) 22504400
https://coronavirus.house.gov

James E. Clyburn, Chairman
Maxine Waters
Carolyn B. Maloney
Nydia M. Velazquez
Bill Foster
Jamie Raskin
Andy Kim
Steve Scalise, Ranking Member
Jim Jordan
Blaine Luetkemeyer
Jackie Walorski
Mary E. Green, M.D.

December 10, 2020

The Honorable Alex M. Azar II
Secretary
Department of Health and Human Services
200 Independence Avenue,
S.W. Washington, D.C. 20201

Dr. Robert R. Redfield
Director
Centers for Disease Control and Prevention
395 E Street, S.W., Suite 9100
Washington, D.C. 20201

Dear Secretary Azar and Director Redfield:

I write today to express my serious concern about what may be deliberate efforts by the Trump Administration to conceal and destroy evidence that senior political appointees interfered with career officials’ response to the coronavirus crisis at the Centers for Disease Control and Prevention (CDC). This week, a career CDC official stated in a transcribed interview with Select Subcommittee staff that she was instructed to delete an email in which a Department of Health and Human Services (HHS) appointee demanded that CDC alter or rescind truthful scientific reports he believed were damaging to President Trump. She also stated that she understood the instruction to delete the email came from CDC Director Robert Redfield. After the career official provided this troubling testimony, HHS abruptly canceled four transcribed interviews the Select Subcommittee had scheduled with other CDC employees. These actions follow months of obstruction by HHS, during which the Department has failed to produce key documents your staff promised to provide more than a month ago.

I am deeply concerned that the Trump Administration’s political meddling with the nation’s coronavirus response has put American lives at greater risk, and that Administration officials may have taken steps to conceal and destroy evidence of this dangerous conduct. It is critical that the Department end its stonewalling, preserve or recover all responsive documents, and provide the documents and witnesses that the Select Subcommittee needs to investigate this conduct and help protect American lives during this deadly pandemic.

Interview Reveals Instructions to Delete Critical Email and Delay Scientific Report

On December 7, 2020, Select Subcommittee staff conducted a transcribed interview of Dr. Charlotte Kent, Chief of the Scientific Publications Branch and Editor-in-Chief of the Morbidity and Mortality Weekly Report (MMWR) at CDC. During the interview, Dr. Kent stated that she was instructed to delete an August 8, 2020, email sent by HHS senior advisor Dr. Paul Alexander, and that she understood the direction came from Director Redfield. An excerpt from this email was later published in the press. However, the Department has not produced the email to the Select Subcommittee in response to our requests.

In the email, Dr. Alexander demanded that CDC insert new language in a previously published scientific report on coronavirus risks to children or “pull it down and stop all reports immediately.” He also wrote:

CDC tried to report as if once kids get together, there will be spread and this will impact school reopening. … Very misleading by CDC and shame on them. Their aim is clear. … This is designed to hurt this Presidnet [sic] for their reasons which I am not interested in.1

Dr. Kent stated in her interview that this email was sent to her, Dr. Redfield, and possibly HHS Assistant Secretary for Public Affairs Michael Caputo on Saturday, August 8. She stated that she was on vacation at the time, and she received a call “early Sunday morning” from the career CDC official who was editing the MMWR in her absence. This official explained that Dr. Michael Iademarco, who was Dr. Kent’s supervisor, had passed on an instruction from Dr. Redfield to delete the August 8 email from Dr. Alexander.

Dr. Kent stated in her interview, “I was instructed to delete the email.” She stated that she did not speak directly to Director Redfield about this instruction, but was informed that the instruction came from him, explaining, “that’s what I understood, that it came from Dr. Redfield.” She continued, “I went to look for it after I had been told to delete it, and it was already gone.” When asked who deleted the email, she replied, “I have no idea.”2

Dr. Kent stated, “I considered this to be very unusual.” When asked if she would normally retain this type of email, she stated, “typically it would have been.”3

Federal employees have affirmative obligations to preserve documents, and destruction of federal records is potentially illegal. The Federal Records Act requires the head of each federal agency to “make and preserve records containing adequate and proper documentation of the organization, functions, policies, decisions, procedures, and essential transactions of the agency.”4 Federal law also provides for up to three years of imprisonment for willful destruction of federal records.5

Dr. Kent also revealed other troubling conduct by HHS and CDC political appointees. For example, she stated that CDC delayed the publication of an MMWR article regarding a coronavirus outbreak at a Georgia summer camp to ensure that the scientific report would not be released until after Dr. Redfield’s July 31, 2020, testimony before the Select Subcommittee. Documents show that the article was originally scheduled to be released to the public on July 29, but the release was delayed for two days following a “requested delay by Dr. Redfield and HHS.”6 Dr. Kent explained that she understood that the reason for the delay was, “there was an interview with the congressional Oversight Committee, and there were some very important things that they wanted to convey during that meeting.” When asked whether she was referring to Dr. Redfield’s July 31 testimony before the Select Subcommittee, she responded, “that’s probably it,” adding, “[a]nd then the report would be released afterward.”7

At the July 31 hearing, Dr. Redfield testified that he believed schools should reopen for “face-to-face learning” in September 2020 and noted, “There’s really very significant public health consequences of the school closure.”8 He did not discuss the CDC study, which found that the virus spread widely among children at a summer camp in Georgia.9 The hearing ended at approximately 12:45 p.m., and CDC released the report approximately 15 minutes later at 1:00 p.m.10

HHS Is Obstructing the Select Subcommittee’s Investigation

The Select Subcommittee requested documents and transcribed interviews from HHS on September 14, 2020, following press reports indicating that political appointees had sought to block, alter, and delay CDC publications related to the coronavirus pandemic. The Select Subcommittee’s letter requested interviews beginning on September 22, 2020, and documents by September 28, 2020.11

On September 22, 2020, after HHS refused to make any witnesses available by the deadline, the Select Subcommittee sent a follow-up letter seeking compliance with the requests.12 The Department did not produce any documents by the September 28 deadline.

On October 2, 2020, Secretary Azar testified before the Select Subcommittee. During the hearing, I raised concerns about “clear political interference in the CDC’s efforts to carry out the department’s science-based mission.” I also stated, “I will hope that you will agree and begin producing the documents and allowing these witnesses to come forward next week.”13

Following the hearing, HHS did not produce any documents or witnesses, despite outreach from Select Subcommittee staff. On October 22, 2020, I wrote to Secretary Azar again, stating:

I urge you to end your obstruction of this crucial investigation, allow CDC officials to speak freely to Congress, and produce responsive documents. If you refuse to comply voluntarily, you will force the Select Subcommittee to consider issuing subpoenas.14

Our staffs subsequently engaged in several days of negotiations. On October 29, 2020, HHS agreed to make a complete production of all responsive documents by November 23, 2020, and to make five witnesses available for interviews. With respect to documents, Department staff wrote:

HHS will target November 9 for a complete production of documents for the five named custodians, as well as others whom we have identified to date. This will take a good amount of resources and will likely require contract-attorney reviewers, but we will aim to have the production to you by the 9th. We will also commit to target November 23 for a complete production for the remaining political appointees.15

Unfortunately, HHS has not honored this agreement. The Department has produced some documents, which consist primarily of publicly available articles, incomplete sets of emails related to Dr. Alexander, and a small number of other emails from CDC. During a call on December 2, 2020, Department staff refused to provide even an estimate of when HHS would produce the remaining documents, including responsive emails involving Secretary Azar, Dr. Redfield, and other senior officials.

On November 30, 2020, the Department agreed to make five witnesses available for transcribed interviews beginning on December 7, 2020. However, hours after Dr. Kent’s interview in which she revealed she was instructed to delete a key document, your staff wrote to Select Subcommittee staff that the Department is “cancelling the interviews that were scheduled for this week,” baselessly attacking the Select Subcommittee staff’s integrity as a pretextual justification for doing so.16

Need for Compliance

On September 14, 2020, the Select Subcommittee explained that this investigation seeks “to determine the scope of political interference with CDC’s scientific reports and other efforts to combat the pandemic, the impact of this interference on CDC’s mission, whether this interference is continuing, and the steps that Congress may need to take to stop it before more Americans die needlessly.”17

Those goals are even more urgent in light of the information obtained by the Select Subcommittee showing that top CDC and HHS officials may have taken steps to obstruct oversight into their activities and to delay the release of accurate scientific information regarding the coronavirus for political purposes. With coronavirus cases, hospitalizations, and deaths in the United States reaching new records, it is critical that the American people can trust the federal government to provide accurate public health information based on the best science—not based on politics.

For all these reasons, please produce all remaining responsive documents by December 15, 2020. If you do not make a complete production by that date, the Select Subcommittee will have no choice but to issue subpoenas to compel production.

In addition, the Select Subcommittee requests a transcribed interview with Director Redfield on December 17, 2020. The Select Subcommittee also requests that the transcribed interviews of the other four CDC officials that HHS abruptly canceled be rescheduled immediately.

Finally, please produce the following additional documents by December 15, 2020:

1. All documents and communications related to efforts to delete, conceal, or withhold Dr. Alexander’s August 8, 2020, email;

2. All documents and communications related to efforts to delete, conceal, or withhold any documents responsive to the Select Subcommittee’s September 14, 2020, requests;

3. All documents and communications related to instructions or guidance provided to any HHS or CDC employee to withhold information, documents, or testimony from the Select Subcommittee; and

4. A list of all federal officials and employees involved in any of the activities described in Requests 1 through 3.

Sincerely,

__________________________
James E. Clyburn
Chairman

cc: The Honorable Steve Scalise, Ranking Member

APPENDIX

Excerpts from Transcribed Interview with Dr. Charlotte Kent

Director Redfield Instructed CDC Officials to Delete Email from Dr. Alexander

Q: Who was that email sent to?

A: I don’t have a copy. I believe it was sent to me and Dr. Redfield, and I’m not exactly sure who -- it would -- given, you know, he’s addressing Michael, I would assume it was also sent to Mr. Caputo.

Q: You said -- you said that this was sent while you were on vacation. Do you recall when that was approximately?

A: It was, I think -- I think he sent it -- I think it was maybe, like, August. It was -- he sent it, I think, on a Saturday in August around -- I can’t -- I don't remember the date exactly, but, like, August 7th, 8th, around in there, whatever that Saturday is.

Q: You said you don’t have a copy. I realized we haven’t given you one because we don’t seem to have one. Did you -- do you still have one in your possession?

A: I don’t have one in my possession.

Q: Why is that?

A: While I was on vacation, the woman who was serving as the acting and editor-in-chief, there was discussion with her -- her name is [REDACTED] -- and Dr. Iademarco about this. Dr. Iademarco reached out to Dr. Redfield, and so Dr. Redfield said we wouldn’t be doing this according to this -- you know, about what I heard from [REDACTED] who heard from, you know, Admiral Iademarco, and that we did not -- that I was instructed to delete the email because it would be part of Dr. Redfield’s, you know, the documentation that he has in his email. So actually when I went back to delete, it was already gone.

Q: Sorry. Who instructed you to delete it?

A: I heard from [REDACTED], who, as I understood, heard from Dr. Iademarco, who heard from Dr. Redfield to delete it.

Q: Sorry. I just want to make sure I understand. It sounds like you’re saying Dr. Redfield told Dr. Iademarco --

A: Yes.

Q: -- who told [REDACTED], who told you.

A: Yes, right. Yeah. So I did not have direct -- that’s what I understood, that it came from Dr. Redfield, and that it was also stated that it would -- because of Dr. Redfield, you know, all of his email are part of the public record, that it would be maintained in that.

Q: I see. When you say it was already gone, what does that mean?

A: That means when I went to look for it, it was not there.

Q: Did you go to look for it in response to a request from our -- the Select Subcommittee to produce documents?

A: No, I went to look for it after I had been told to delete it, and it was already gone.

Q: Why did you go to look for it?

A: Because I had been instructed to delete it, and so I went to look for it to delete it, and it was already gone.

Q: Oh, I see. You didn’t actually delete it yourself because it was already gone.

A: No. No, uh-huh. It was already -- yes.

Q: Do you know -- do you know who deleted it?

A: I have no idea.
. . .

Q: Did you -- so you learned while you were on vacation at this point in August that -- about this email and Dr. Alexander’s efforts to -- you referenced that he’d wanted to change MMWRs. What else -- did anything else happen? Did you learn about that through anyone other than the conversation you referenced with [REDACTED]?

A: I mean -- I mean, we just discussed the content of this email, but, you know, I had been assured, you know, that Dr. Redfield was not going to -- you know, didn’t think this was appropriate.

Q: He didn’t think that what was appropriate?

A: To comply with the request in this email.
. . .

Q: Do you recall when [REDACTED] told you to delete the email?

A: It would be the day after it was sent. So as I recall, Dr. Alexander sent it at night, and she called me early Sunday morning about it. I think I actually -- I read it and told her that I, you know, I would be happy to talk to her whenever she was available.

Q: You read what?

A: Oh, so sorry. So I read the email early -- I think early Sunday morning. I believe he sent it late Saturday, and he -- I just -- and I think she had sent me a heads up about it. And so she and I talked early in the morning, and then she talked -- and then she just told me that Dr. Iademarco and Dr. Redfield will discuss it on Sunday --

Q: Yeah.

A: -- at a civil hour, and then I think she communicated after that discussion. You know, it was sort of down -- you know, back up, like, that she would -- you know, after Dr. Redfield talked to Dr. Iademarco, he -- and told him that, you know, we would not be complying with this request, that’s when she got back to me with that statement and the request to delete the email.

Q: Did you discuss any -- did anyone raise any concerns to you about the request to delete the email?

A: Well, certainly the request is not typical. It’s not something that we would -- you know, it was clear that the director said he would not comply with it. I mean, I think it’s -- you know, it’s surprising, you know, when you receive something like this.

Q: Are you aware of -- have you received training or are otherwise aware of document retention obligations for government officials?

A: Yes, the -- I’m aware that we are to keep documents.

Q: So when you were told to delete the email --

A: Mm-hmm.

Q: -- did you discuss with anyone whether that request raised any concerns regarding those obligations?

A: I didn’t discuss with anyone. I’m also familiar with the -- that, you know, the director’s email is something that, you know, is not tampered with. And so when I was -- I considered this to be very unusual. I think that the request to -- you know, I do know that, you know, certain parts of -- persons in the Agency, like Center directors and the director, their email, you know, cannot be deleted. So I felt like there -- honestly, I felt like there were safeguards that if it was needed to discover this information, it would be readily discoverable.

Q: Is this a type of email that you would’ve normally kept under your typical practices?

A: Yes, typically it would have been.
. . .

Q: Do you know if anyone other than the people that you’ve described in the -- in the chain that was communicated down to you were aware of the request to delete that email?

A: I am not aware of -- you know, I can’t remember if I discussed it with -- I might’ve discussed it with the [REDACTED] of MMWR. It’s the sort of thing I typically would have, but I don’t remember if I did for sure because, technically, I was on vacation. So, but that, you know, that would’ve been the only people within the Agency, other person possibly.

Q: I'm sorry. What’s the name of that person?

A: Her name is [REDACTED].

Q: Did anyone ever tell you not to discuss Dr. Alexander’s request?

A: I don’t recall that. I don’t. Yeah, I don’t -- I don’t recall that.

Q: Did anyone ever tell you how you should address Dr. Alexander’s request? And I’m not talking about prep for this interview.

A: I don’t -- I don’t recall being given explicit guidance about, you know, that particular email other than to delete it.
 
Director Redfield and HHS Officials Delayed Release of Damaging Scientific Report Until After Congressional Testimony

Q: These two emails relate to each other. They were both sent within about a minute apart. One is from you to Michael Iademarco, and it says at the top: “Amanda called me to say -- request a delay by Dr. Redfield and HHS. Delay will make for better timing.” That’s Exhibit 12. On Exhibit 13, four emails down the chain, you write, “Just got the call. Request a delay until Friday by Dr. Redfield. Timing will be better.” So in any case, this, I think, is the delay that you’ve already talked to us about.

A: Yes.

Q: Do you have any understanding of why was the timing better?

A: The timing was better -- well, one, it was only a 2-day delay, so it’s not a long delay, and it couldn’t be -- because of our production processes, it couldn't be -- it couldn’t be released on Thursday because that’s when we do our regular content. So as I understood, that there was a desire to make the communication about this report, you know, kind of front and center, that there wouldn’t be a distraction because of other things that were occurring, and so that was why the delay. Like, when we schedule reports, we really try to think about the communication because generally you can only communicate effectively about one topic, you know. And if there’s a lot of other things that are going to be in the news, then we try to do -- you know, kind of do things in a smooth way so that there’s not a lot of dissonance. So the -- my understanding was that they felt it would be more effectively communicated if it was delayed until Friday.

Q: You said other things that were happening. Do you know what other things?

A: I think the -- as I understood, on Thursday, there was an interview with the congressional Oversight Committee, and there were some very important things that they wanted to convey during that meeting.

Q: Is this the only time that you’re -- that you can recall at any -- at any point in time during your response or otherwise where somebody asked you to delay the publication of an MMWR, other than for a, you know, scientific review and whatnot?

A: This is the only time I -- well, you know, this is -- I can’t say that there wasn’t some other time. We published 163 reports, and I cannot say that there has never been another time where we decided to delay something because it would be better from a communications perspective to release it a little bit later because there was going to be guidance that was coming out that was going to be ready, and they, you know, amplified the message. I certainly would have discussions about that all the time. This is the only time that I recall getting a request, you know, that was related to, you know, Dr., you know, Redfield and communication around him. Because we do try to be -- again, effectively communicate things and to have things be -- you know, the timing not be disruptive, it didn’t stand out especially in my mind that this, you know. And, again, it was only delaying it by 2 days, so. You know, as we -- as you -- if you go through, we’ve delayed a number of reports, but --
. . .

Q: You mentioned -- you said a briefing with congressional Oversight. Was that the -- Dr. Redfield’s testimony before the Select Committee that you’re mentioning?

A: I am not -- I’m not -- you know, I can’t recall exactly, you know, if that’s the proper, you know, thing. It was something that was happening on the Thursday.
. . .

Q: Sorry. Just to follow up on that, I believe there was a hearing that Friday on July 31st.

A: Oh, okay. So yeah.

Q: At which Dr. Redfield testified before our committee. So is it possible that’s what was being referred to? That was -- that was Friday, July 31st at 9:00 a.m.

A: Possibly, yeah. Yeah. So, oh, that’s probably it.

Q: Okay. Thank you.

A: And then the report would be released afterward.

_______________

Notes:

1 See Trump Officials Interfered with CDC Reports on Covid-19, Politico (Sept. 12, 2020) (online at http://www.politico.com/news/2020/09/11 ... -19-412809) (quoting from August 8, 2020, email from Dr. Alexander).

2 Transcribed Interview of Dr. Charlotte Kent (Dec. 7, 2020).

3 Id.

4 See 44 U.S.C. §§ 3101-3107 (Chapter 31, Records Management by Federal Agencies); 44 U.S.C. §§3301-3314 (Chapter 33, Disposal of Records); and 36 C.F.R., Chapter XII, Subchapter B (Records Management).The definition of “records” includes emails. See 44 U.S.C. § 3301(a)(2) (defining “records” as inclusive of “all traditional forms of records, regardless of physical form or characteristics, including information created, manipulated, communicated, or stored in digital or electronic form”).

5 18 U.S.C. § 2071.

6 Email from Charlotte Kent, Chief of the Scientific Publications Branch, Centers for Disease Control and Prevention, to Michael Iademarco, Director of the Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (July 28, 2020) (online at coronavirus.house.gov/sites/democrats.coronavirus.house.gov/files/SSCCManual-000059-61_Redacted.pdf).

7 Transcribed Interview of Dr. Charlotte Kent (Dec. 7, 2020).

8 Select Subcommittee on the Coronavirus Crisis, Hearing on “The Urgent Need for a National Plan to Contain the Coronavirus” (July 31, 2020) (online at coronavirus.house.gov/subcommittee-activity/hearings/hybrid-hearing-urgent-need-national-plan-contain-coronavirus).

9 Christine M. Szablewski, et al., SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp — Georgia, June 2020, Morbidity and Mortality Weekly Report (Aug. 7, 2020) (online at http://www.cdc.gov/mmwr/volumes/69/wr/m ... mm6931e1_w).

10 Centers for Disease Control and Prevention, Media Statement: Study Highlights Importance of CDC Mitigation Strategies (July 31, 2020) (online at stacks.cdc.gov/view/cdc/91341) (noting that CDC’s media statement concerning the MMWR article was “Embargoed until: Friday, July 31, 2020, 1 p.m. ET”).

11 Letter from Chairman James E. Clyburn, Select Subcommittee on the Coronavirus Crisis, et al. to Secretary of Health and Human Services Alex M. Azar II and Director Robert R. Redfield, Centers for Disease Control and Prevention (Sept. 14, 2020) (online at coronavirus.house.gov/sites/democrats.coronavirus.house.gov/files/2020-09-14.Majority%20to%20Azar%20and%20Redfield%20re%20HHS%20and%20CDC%20on%20Political%20Interference%20.pdf).

12 Letter from Chairman James E. Clyburn, Select Subcommittee on the Coronavirus Crisis, to Secretary of Health and Human Services Alex M. Azar II (Sept. 22, 2020) (online at coronavirus.house.gov/sites/democrats.coronavirus.house.gov/files/2020-09-22.Clyburn%20to%20Azar%20re%20HHS%20TIs%20.pdf).

13 Select Subcommittee on the Coronavirus Crisis, Hybrid Hearing with Secretary of Health and Human Services Alex M. Azar II (Oct. 2, 2020) (online at coronavirus.house.gov/subcommittee-activity/hearings/hybrid-hearing-secretary-health-and-human-services-alex-m-azar-ii).

14 Letter from Chairman James E. Clyburn, Select Subcommittee on the Coronavirus Crisis, to Secretary of Health and Human Services Alex M. Azar II (Oct. 22, 2020) (online at coronavirus.house.gov/sites/democrats.coronavirus.house.gov/files/2020-10-22.Clyburn%20to%20Azar%20re%20TIs%20.pdf).

15 Email from Staff, Department of Health and Human Services, to Staff, Select Subcommittee on the Coronavirus Crisis (Oct. 29, 2020).

16 Email from Staff, Department of Health and Human Services to Staff, Select Subcommittee on the Coronavirus Crisis (Dec. 7, 2020). HHS counsel claimed that the basis for this sudden cancellation was that Select Subcommittee staff counsel asked the witness whether, in addition to being instructed to delete a key email, she was instructed by anyone to withhold other information from Congress. Instructing an agency employee to obstruct a congressional matter is highly inappropriate, potentially illegal, and not protected by any valid privilege. The Select Subcommittee has a strong interest in understanding whether agency officials are instructing employees to obstruct this investigation, especially in light of Dr. Kent’s statement that she was directed to delete a document that was subsequently withheld from the Select Subcommittee.

17 Letter from Chairman James E. Clyburn, Select Subcommittee on the Coronavirus Crisis, et al., to Secretary of Health and Human Services Alex M. Azar II and Director Robert R. Redfield, Centers for Disease Control and Prevention (Sept. 14, 2020) (online at coronavirus.house.gov/sites/democrats.coronavirus.house.gov/files/2020-09-14.Majority%20to%20Azar%20and%20Redfield%20re%20HHS%20and%20CDC%20on%20Political%20Interference%20.pdf).

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Interim Staff Report: INEFFICIENT, INEFFECTIVE, AND INEQUITABLE: The Trump Administration's Failed Reponse to the Coronavirus Crisis
As New Cases Skyrocket, Report Finds Response is Among the ‘Worst Failures of Leadership in American History’
by Select Subcommittee on the Coronavirus Crisis
October, 2020

PDF HERE:

TABLE OF CONTENTS

• EXECUTIVE SUMMARY
• THE TRUMP ADMINISTRATION'S FAILED RESPONSE TO THE PANDEMIC CAUSED A PUBLIC HEALTH CATASTROPHE
o The President Downplayed the Crisis, Contradicting Internal White House Reports
o Political Appointees Have Improperly Interfered in the Nation's Public Health Response More Than 60 Times
o The Trump Administration’s $765 Million Loan to Kodak
o The Administration Has Failed to Address Conflicts of Interest in Vaccine Development
o The Administration and Some States Have Not Done Enough to Help Americans Vote Safely During the Pandemic
• THE TRUMP ADMINISTRATION FAILED TO PROTECT MILLIONS OF AMERICANS IN FINANCIAL DISTRESS
o Treasury and IRS Delayed Delivery of Economic Impact Payments to Nine Million Americans
o The Administration Has Not Provided Critical Housing Protections to Struggling Americans
• THE TRUMP ADMINISTRATION PRIORITIZED WALL STREET OVER MAIN STREET AND LEFT FEDERAL RELIEF PROGRAMS VULNERABLE TO FRAUD
o Treasury and SBA Neglected Underserved Communities and Allowed Billions of Dollars in Potential Fraud in the Paycheck Protection Program
o Fed and Treasury Lending Facilities Prioritized Big Corporations and Investors Over Small Businesses, Workers, and States
o The Administration Weakened the Payroll Support Program, Allowing Thousands of Aviation Workers to Lose Their Jobs
• APPENDIX A: KEY SELECT SUBCOMMITTEE ACTIONS
• APPENDIX B: THE TRUMP ADMINISTRATION'S PATTERN OF POLITICAL INTERFERENCE
• ENDNOTES

EXECUTIVE SUMMARY

The Select Subcommittee on the Coronavirus Crisis was established by the House of Representatives on April 23, 2020. Modeled after the Truman Committee that saved lives and taxpayer dollars by preventing waste, fraud, and abuse during World War II, the panel is charged with investigating the effectiveness, efficiency, and equity of the nation’s response to the public health and economic crises caused by the coronavirus pandemic.1

This report describes some of the Select Subcommittee’s key findings during its first six months. In that time, the Subcommittee launched 30 investigations—many of them ongoing— sent more than 120 letters, and reviewed hundreds of thousands of pages of documents. The Subcommittee held 15 public hearings and briefings with senior Administration officials, experts in public health and economics, and Americans personally impacted by the pandemic. The Subcommittee also published seven staff reports detailing its initial findings.

The Select Subcommittee’s findings demonstrate that the Trump Administration’s response to the coronavirus pandemic is among the worst failures of leadership in American history. The virus is a global scourge, but it has been an American fiasco, killing more people in the United States than in any other country. President Trump’s decision to mislead the public about the severity of the crisis, his failure to listen to scientists about how to keep Americans healthy, and his refusal to implement a coordinated national plan to stop the coronavirus have all contributed to devastating results: more than 227,000 Americans dead, more than 8.8 million Americans infected, and a dangerous virus that continues to spread out of control nine months after it reached our nation’s shores.

The Trump Administration’s failure to contain the coronavirus also exacerbated and extended an economic collapse of historic proportions, with tens of millions of Americans losing their jobs and at least six million Americans falling into poverty. The Administration’s response to this economic crisis has benefited larger companies and wealthy Americans, while leaving behind many disadvantaged communities and struggling small businesses. The Administration’s implementation of relief programs passed by Congress has also been marred by fraud, waste, and abuse. As described below and in Appendix A, the Select Subcommittee’s investigations identified more than $4 billion in potential fraud in small business programs, led the Administration to halt a potentially wasteful $765 million loan, and returned more than $100 million in taxpayer dollars to the U.S. Treasury.

The Trump Administration’s Failed Response to the Pandemic Caused a Public Health Catastrophe

As of October 28, 2020, more than 227,000 Americans have died from the coronavirus, and 8.8 million have been infected.2 The coronavirus is set to be the third-highest cause of death in the United States this year, behind only heart disease and cancer.3 The country appears to be entering a third wave of the crisis, with cases on the rise in 45 states. Hospitalizations are up 46 percent in the past month, with more than 43,000 Americans currently hospitalized with the coronavirus.4 The nation hit a single-day record of more than 85,000 new cases on October 23, 2020.5 Experts predict another 90,000 Americans are likely to die from the virus before the end of 2020.6

The United States has the highest number of cases and highest number of deaths from the coronavirus of any country in the world.7 It has fared worse than most other countries, even when accounting for differences in population size. The United States has the eleventh highest per capita coronavirus death rate among 168 countries reporting cases.8

The loss of life from the coronavirus—more American deaths than the battles of World War I, the Korean War, Vietnam War, Afghanistan War, and Iraq War combined9—could have been significantly reduced by an effective federal response. Instead, as described in Part I of this report, the Select Subcommittee’s investigations show that the Trump Administration downplayed the threat of the virus and undermined the nation’s public health:

• The Trump Administration Refused to Take Responsibility and Implement a National Plan to Defeat the Virus. At the Select Subcommittee’s first public briefing in May 2020, top scientific experts—including a former Food and Drug Administration (FDA) Commissioner appointed by President Trump—urged the Administration to develop and implement a coordinated national strategy to respond to the crisis.10 Since then, the Select Subcommittee has held three more public hearings to call on the Administration to implement a national plan on testing, contact tracing, public health measures, and protective equipment.11 Yet the Administration has refused to lead, pushing the burden to state and local governments instead. At a July 31, 2020, Select Subcommittee hearing, Dr. Anthony Fauci testified that the government’s failed response led the United States to have a far worse virus outbreak than in Europe.12 On October 2, 2020, Secretary of Health and Human Services Alex Azar shrugged off the Administration’s failed leadership, telling the Subcommittee, “We wish we didn’t have this unprecedented coronavirus pandemic but people do die in pandemics,” and saying: “The disease spreads. It’s dependent on all of us acting with individual responsibility.”13

• The President Downplayed the Crisis, Contradicting Internal White House Reports. Since June 2020, the White House Coronavirus Task Force has privately sent weekly reports to states that track the growing outbreak and urge swift action to contain the virus. These private reports contradict the rosy public statements from the President, Vice President, and other political appointees. The Select Subcommittee released 14 weeks of these private reports, which show that the number of states in the “red zone” due to severe outbreaks grew from seven states on June 23, 2020, to 31 states on October 18, 2020. The reports also show that all 50 states need to do more testing to contain the virus—contrary to the President’s efforts to “slow the testing down.” 14 The Select Subcommittee also found that after months of political pressure from President Trump, the Task Force weakened some public health recommendations, including calls for mask mandates in certain states.15

• Political Appointees Have Improperly Interfered in the Nation’s Public Health Response More Than 60 Times. The Select Subcommittee has identified at least 61 instances in which Trump Administration officials injected politics into public health decisions. As shown in Appendix B, President Trump and others in his Administration engaged in a persistent pattern of political interference, repeatedly overruling and sidelining top scientists and undermining Americans’ health to advance the President’s perceived political interests. These incidents degraded efforts to provide Americans access to testing and protective equipment, develop treatments and vaccines, and provide scientifically sound public health advice. The Subcommittee’s investigations led the Administration to reverse some of these actions, including correcting inaccurate Centers for Disease Control and Prevention (CDC) guidance on testing, removing senior appointees from the Department of Health and Human Services (HHS) who tried to alter accurate scientific reports, and committing to revise CDC school reopening guidance that does not reflect the best science.16

• The Administration Directed Funding for Critical Supplies, Often Without Competition, to Companies that Have Political Connections, Lack Experience, and Failed to Perform. The Select Subcommittee is investigating questionable contracts and loans that may be hindering the nation’s ability to quickly produce and distribute protective equipment and other supplies needed to contain the virus. In August 2020, the Subcommittee launched an investigation into a planned $765 million loan to the Eastman Kodak Company (Kodak) to produce pharmaceutical ingredients—even though the company lacked any pharmaceutical experience and its executives and directors reaped huge stock windfalls before the deal was announced.17 The Trump Administration put the loan on hold after the investigation was announced, potentially saving taxpayers three-quarters of a billion dollars.18 The Subcommittee is also investigating other multimillion contracts that four federal agencies issued to seven different contractors that raise significant red flags.19

• The Administration Has Failed to Address Conflicts of Interest in Vaccine Development. The Select Subcommittee launched an investigation into potential conflicts of interest among scientific advisors to Operation Warp Speed (OWS), the Administration’s program to develop and manufacture coronavirus vaccines and treatments. The Select Subcommittee’s investigation revealed that top advisors to this project have potential conflicts of interest—including financial interests in companies being funded by the federal government to develop vaccines—that do not appear to be resolved.20

• The Administration and Some States Have Not Done Enough to Help Americans Vote Safely During the Pandemic. Problems during the 2020 primary elections— including closed polling places, long lines, and poll worker shortages—highlighted the risk that some states were not prepared to carry out a free, fair, and safe general election during the pandemic. The Select Subcommittee investigated impediments to voting during the pandemic in four states: Florida, Georgia, Texas and Wisconsin. The Subcommittee found that voters in these states may face long lines and limited polling places and urged swift state action and federal financial support.21

The Trump Administration Failed to Protect Millions of Americans in Financial Distress

The nation’s economic crisis is a direct result of the ongoing public health crisis, and the Trump Administration’s failures to contain the coronavirus made the economic crisis more severe and protracted. On September 23, 2020, Federal Reserve (Fed) Chairman Jerome Powell testified before the Select Subcommittee that “the path of the economy is going to depend on our ability to retain control, to get control of the virus and keep control.”22

The economic contraction has taken a heavy toll on American workers and families. Since February 2020, the economy has lost $16 trillion due to lost economic output, premature deaths, and health impairments caused by the pandemic.23 More than 60 million unemployment claims have been filed—more than at any other time in American history.24 Since May, between six and eight million Americans have fallen into poverty.25 In October, 12 percent of households with children did not have enough food to eat in the last week.26 At least one-third of adults are concerned that “eviction or foreclosure in the next two months is either very likely or somewhat likely.”27 The job losses from the coronavirus pandemic have disproportionately impacted minority communities and workers earning lower wages, resulting in the most unequal recession in modern U.S. history.28

As described in Part II of this report, the Select Subcommittee’s investigations reveal how the Trump Administration’s response to this crisis has often failed to help the most vulnerable Americans:

• The Treasury Department and Internal Revenue Service Delayed Delivery of Economic Impact Payments to Nine Million Americans. In the Coronavirus Aid, Relief, and Economic Security (CARES) Act, Congress provided for Economic Impact Payments (EIPs) of up to $1,200, but nine million disproportionately low-income Americans were still waiting to receive their checks in September—more than six months after the CARES Act was enacted. In response to the Select Subcommittee’s investigation and repeated follow-up efforts, Treasury and IRS admitted these EIPs were still outstanding,29 sent notices to the nine million Americans waiting for their checks, and extended the deadline for them to claim their EIPs.30

• The Administration Has Not Provided Critical Housing Protections to Struggling Americans. Following the expiration of the CARES Act eviction moratorium and enhanced unemployment benefits in late July 2020, millions of Americans have faced the danger of losing their homes. The Select Subcommittee obtained data showing that in August 2020, more than 31,000 homeowners were over 60 days delinquent on their federally backed mortgage but had not received forbearance and therefore could be at risk of foreclosure in January 2021. This data also shows lower-income borrowers were less likely that those with higher incomes to get forbearance. The Subcommittee has urged the Federal Housing Finance Agency (FHFA) to provide automatic forbearance to homeowners who miss two or more payments.31

• The Administration Refused to Extend Enhanced Unemployment Insurance, Hurting the Economy. At a Select Subcommittee’s hearing in July 2020, Former Fed Chair Janet Yellen testified that failure to extend the enhanced federal jobless benefits from the CARES Act “would be a catastrophe.”32 Yet the Trump Administration refused to agree to comprehensive legislation extending the benefits before they expired on July 26, 2020.33 In October 2020, unemployment remained unacceptably high, and a growing number of people have been unemployed for more than six months.34

The Trump Administration Prioritized Wall Street Over Main Street and Left Federal Relief Programs Vulnerable to Fraud

Congress enacted relief programs to support Americans workers and small businesses during the pandemic. These programs, many of which have now expired, were critical in preventing the economic crisis in Spring and Summer 2020 from getting even worse. Yet, as described in Part III of this report, the Select Subcommittee’s investigations show that the Trump Administration weakened these programs by prioritizing larger and wealthier businesses over truly struggling small businesses, exacerbating inequity in the economic downturn. The Administration also failed to institute adequate financial controls, leading to significant fraud, waste, and abuse.

• Treasury and the Small Business Administration Neglected Underserved Communities and Allowed Billions of Dollars in Potential Fraud in the Paycheck Protection Program. The Select Subcommittee’s investigation found that Treasury and SBA ignored the CARES Act’s call to issue guidance to prioritize small businesses in underserved markets, including minority and women-owned businesses.35 Documents obtained by the Select Subcommittee show that Treasury privately encouraged banks to limit their Paycheck Protection Program (PPP) lending to existing customers, thereby excluding many minority-owned businesses who were less likely to have existing banking relationships.36 The Administration also failed to implement robust fraud controls, and a Subcommittee analysis identified more than 22,500 loans worth $4 billion that may have been subject to fraud.37

• The Fed Bought Corporate Bonds Issued by Large Companies that Laid Off or Furloughed More Than a Million Workers—and Sent Billions of Dollars to Shareholders. During the pandemic, the Fed—for the first time in its history—directly purchased corporate debt.38 This action lowered the cost of raising capital for large corporations, leading to record bond issuances.39 But the Fed failed to protect workers at these companies. The Select Subcommittee found the Fed bought bonds issued by companies that laid off or furloughed more than one million workers between March and September 2020, and from 383 companies that issued dividends to shareholders during the pandemic.40

• The Fed’s Programs to Help Smaller Businesses and States Were Not Effective. The Fed set up the Main Street Lending Program to help small and medium-sized businesses but set restrictive terms that drastically limited the program’s usefulness. The program has $600 billion in lending capacity, but the Fed has issued just 252 loans totaling less than 0.4 percent of available capital.41 The Fed’s Municipal Liquidity Facility failed to deliver relief to state and local governments, issuing only two notes totaling $1.7 billion out of the available $500 billion,42 largely because of onerous interest rates and a short repayment period.43 Large corporations are awash in cheap credit, but cities, states, and small businesses—which employ tens of millions of Americans and provide critical services—continue to struggle.44

• The Administration Weakened the Payroll Support Program, Allowing Thousands of Aviation Workers to Lose their Jobs. Congress created the Payroll Support Program (PSP) to “preserve aviation jobs,” but the Select Subcommittee’s investigation found that the Trump Administration weakened the program by delaying funding, allowing companies to conduct massive layoffs while their applications were pending without losing any funding, and failing to impose a deadline to spend PSP funds. Treasury permitted aviation contractors to lay off or furlough more than 16,500 workers before receiving funding.45 As a result of the Select Subcommittee’s inquiries, four aviation contractors committed to preserve over 30,000 jobs until their PSP funding is exhausted.46

This report identifies several recommendations to address the Select Subcommittee’s preliminary findings and improve the Administration’s failed response to the pandemic. Four elements are critical: (1) the federal government needs a coordinated national plan to defeat the coronavirus, save American lives, and revive our economy; (2) this plan must be guided by the best available science, not political expediency; (3) Americans need Congress to pass and the President to sign comprehensive relief legislation to tackle the virus and support workers, families, and communities; and (4) economic relief legislation must be implemented in a manner consistent with Congress’s intent to target assistance to the most vulnerable Americans rather than wealthy corporations.

[admin]

Why Covid Numbers Will Get Worse Even With The Vaccines--A Surgeon Explains
by Duc C. Vuong
Dec 22, 2020

[admin]

Why Vaccines Won’t "Keep" You From Catching COVID--A Surgeon Explains It Easily
by Duc C. Vuong
Dec 25, 2020

[admin]

The New UK Coronavirus Strain Is Already In The USA--A Surgeon Explains Why
by Duc C. Vuong
Dec 23, 2020



The new UK strain is already in the United States. I promise you, they just haven't found it yet. Okay?

Now what happens when we combine a much more virulent strain PLUS the American "attitude"? And I'll finish it with that number 10.

This new, more virulent UK strain + American "attitude" + Christmas = Disaster.

I've been telling you guys that the peak is coming in mid-January and it's going to be awful. If you didn't see my video yesterday, 4-5 million Americans traveled for Thanksgiving. For Christmas it's predicted that 85 million Americans are going to travel for the holidays. We see what's happening with Thanksgiving service now. 2-3 weeks from now it's going to be a shit-show! A disaster! PLUS this new, more virulent strain is here in the United States, they just haven't told you. Y'all don't know about it. You know about it because you heard it from me. That's it.

[admin]

Long haul COVID-19 victims experiencing bizarre symptoms after recovery
by 60 Minutes Australia
Sep 20, 2020



9:03



[Alyssa Milano] Hi, everybody. I just wanted to show you the amount of hair that's coming out of my head as a result of COVID.

[60 Minutes] Alyssa Milano is one of the every-growing cohort of Coronavirus survivors being crippled by the conditions and unexpected aftereffects.

[Alyssa Milano] This is my hair loss from COVID19.

[60 Minutes] It's come as a total surprise to the actress who up until recently had lived a charmed life. But this is the 47-year-old in April, struggling to breathe, fearing she was about to die. Alyssa says that while she's since tested positive to coronavirus antibodies, hospitals in the U.S. were simply too overwhelmed to treat her properly at the time.

[Alyssa Milano] This is not a flu. I have never been sick like this in my life. It's very weird, because it literally feels like its' moving throughout your body. I get panicky just even thinking that I went through that in those nights where I couldn't breathe.

The COVID-19 pandemic is a wake-up call.

[60 Minutes] Like so many coronavirus sufferers, Alyssa discovered that when you're supposed to have recovered, things can actually get worse. And she's been documenting the ongoing side effects, like hair loss in online video diaries

[Alyssa Milano] Wear a damn mask!

[60 Minutes] Was it hard for you to make that video, because I'd imagine part of you doesn't want anyone to see you looking like that.



[Alyssa Milano] It was hard, but I think you could tell that I'm kind of defiant in it. I just watched it recently and I was like, "Whoa, I seem pretty pissed." And I think it's about so many months we did not take this seriously in the United States, and I think a lot of personal stories are good, because we're writing these textbooks as we're going along. Right? Like people weren't talking about hair falling out in clumps three weeks ago before I made that video.

[60 Minutes] It's not just about hair loss though. Almost every aspect of Alyssa's life has suffered.

[Alyssa Milano] I have heart palpitations, muscle fatigue, my hair is falling out, and I think the hardest one for me, my brain is usually very quick, is I have this brain fog, and I lose track of my words. It could be a word like "coffee", and it'll just disappear for me. It is a really hard illness.

[60 Minutes] Is part of you scared that all these months on now that you might never recover fully from COVID=19?

[Alyssa Milano] Yes. For sure. And all of my friends that have had this, there's not anyone that is not a long hauler. No one has recovered completely from this that I know.

Day 55: Fatigue, chest pain, sick of being sick!
Day 144: Debilitating fatigue, shortness of breath, bitter taste, chills, ear pain
Day 95: Extreme muscle pain
Day 92: Chest pain and headache
Dizziness, nausea, stomach pain, fatigue, tinnitus, joint pain, muscle pain, night sweats, headaches, brain fog
Day 104: Fatigue, abdominal pain, nausea, muscle pain, blurred vision, severe acid reflux, chest pain, brain fog, headaches, shortness of breath #HELP
Day 90: Extreme fatigue, persistent headaches, muscle fatigue
Day 84: Fatigue, shortness of breath, pulsating headaches, fever, pins and needles
Day 61: Breathlessness/shortness of breath, severe joint and muscle pain
Day 56: Chest pain, fatigue, pins & needles, joint & muscle pain, headaches, chills & sweats, shortness of breath, numbness, excessive thirst, brain fog, and more!
Day 101: Tachycardia, shortness of breath, chest pain, headaches/dizziness

[admin]

A Massachusetts Republican Party leader says he thinks he got COVID-19 at a White House Hanukkah event
by Kelly McLaughlin
12/29/20

NOTICE: THIS WORK MAY BE PROTECTED BY COPYRIGHT

YOU ARE REQUIRED TO READ THE COPYRIGHT NOTICE AT THIS LINK BEFORE YOU READ THE FOLLOWING WORK, THAT IS AVAILABLE SOLELY FOR PRIVATE STUDY, SCHOLARSHIP OR RESEARCH PURSUANT TO 17 U.S.C. SECTION 107 AND 108. IN THE EVENT THAT THE LIBRARY DETERMINES THAT UNLAWFUL COPYING OF THIS WORK HAS OCCURRED, THE LIBRARY HAS THE RIGHT TO BLOCK THE I.P. ADDRESS AT WHICH THE UNLAWFUL COPYING APPEARED TO HAVE OCCURRED. THANK YOU FOR RESPECTING THE RIGHTS OF COPYRIGHT OWNERS.

The vice chairman of the Massachusetts Republican State Committee is recovering from COVID-19, which he says he likely contracted at a White House Hanukkah party earlier this month.

Tom Mountain, who was hospitalized and almost put on a ventilator after testing positive for COVID-19, told WJAR that while it's impossible to know exactly where he contracted the virus, he tested positive three days after going to the December 9 Hanukkah party.

"Lets put it this way: When I went down to Washington, DC, for the White House Hanukkah event, I was perfectly fine," 60-year-old Mountain, from Newton, Massachusetts, said. "And three days later after that event, I was in the hospital at Brigham and Women's ready to be put on a lifesaving ventilator."

The White House Hanukkah party was one of at least 25 indoor holiday celebrations held this year, according The Washington Post, and Mountain shared photos with WJAR showing him posing for a maskless photo during the event.

At the time of the party, public health officials were urging people not to gather for parties and celebrations over concerns that gatherings could spread COVID-19.

"I was one of the naysayers," Mountain told WJAR. "I am no longer a naysayer."

Mountain, who attended the event to represent the Massachusetts Republican Jewish Committee and wore a "Trump" jacket, said more than 100 people attended the three-hour party in Washington, DC, including President Donald Trump.

"People would just leisurely and gingerly take off their mask to mingle, to schmooze. I don't even think some people wore masks the entire time," he said. "And again, I was guilty as anyone else. I just wasn't wearing a mask."

Mountain told WJAR that after he tested positive for COVID-19, at least four of his immediate family members also contracted the virus.

He told The Boston Globe that weeks after contracting the virus, he's still experiencing some COVID-19 symptoms, including a cough.

The White House did not immediately respond to Insider's request for comment.

***


[MSNBC] Given what you've been through, and knowing what you know now -- of course, New Year's Eve is coming up -- what's your message about gatherings, people coming together?

[Tom Mountain] Wear a mask. Stay as far away from people as possible.

[admin]

“Say Her Name: Dr. Susan Moore.” Black Female Doctors Condemn Racial Disparities in Healthcare
by Amy Goodman
DemocracyNow.org
DECEMBER 30, 2020

NOTICE: THIS WORK MAY BE PROTECTED BY COPYRIGHT

YOU ARE REQUIRED TO READ THE COPYRIGHT NOTICE AT THIS LINK BEFORE YOU READ THE FOLLOWING WORK, THAT IS AVAILABLE SOLELY FOR PRIVATE STUDY, SCHOLARSHIP OR RESEARCH PURSUANT TO 17 U.S.C. SECTION 107 AND 108. IN THE EVENT THAT THE LIBRARY DETERMINES THAT UNLAWFUL COPYING OF THIS WORK HAS OCCURRED, THE LIBRARY HAS THE RIGHT TO BLOCK THE I.P. ADDRESS AT WHICH THE UNLAWFUL COPYING APPEARED TO HAVE OCCURRED. THANK YOU FOR RESPECTING THE RIGHTS OF COPYRIGHT OWNERS.

GUESTS:
Dr. Joia Crear-Perry, president of the National Birth Equity Collaborative.
Dr. Camara Phyllis Jones: family physician, epidemiologist and past president of the American Public Health Association. She teaches at the Rollins School of Public Health at Emory University and at the Morehouse School of Medicine.

When Black doctor Susan Moore died from COVID-19 after posting a video from her hospital bed describing racist treatment by medical staff, her chilling message was compared to the video of George Floyd begging for his life as he was killed by Minneapolis police. We speak to two leading Black women doctors fighting racial disparities in healthcare who wrote The Washington Post opinion piece, “Say her name: Dr. Susan Moore.” “It is a typical and ongoing devaluation of our lives and distrust of our word,” says Dr. Camara Phyllis Jones, a family physician and former president of the American Public Health Association. Dr. Joia Crear-Perry, president of the National Birth Equity Collaborative, says Dr. Moore’s complaints about being disrespected by medical staff are “really familiar” to her. “We’ve found that Black patients, Black birthing people are not valued; they’re not listened to,” she says.

Transcript

This is a rush transcript. Copy may not be in its final form.
AMY GOODMAN: This is Democracy Now!, democracynow.org, The Quarantine Report. I’m Amy Goodman.

As we just reported, the death of a Black doctor from COVID-19 is shining stark new light on racism in medical care and how the virus is devastating Black communities. The Centers for Disease Control and Prevention reports Black and Latinx people are dying of COVID-19 at a rate almost three times that of white Americans.

Earlier this month, Dr. Susan Moore posted this now-viral video on Facebook describing racist treatment by medical staff who did not respond to her pleas for care, despite being in intense pain and being a doctor herself. She said in the video, “This is how Black people get killed.”

For more, we’re joined by two of the Black female physicians who wrote a Washington Post opinion piece headlined “Say her name: Dr. Susan Moore.” In it, they write, quote, “If anyone knew how to fight for herself, it would have been Moore. Still, she was sent home. Less than three weeks later, she was dead. … The deaths of [Mr.] George Floyd and so many others mistreated, injured or killed at the hands of our policing system have made us accustomed to seeing the video. But injustice in health care is rarely broadcast from cellphone videos or shared for thousands to witness,” they said.

Joining us in Atlanta is Dr. Camara Phyllis Jones, family physician, epidemiologist, past president of the American Public Health Association. She teaches at Emory Rollins School of Public Health and the Morehouse School of Medicine in Atlanta, Georgia. And in Washington, D.C., Dr. Joia Crear-Perry is with us, president of the National Birth Equity Collaborative.

We welcome you both to Democracy Now! Seeing that video that we just played of Dr. Susan Moore, she said, “I put forth, and I maintain: If I was white, I wouldn’t have to go through that.” Dr. Camara Phyllis Jones, if you would first talk about your response when you saw this heartbreaking, enraging video that Dr. Moore made from her hospital bed just before she died?

DR. CAMARA PHYLLIS JONES: Well, first of all, hearing it again is making me tense. She was fighting for her life. Many patients know that they’re not getting — they feel a little devalued. But she knew exactly what she should have gotten, and so she knew exactly how bad the treatment was. And so, here she was, calling out racism.

And the people there were intimidated, they said, in later statement, intimidated by her, intimidated by her asking to be valued for her own full humanity. Since when do we have to diminish ourselves and hope for scraps of care?

So I was angry then. I’m angry now. It’s another — just another naming of racism in this racist society. So, racism is not limited to healthcare. It’s not limited to policing. It’s in education. It’s in housing. It’s everywhere. It’s woven throughout the fabric of this nation. It’s foundational in our history.

AMY GOODMAN: Dr. Jones, Dr. Moore described how a white doctor questioned the veracity of her pain. Dr. Moore said the doctor, quote, “made me feel like I was a drug addict,” and, quote, “he did not even listen to my lungs. He didn’t touch me in any way.” Respond.

DR. CAMARA PHYLLIS JONES: So, that also is typical. We know, historically, there are these ideas of biological differences between the races, which do not exist. We have mapped the human genome. There is no basis in the human genome for biological subspecies. But people have — since Marion Sims experimented and perfected his surgical techniques on enslaved women without using anesthesia, up to the neglect of people with sickle cell anemia, when they come in with pain and are disbelieved or undertreated, or people with kidney stones, it is a typical and ongoing devaluation of our lives and distrust of our word.

AMY GOODMAN: So, let me bring Dr. Joia Crear-Perry into this conversation, president of the National Birth Equity Collaborative. Can you talk about both Dr. Moore saying that she felt like they were treating her as a drug addict instead of a doctor, even though they knew she was a fellow physician — and it shouldn’t take that — and what that means in your profession, and what you see, the fact that African Americans, like Dr. Moore, are dying at an astronomical rate of COVID-19? Already the country is in — across the country, people are dying, the worst record for deaths in the world, but the African American community is particularly hard hit.

DR. JOIA CREAR-PERRY: Yeah. Thank you so much.

Every time I hear the video, it saddens me again. It feels really familiar. The work that we do with the National Birth Equity Collaborative, working on Black maternal health, we found that Black patients, Black birthing people are not valued; they’re not listened to. So it felt very familiar, because I’ve heard it many, many times. If you see the stories over the last few years around the fact that we’re three to four times more likely to die in childbirth than our white counterparts — in places like New York City, eight to 10 times more likely to die — she is explaining to us how that happened.

When you come to a place and people do not evaluate you for your pain, they don’t believe you — you have to have a CAT scan to prove that you have pain? That doesn’t seem logical to most providers, that if you were to come in, that’s actually — we complain about expending too much money in healthcare. That was a wasted resource. You don’t need to get a CAT scan to prove pain. That’s not something that we normally do. We only do that to Black patients, to patients we don’t believe, to Brown patients, to Indigenous folks, when we say, “Well, you’ve got to prove pain, because you’re superhuman.”

That goes also back to what Dr. Jones was talking about, this legacy and this history of a belief in a biological basis of race. They’ve done studies to prove that medical students believe we have thicker skin — medical students. And I’m not saying that we’re picking on the medical students, because they’re being taught by deans and professors who are saying things like Black people have thicker skin. I mean, I was taught in my own medical school in the late 1990s, which is not that long ago, that there were three biological races: Mongoloid, Caucasoid and Negroid. So, that belief and that language that there’s a biological reason that we don’t feel pain and that we’re superhuman and that we’re —

And it’s also — it’s interesting to see that she was fighting for herself. She knew the right words. He even threatened her. You hear her. She said, “I’ll put you out at 10:00 at night.” We’ve seen those kind of things happen, where we tell patients, “If you don’t act right, I’m not going to give you this epidural.” Right? This threatening around “If you don’t behave the way I want you to behave, I will then punish you, because you’re asking to be valued and not to be in pain. You’re asking for things that are basic human needs, and therefore I don’t think you deserve those things, so let me punish you for even asking to be seen as human.”

AMY GOODMAN: So, in the piece that the four of you wrote, all African American women doctors, in The Washington Post, you compare the death of Dr. Susan Moore with the police killing of George Floyd. Dr. Joia Crear-Perry, you are not only a doctor in the hospitals of this country, but you were in the streets protesting George Floyd’s death. Can you talk about what you see is the connection?

DR. JOIA CREAR-PERRY: Well, there’s an overriding, -arching policing of Blackness. It was in law from the beginning. If you think about like after Reconstruction, we were — that people were told that they should make sure that Black folks don’t go into certain neighborhoods. They were not allowed, refused. To catch a slave running away.

You see these videos of even like recently: In New York City, a woman saw her phone was missing, and she assumed that a Black child had taken it, and went to attack the child, and felt that she had perfect permission as a white woman to attack a 14-year-old child, assuming that they had stolen her phone.

So, that belief that we’re supposed to be policed and organized and planned and controlled is embedded in policing and in healthcare. How we police women’s bodies — and it’s women plus being Black, both things, gendered racism, together — really gets the outcomes that we see, so that throughline.

I don’t want us to blame — and sometimes we’ll focus on the doctor who took care of Dr. Moore in Indiana. And yes, perhaps he should get some kind of accountability for his individual behavior. But the structure, the structural racism, is the undergirding of both our police system and our healthcare system, the belief in needing to control, the belief in needing to not value, to not listen to people, that we’re not having a co-created patient plan.

When we talk about patients, we say things like we want to have — co-create it, and we want to make sure that we have shared decision-making. If you don’t believe in the person that you’re sharing this decision-making with, if you think that they are not fully capable and not fully human, then there’s never really any shared decision-making. It’s authoritarian. And so, that’s the same thing that happens in policing.

So, if we are going to undo the racism that’s in this country, we have to start first with some truth, some historical truth about how we got here and some current truth about what happens today.

So, Dr. Susan Moore’s video gives us a — just the same way that George Floyd’s video did, we’re not just looking at numbers or data. We actually see the people who are being murdered, who are dying, hear their stories, see them as fully human and say, “Why would we ever do that to any human being ever? Don’t we want all people to have justice and joy? Don’t we want them all to be able to thrive?” We wanted George Floyd to still be here, and we also want Dr. Susan Moore to still be here. So how do we use their history and their legacy to build a better world for all of us?

AMY GOODMAN: On Tuesday, Vice President-elect Kamala Harris received a COVID-19 vaccination on live TV at the United Medical Center in Washington’s predominantly Black Anacostia neighborhood.

VICE PRESIDENT-ELECT KAMALA HARRIS: I have now been vaccinated. As Joe likes to say, there’s a big difference between the vaccine and vaccinations. I want to encourage everyone to get the vaccine. It is relatively painless. It happens really quickly. It is safe, the Moderna, the Pfizer. Today, I had the Moderna vaccine. My husband is going to have it today, as well. I look forward to getting the second vaccine.

And literally, this is about saving lives. It’s literally about saving lives. I trust the scientists. And it is the scientists who created and approved this vaccine. So I urge everyone: When it is your turn, get vaccinated.

AMY GOODMAN: So, of course, the vice president-elect, Kamala Harris, will be the first African American and African American woman vice president in U.S. history. And she was injected by Patricia Cummings. She was vaccinated by this African American nurse, who is the daughter of Guyanese immigrants.

The significance, Dr. Camara Phyllis Jones, of seeing this image clearly in the Black community of Washington, D.C., being vaccinated by a Black woman, the Black woman vice president to be? The message that is being sent, as African Americans, studies show, are — perhaps 40% are now willing to get a vaccine? What do you think needs to be overcome for the Black community to feel more comfortable with this vaccine, given the history, you said, for example, of Marion Sims, considered the father of modern gynecology, experimenting on enslaved women?

DR. CAMARA PHYLLIS JONES: The first thing is that we don’t need to go out trying to convince people to get the vaccine. We need to honor and hear their questions, answer their questions. And in some cases, the answer to the question could be “I don’t know,” because there is a lot that we still don’t know about the long-term effects of the vaccine or the rare effects.

But I do have to say that when you look at the benefits and the risks, I have decided that when my turn in line comes, I will get the vaccine, because even though there is uncertainty — there are things that we don’t know, because the virus is new and the vaccine is newer. You know, we haven’t been studying it long, and we haven’t studied it in a whole lot of people. But we live with uncertainty in our lives. I am willing to live with the uncertainty associated with the vaccine, as opposed to dying with COVID-19, which is a much bigger risk. The whole issue is a risk-benefit analysis. Both the Pfizer and Moderna vaccines have shown themselves to be highly, highly effective.

So, what we need to do is not try to say, “Oh, those people, why don’t they just get over that history?” or, “Oh, those people, why do they have all these questions or this distrust?” First of all, we need to make sure that we evidence trustworthiness in all of our systems, going forward. Dr. Susan Moore’s example was not an example that engenders a feeling of, you know, trust, because the system was not trustworthy in her case. So, all of our systems, if we want to convince people to get the vaccine, have to evidence themselves to be trustworthy.

And we, as a nation, need to say, “We honor your lives, not just when you get the vaccine, but we honor your lives, and we’re going to provide the support you need to safely shelter in place. We are going to provide the regulations that the workplaces need, that if you have to go to work, they are safe workplaces. We’re going to provide you with the PPE that you need as a grocery clerk or as a bus driver or a warehouse worker to keep you safe.” It’s not just, “Oh, now that we have the vaccine, we want to convince you to take the vaccine, because, well, maybe we’re worried about herd immunity, and we’re really not worried about you at all, but, you know, to get to herd immunity, we need to do this.”

No, be trustworthy in all ways, and be about my people, my community, my health in all ways. That’s the evidence that is going to really convince people that, yes, maybe I should take the vaccine.

But I have to say, at the individual level right now, risk-benefit, I agree. I can live with the uncertainty, because these two vaccines, in particular, have shown themselves to be highly efficacious.

AMY GOODMAN: I want to put this question to Dr. Joia Crear-Perry. In 2018, tennis star Serena Williams and her husband, the Reddit co-founder, Alexis Ohanian, welcomed into the world their daughter, Alexis Olympia Ohanian Jr. The baby was born by an emergency C-section. Williams told Vogue magazine how she self-diagnosed a life-threatening emergency after giving birth. Shortly after delivering, the tennis star suddenly felt out of breath and assumed she was having a pulmonary embolism, given her history of blood clots.

I want to read from the 2018 piece in Vogue by Rob Haskell that describes Serena Williams’s birth experience: quote, “She walked out of the hospital room so her mother wouldn’t worry and told the nearest nurse, between gasps, that she needed a CT scan with contrast and IV heparin (a blood thinner) right away. The nurse thought her pain medicine might be making her confused. But Serena insisted, and soon enough a doctor was performing an ultrasound of her legs. 'I was like, a Doppler? I told you, I need a CT scan and a heparin drip,' she remembers telling the team. The ultrasound revealed nothing, so they sent her for the CT, and sure enough, several small blood clots had settled in her lungs. Minutes later she was on the drip. 'I was like, listen to Dr. Williams!'”

So, Dr. Joia Crear-Perry, you are president of the National Birth Equity Collaborative. Talk about the significance of what Serena Williams brought to life when it comes to postpartum deaths of African American women.

DR. JOIA CREAR-PERRY: Thank you. You know, I also want to show the throughline between Dr. Susan Moore and Serena Williams. Both of them are experts on their body, and they were seen as not experts, right? They both said, “This is what’s happening. This is what I need.” And the more that they could articulate expertise, the more that the people around them didn’t know what to do with them, because they were so accustomed to the bias inside of them saying, “These people aren’t experts. They don’t know what they’re talking about. I know better. I am the one that’s in control.” And that is the tension that we see when it comes to racism as a structure. I don’t want us to, once again, focus on individuals, but really the structures of how this plays out.

So, for us, we knew, when we found out, about six years ago, through Amnesty International, and the U.N. had sanctioned the United States around the fact that we had the worst outcomes for birthing people in the world, and then that Black people were three to four times more likely to die within a year of childbirth than their white counterparts, that we saw that — we knew that the language was going to be: “Of course they die. They are so fat. They don’t listen. They don’t go to the doctor.” All the blaming and shaming that normally happens to communities of color, the same thing that happened during COVID-19: “Of course they’re dying. They have all these preexisting illnesses. Of course. They all live together, and they don’t follow instruction.” Meanwhile, we’re more likely to put a mask on than anybody else. We’re more likely — we clean not only other people’s houses, we clean our own houses, so we’re usually extra sanitary, because we’re cleaning up for you and for ourselves. So this idea of blaming and shaming, we knew that was going to be the language.

So, Serena Williams was so important, because it showed that a person with wealth, with stature, with grace was, once again, not believed, seen as a poor historian of her own health, even though, if anybody, she’s paid her entire life, since she was a child, around her health. She knows her body better than anybody, because she’s a professional athlete. Professional athletes know everything about their bodies, because that’s how they make money. That’s how they live. For them not to listen to Serena, man, what does that mean for people like Susan Moore or like me or like any of us?

From birthing to elder care, it’s the same throughline of disbelief, of not having trust. When you talk to patients — our work, when we talk to patients that works with hospital systems, from big ones like Kaiser to little ones in Kalamazoo, Michigan, every one of them, what the patients want, when we talk to patients, is to be trusted. They want you to think and know that no matter their skin color, no matter their gender, no matter where they live, that they want justice and joy, that they want — that they are good historians. You don’t write things down like “noncompliant.” When you’re doing those things, you’re blaming and shaming the patient and really not thinking about all the things that could be happening.

So, Serena coming forth and talking about her — she also reminded me so much around how she walked outside because she didn’t want to scare her family members. That’s typical Black woman, right? Like, “I don’t anybody to get upset, so let me just go out here and just mention right quick that I might be dying, and this is what I need.” And then, she knew exactly, the same way that Dr. Susan Moore did: “These are the medicines that I need. This is the testing that I need.”

And unfortunately, when we show expertise as Black people, because we have not been historically seen as experts about anything, well, people don’t know what to do with that. So, nurses, doctors, systems, cultures, when we show up as the expert, we can feel the nervousness that others have around our expertise. But we’re like, “That’s your bias, not ours. That’s your assumptions about who I’m supposed to be, the box you’ve put me into.”

And wouldn’t it be amazing for all of us to let go of all of those boxes, to see Serena, Dr. Moore, to see our patients who live in Bogalusa, Louisiana, anywhere, as experts on their own bodies, that they have value, that they have thoughts and ideas that are amazing, no matter where you live, no matter your race or your gender?

And that’s really what we’ve learned through the Black maternal health work, working inside of hospitals, that when you look at your data, when you disaggregate your data, without question, Black patients will receive pain management later, they get their hypertension treated later. And you can really undo that. You can stop the structure of the system and say, “We are devaluing people, and we’re not going to do that anymore. We’re going to really see all of them and believe them and trust them and invest in them and make sure that they all can be seen in the future.”

AMY GOODMAN: Talking about throughlines, as we wrap up, Dr. Joia Crear-Perry, I think of Erica Garner, who was a guest on our show a number of times, fierce fighter against police brutality. Erica was the daughter, of course, of Eric Garner, who was killed by police in Staten Island. Erica would die just after giving birth to her second child, when she was just 27 years old. We did a show on Erica and Serena Williams showing that throughline. As we wrap up, a final thought on the Lancet study that you did, the respected international medical journal, called “Moving towards anti-racist praxis in medicine”?

DR. JOIA CREAR-PERRY: Yeah, and I just want to highlight that throughline. She died from cardiomyopathy. Her heart was enlarged. Just think about that. The stress of trying to fight for the value of her father and for his death not to be ignored and to hold the policemen accountable, ultimately, caused her heart to weaken — the stress of having to fight for humanity. For years, we liked to blame genetics on cardiomyopathy and looking for what the gene is that makes people’s heart weaker. But we know that your stress, your mental health, impacts your physical health. And until we undo racism, we’re going to see Black folks having higher rates of obesity, higher rates of hypertension and higher rates of cardiomyopathy. And that throughline of racism is consistent for all of us. And that’s what’s shortening all of our lives. So we need that to end.

And that’s what we talk about in this antiracism praxis. If I was taught in medical school, as I was — I was taught that there were three biological races — that’s racism. Racism was not created by God. Racism was not created by medicine. Those things have been — racism was created by people who wanted to hold power and wealth. And so, our job is to fight for equality and justice and joy, and to say, “How do we undo all these places inside of medicine where we say that Black people have different lungs or different kidney capacity or different pelvis shapes?” All this talk that we have a different shape of our pelvis, how could that possibly be, when it’s just melanin production that makes us different? That’s the only one difference. Our pelvis and our melanin have nothing to do with each other. So, really undoing those racist ideas that we were all taught inside of medicine —

AMY GOODMAN: Well —

DR. JOIA CREAR-PERRY: — so that we can have antiracism. Sorry.

AMY GOODMAN: I want to thank you so much for being with us, Dr. Joia Crear-Perry, president of the National Birth Equity Collaborative, and Dr. Camara Phyllis Jones, family physician, epidemiologist, past president of the American Public Health Association, teaching at both Emory School of Public Health, as well as the Morehouse School of Medicine. We will link to the piece they co-authored with two other African American women doctors in The Washington Post, “Say her name: Dr. Susan Moore.”

When we come back, “The truth in Black and white: An apology from The Kansas City Star.” Stay with us.

[admin]

Part 1 of 2

The Lab-Leak Hypothesis For decades, scientists have been hot-wiring viruses in hopes of preventing a pandemic, not causing one. But what if …?
by Nicholson Baker
New York Magazine
January 4, 2021

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Illustration: Illustration by Robert Beatty for New York Magazine

I. Flask Monsters

What happened was fairly simple, I’ve come to believe. It was an accident. A virus spent some time in a laboratory, and eventually it got out. SARS-CoV-2, the virus that causes COVID-19, began its existence inside a bat, then it learned how to infect people in a claustrophobic mine shaft, and then it was made more infectious in one or more laboratories, perhaps as part of a scientist’s well-intentioned but risky effort to create a broad-spectrum vaccine. SARS-2 was not designed as a biological weapon. But it was, I think, designed.

-- A Proposed Origin for SARS-CoV-2 and the COVID-19 Pandemic [W/Comments], by Jonathan Latham, PhD and Allison Wilson, PhD

-- 2019 Global Health Security Index: Building Collective Action and Accountability, by Nuclear Threat Initiative, Center for Health Security, Johns Hopkins Bloomberg School of Public Health, and The Economist Intelligence Unit

-- Is Considering a Genetic-Manipulation Origin for SARS-CoV-2 a Conspiracy Theory That Must Be Censored?, by Rossana Segreto, University of Innsbruck, and Yuri Deigrin, Youthereum Genetics Inc.

-- Laboratory Escapes and “Self-fulfilling prophecy” Epidemics, by Martin Furmanski MD, Scientist’s Working Group on Chemical and Biologic Weapons, Center for Arms Control and Nonproliferation, February 17, 2014

-- Master's Thesis: "The Analysis of Six Patients With Severe Pneumonia Caused By Unknown Viruses", by Li Xu, No. 1 School of Clinical Medicine, Kun Ming Medical University, May, 2013

-- Risk and Benefit Analysis of Gain of Function Research, Final Report, April 2016, by Gryphon Scientific

-- Did the SARS-CoV-2 virus arise from a bat coronavirus research program in a Chinese laboratory? Very possibly, by Milton Leitenberg

Many thoughtful people dismiss this notion, and they may be right. They sincerely believe that the coronavirus arose naturally, “zoonotically,” from animals, without having been previously studied, or hybridized, or sluiced through cell cultures, or otherwise worked on by trained professionals. They hold that a bat, carrying a coronavirus, infected some other creature, perhaps a pangolin, and that the pangolin may have already been sick with a different coronavirus disease, and out of the conjunction and commingling of those two diseases within the pangolin, a new disease, highly infectious to humans, evolved. Or they hypothesize that two coronaviruses recombined in a bat, and this new virus spread to other bats, and then the bats infected a person directly — in a rural setting, perhaps — and that this person caused a simmering undetected outbreak of respiratory disease, which over a period of months or years evolved to become virulent and highly transmissible but was not noticed until it appeared in Wuhan.

There is no direct evidence for these zoonotic possibilities, just as there is no direct evidence for an experimental mishap — no written confession, no incriminating notebook, no official accident report. Certainty craves detail, and detail requires an investigation. It has been a full year, 80 million people have been infected, and, surprisingly, no public investigation has taken place. We still know very little about the origins of this disease.

Nevertheless, I think it’s worth offering some historical context for our yearlong medical nightmare. We need to hear from the people who for years have contended that certain types of virus experimentation might lead to a disastrous pandemic like this one. And we need to stop hunting for new exotic diseases in the wild, shipping them back to laboratories, and hot-wiring their genomes to prove how dangerous to human life they might become.

Over the past few decades, scientists have developed ingenious methods of evolutionary acceleration and recombination, and they’ve learned how to trick viruses, coronaviruses in particular, those spiky hairballs of protein we now know so well, into moving quickly from one species of animal to another or from one type of cell culture to another. They’ve made machines that mix and mingle the viral code for bat diseases with the code for human diseases — diseases like SARS, severe acute respiratory syndrome, for example, which arose in China in 2003. While the first documented case of SARS was in November 2002, it became a pandemic in 2003, and the WHO issued its first alert about the virus in March of that year, and MERS, Middle East respiratory syndrome, which broke out a decade later and has to do with bats and camels. Some of the experiments — “gain of function” experiments — aimed to create new, more virulent, or more infectious strains of diseases in an effort to predict and therefore defend against threats that might conceivably arise in nature. The term gain of function is itself a euphemism; the Obama White House more accurately described this work as “experiments that may be reasonably anticipated to confer attributes to influenza, MERS, or SARS viruses such that the virus would have enhanced pathogenicity and/or transmissibility in mammals via the respiratory route.” The virologists who carried out these experiments have accomplished amazing feats of genetic transmutation, no question, and there have been very few publicized accidents over the years. But there have been some.

And we were warned, repeatedly. The intentional creation of new microbes that combine virulence with heightened transmissibility “poses extraordinary risks to the public,” wrote infectious-disease experts Marc Lipsitch and Thomas Inglesby in 2014. “A rigorous and transparent risk-assessment process for this work has not yet been established.” That’s still true today.

-- Why Do Exceptionally Dangerous Gain-of-Function Experiments in Influenza?, by Marc Lipsitch

-- Ethical Alternatives to Experiments with Novel Potential Pandemic Pathogens, by Marc Lipsitch, Allison P. Galvani

In 2012, in Bulletin of the Atomic Scientists, Lynn Klotz warned that there was an 80 percent chance, given how many laboratories were then handling virulent viro-varietals, that a leak of a potential pandemic pathogen would occur sometime in the next 12 years.

-- Danger of Potential-Pandemic-Pathogen Research Enterprises, by Lynn C. Klotz

-- Human error in high-biocontainment labs: a likely pandemic threat, by Lynn Klotz

-- Is there a Role for the States Parties to the BWC in Oversight of Lab-created Potential Pandemic Pathogens?, by Lynn C. Klotz, PhD

-- Letter to The NSABB Board [U.S. National Science Advisory Board for Biosecurity], by Lynn C. Klotz, Ph.D., Senior Science Fellow and member of the Scientist Working Group on Biological and Chemical Weapons Center for Arms Control and Non-proliferation, Washington, DC, USA

-- The consequences of a lab escape of a potential pandemic pathogen, by Lynn C. Klotz, The Center for Arms Control and Non-Proliferation, Washington, DC, USA; and Edward J. Sylvester, Science and Medical Journalism, Walter Cronkite School of Journalism and Mass Communication, Arizona State University, Phoenix, AZ, USA

A lab accident — a dropped flask, a needle prick, a mouse bite, an illegibly labeled bottle — is apolitical. Proposing that something unfortunate happened during a scientific experiment in Wuhan — where COVID-19 was first diagnosed and where there are three high-security virology labs, one of which held in its freezers the most comprehensive inventory of sampled bat viruses in the world — isn’t a conspiracy theory. It’s just a theory. It merits attention, I believe, alongside other reasoned attempts to explain the source of our current catastrophe.

II. “A Reasonable Chance”


Seeking Ebola strains in Sierra Leone’s wild-animal population for USAID’s Predict project in 2018. Photo: Simon Townsley

From early 2020, the world was brooding over the origins of COVID-19. People were reading research papers, talking about what kinds of live animals were or were not sold at the Wuhan seafood market — wondering where the new virus had come from.

Meanwhile, things got strange all over the world. The Chinese government shut down transportation and built hospitals at high speed. There were video clips of people who’d suddenly dropped unconscious in the street. A doctor on YouTube told us how we were supposed to scrub down our produce when we got back from the supermarket. A scientist named Shi Zhengli of the Wuhan Institute of Virology published a paper saying that the novel coronavirus was 96 percent identical to a bat virus, RaTG13, found in Yunnan province in southern China.

-- A SARS-like cluster of circulating bat coronaviruses shows potential for human emergence, by Vineet D Menachery, Boyd L Yount Jr, Kari Debbink, Sudhakar Agnihothram, Lisa E Gralinski, Jessica A Plante, Rachel L Graham, Trevor Scobey, Xing-Yi Ge, Eric F Donaldson, Scott H Randell, Antonio Lanzavecchia, Wayne A Marasco, Zhengli-Li Shi & Ralph S Baric

-- Bat Severe Acute Respiratory Syndrome-Like Coronavirus WIV1 Encodes an Extra Accessory Protein, ORFX, Involved in Modulation of the Host Immune Response, by Lei-Ping Zeng, Yu-Tao Gao, Xing-Yi Ge, Qian Zhang, Cheng Peng, Xing-Lou Yang, Bing Tan, Jing Chen, Aleksei A. Chmura, Peter Daszak, and Zheng-Li Shi

-- Discovery of a rich gene pool of bat SARS-related coronaviruses provides new insights into the origin of SARS coronavirus, by Ben Hu, Data curation, Formal analysis, Investigation, Validation, Visualization, Writing – original draft,#1 Lei-Ping Zeng, Investigation, Methodology, Xing-Lou Yang, Investigation, Resources, Xing-Yi Ge, Formal analysis, Resources, Wei Zhang, Investigation, Bei Li, Investigation, Jia-Zheng Xie, Investigation, Xu-Rui Shen, Investigation, Yun-Zhi Zhang, Resources, Ning Wang, Investigation,1 Dong-Sheng Luo, Investigation, Resources,1 Xiao-Shuang Zheng, Investigation, Mei-Niang Wang, Resources,1 Peter Daszak, Funding acquisition, Writing – review & editing, Lin-Fa Wang, Conceptualization, Funding acquisition, Writing – review & editing, Jie Cui, Conceptualization, Formal analysis, Funding acquisition, Software, Writing – review & editing, and Zheng-Li Shi, Conceptualization, Funding acquisition, Methodology, Project administration, Supervision, Visualization, Writing – review & editing

On March 13, I wrote in my journal that there seemed to be something oddly artificial about the disease: “It’s too airborne — too catching — it’s something that has been selected for infectivity. That’s what I suspect. No way to know so no reason to waste time thinking about it.”

This was just a note to self — at the time, I hadn’t interviewed scientists about SARS-2 or read their research papers. But I did know something about pathogens and laboratory accidents; I published a book last year, Baseless, that talks about some of them. The book is named after a Pentagon program, Project Baseless, whose goal, as of 1951, was to achieve “an Air Force–wide combat capability in biological and chemical warfare at the earliest possible date.”

A vast treasure was spent by the U.S. on the amplification and aerial delivery of diseases — some well known, others obscure and stealthy. America’s biological-weapons program in the ’50s had A1-priority status, as high as nuclear weapons. In preparation for a total war with a numerically superior communist foe, scientists bred germs to be resistant to antibiotics and other drug therapies, and they infected lab animals with them, using a technique called “serial passaging,” in order to make the germs more virulent and more catching.

And along the way, there were laboratory accidents. By 1960, hundreds of American scientists and technicians had been hospitalized, victims of the diseases they were trying to weaponize. Charles Armstrong, of the National Institutes of Health, one of the consulting founders of the American germ-warfare program, investigated Q fever three times, and all three times, scientists and staffers got sick. In the anthrax pilot plant at Camp Detrick, Maryland, in 1951, a microbiologist, attempting to perfect the “foaming process” of high-volume production, developed a fever and died. In 1964, veterinary worker Albert Nickel fell ill after being bitten by a lab animal.

His wife wasn’t told that he had Machupo virus, or Bolivian hemorrhagic fever. “I watched him die through a little window to his quarantine room at the Detrick infirmary,” she said.

In 1977, a worldwide epidemic of influenza began in Russia and China; it was eventually traced to a sample of an American strain of flu preserved in a laboratory freezer since 1950. In 1978, a hybrid strain of smallpox killed a medical photographer at a lab in Birmingham, England; in 2007, live foot-and-mouth disease leaked from a faulty drainpipe at the Institute for Animal Health in Surrey. In the U.S., “more than 1,100 laboratory incidents involving bacteria, viruses and toxins that pose significant or bioterror risks to people and agriculture were reported to federal regulators during 2008 through 2012,” reported USA Today in an exposé published in 2014.

-- Hundreds of bioterror lab mishaps cloaked in secrecy, by Alison Young

In 2015, the Department of Defense discovered that workers at a germ-warfare testing center in Utah had mistakenly sent close to 200 shipments of live anthrax to laboratories throughout the United States and also to Australia, Germany, Japan, South Korea, and several other countries over the past 12 years.

-- Review Committee Report: Inadvertent Shipment of Live Bacillus anthracis Spores by DoD, July 13, 2015

In 2019, laboratories at Fort Detrick — where “defensive” research involves the creation of potential pathogens to defend against — were shut down for several months by the Centers for Disease Control and Prevention for “breaches of containment.” They reopened in December 2019.

High-containment laboratories have a whispered history of near misses. Scientists are people, and people have clumsy moments and poke themselves and get bitten by the enraged animals they are trying to nasally inoculate. Machines can create invisible aerosols, and cell solutions can become contaminated. Waste systems don’t always work properly. Things can go wrong in a hundred different ways.

-- A Conspiracy of Cells: One Woman's Immortal Legacy and the Medical Scandal It Caused, by Michael Gold

Hold that human fallibility in your mind. And then consider the cautious words of Alina Chan, a scientist who works at the Broad Institute of MIT and Harvard. “There is a reasonable chance that what we are dealing with is the result of a lab accident,” Chan told me in July of last year. There was also, she added, a reasonable chance that the disease had evolved naturally — both were scientific possibilities. “I don’t know if we will ever find a smoking gun, especially if it was a lab accident. The stakes are so high now. It would be terrifying to be blamed for millions of cases of COVID-19 and possibly up to a million deaths by year end, if the pandemic continues to grow out of control. The Chinese government has also restricted their own scholars and scientists from looking into the origins of SARS-CoV-2. At this rate, the origin of SARS-CoV-2 may just be buried by the passage of time.”

I asked Jonathan A. King, a molecular biologist and biosafety advocate from MIT, whether he’d thought lab accident when he first heard about the epidemic. “Absolutely, absolutely,” King answered. Other scientists he knew were concerned as well. But scientists, he said, in general were cautious about speaking out. There were “very intense, very subtle pressures” on them not to push on issues of laboratory biohazards. Collecting lots of bat viruses, and passaging those viruses repeatedly through cell cultures, and making bat-human viral hybrids, King believes, “generates new threats and desperately needs to be reined in.”

“All possibilities should be on the table, including a lab leak,” a scientist from the NIH, Philip Murphy — chief of the Laboratory of Molecular Immunology — wrote me recently. Nikolai Petrovsky, a professor of endocrinology at Flinders University College of Medicine in Adelaide, Australia, said in an email, “There are indeed many unexplained features of this virus that are hard if not impossible to explain based on a completely natural origin.” Richard Ebright, a molecular biologist at Rutgers University, wrote that he’d been concerned for some years about the Wuhan laboratory and about the work being done there to create “chimeric” (i.e., hybrid) SARS-related bat coronaviruses “with enhanced human infectivity.” Ebright said, “In this context, the news of a novel coronavirus in Wuhan ***screamed*** lab release.”

III. “No Credible Evidence”

The new disease, as soon as it appeared, was intercepted — stolen and politicized by people with ulterior motives. The basic and extremely interesting scientific question of what happened was sucked up into an ideological sharknado.

Some Americans boycotted Chinese restaurants; others bullied and harassed Asian Americans. Steve Bannon, broadcasting from his living room, in a YouTube series called War Room, said that the Chinese Communist Party had made a biological weapon and intentionally released it. He called it the “CCP virus.” And his billionaire friend and backer, Miles Guo, a devoted Trump supporter, told a right-wing website that the communists’ goal was to “use the virus to infect selective people in Hong Kong, so that the Chinese Communist Party could use it as an excuse to impose martial law there and ultimately crush the Hong Kong pro-democracy movement. But it backfired terribly.”

You know Ralph, I think the public has not been in on this debate. It has been a secret debate with the NIH and other people who funded it. I think COVID-19 is a product of this. And I know Trump wants to call it the China virus. Well, the money that went into the creation and the genetic engineering of these coronaviruses in Wuhan was supported by the NIH and the USAID. So why wouldn't it be the NIH virus, or the USAID virus?

-- Interview with Andrew Kimball on the Ralph Nader Radio Show

In The Lancet, in February, a powerful counterstatement appeared, signed by 27 scientists. “We stand together to strongly condemn conspiracy theories suggesting that COVID-19 does not have a natural origin,” the statement said. “Scientists from multiple countries have published and analyzed genomes of the causative agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and they overwhelmingly conclude that this coronavirus originated in wildlife, as have so many other emerging pathogens.”

The behind-the-scenes organizer of this Lancet statement, Peter Daszak, is a zoologist and bat-virus sample collector and the head of a New York nonprofit called EcoHealth Alliance — a group that (as veteran science journalist Fred Guterl explained later in Newsweek) has channeled money from the National Institutes of Health to Shi Zhengli’s laboratory in Wuhan, allowing the lab to carry on recombinant research into diseases of bats and humans. “We have a choice whether to stand up and support colleagues who are being attacked and threatened daily by conspiracy theorists or to just turn a blind eye,” Daszak said in February in Science magazine.

[O]n April 16th Peter Daszak, who is the President of the EcoHealth Alliance, told Democracy Now! in a lengthy interview that the lab escape thesis was “Pure baloney”. He told listeners:

“There was no viral isolate in the lab. There was no cultured virus that’s anything related to SARS coronavirus 2. So it’s just not possible...”

Daszak is the named principal investigator on multiple US grants that went to the Shi lab at WIV. He is also a co-author on numerous papers with Zheng-Li Shi, including the 2013 Nature paper announcing the isolation of coronavirus WIV-1 through passaging (Ge et al., 2013). One of his co-authorships is on the collecting paper in which his WIV colleagues placed the four fully functional bat coronaviruses into human cells containing the ACE2 receptor (Hu et al. 2017). That is, Daszak and Shi together are collaborators and co-responsible for most of the published high-risk collecting and experimentation at the WIV.

If the Shi lab has anything to hide, it is not only the Chinese Government that will be reluctant to see an impartial investigation proceed. Much of the work was funded by the US taxpayer, channeled there by Peter Daszak and the EcoHealth Alliance. Virtually every credible international organisation that might in principle carry out such an investigation, the WHO, the US CDC, the FAO, the US NIH, including the Gates Foundation, is either an advisor to, or a partner of, the EcoHealth Alliance. If the Sars-CoV-2 outbreak originated from the bat coronavirus work at the WIV then just about every major institution in the global public health community is implicated.

-- The Case Is Building That COVID-19 Had a Lab Origin, by Jonathan Latham, PhD and Allison Wilson, PhD

From 2004 on, the WIV published many dozens of partial or full genome sequences of coronaviruses in their collection. On June 1, Daszak and Shi published partial genetic sequences of 781 Chinese bat coronaviruses, more than one-third of which had never been published previously.36 There are also multiple published records of animal infection research with bat coronaviruses at the WIV. In order to carry out the research program described above, the WIV laboratory needs to use live viruses, and not just RNA fragments. This contradicts two of the assertions, made by some commentators, that Shi worked only with RNA fragments and that her laboratory did not maintain live viruses. On May 24, 2020, the director of the WIV acknowledged that the laboratory did have “three live strains of bat corona viruses on site,” but implied only three.37 Knowledgeable virologists assume that the number must be much higher, probably hundreds of live viral isolates.38

It is precisely in the course of the kind of gain of function research that the WIV conducted that there would be the greatest likelihood of infection of a laboratory researcher.

-- Did the SARS-CoV-2 virus arise from a bat coronavirus research program in a Chinese laboratory? Very possibly, by Milton Leitenberg

How Did It Get Out? 1. The Tongguan Mine Shaft in Mojiang, Yunnan, where, in 2013, fragments of RaTG13, the closest known relative of SARSCoV-2, were recovered and transported to the Wuhan Institute of Virology; 2. The Wuhan Institute of Virology, where Shi Zhengli’s team brought the RaTG13 sample, sequenced its genome, then took it out of the freezer several times in recent years; 3. The Wuhan Center for Disease Control and Prevention, which first reported signs of the novel coronavirus in hospital patients; 4. The Huanan Seafood Wholesale Market, an early suspected origin of the pandemic, where the first major outbreak occurred. Illustration: Map by Jason Lee

Vincent Racaniello, a professor at Columbia and a co-host of a podcast called This Week in Virology, said on February 9 that the idea of an accident in Wuhan was “complete bunk.” The coronavirus was 96 percent similar to a bat virus found in 2013, Racaniello said. “It’s not a man-made virus. It wasn’t released from a lab.”

Racaniello’s dismissal was seconded by a group of scientists from Ohio State, the University of Pennsylvania, and the University of North Carolina, who put out a paper in Emerging Microbes and Infections to quiet the “speculations, rumors, and conspiracy theories that SARS-CoV-2 is of laboratory origin.” There was “currently no credible evidence” that SARS-2 leaked from a lab, these scientists said, using a somewhat different argument from Racaniello’s. “Some people have alleged that the human SARS-CoV-2 was leaked directly from a laboratory in Wuhan where a bat CoV (RaTG13) was recently reported,” they said. But RaTG13 could not be the source because it differed from the human SARS-2 virus by more than a thousand nucleotides. One of the paper’s authors, Susan Weiss, told the Raleigh News & Observer, “The conspiracy theory is ridiculous.”

At first glance RaTG13 is unlikely to have evolved into SARS-CoV-2 since RaTG13 is approximately 1,200 nucleotides (3.8%) different from SARS-CoV-2. Although RaTG13 is the most closely related virus to SARS-CoV-2, this sequence difference still represents a considerable gap. In a media statement evolutionary virologist Edward Holmes has suggested this gap represents 20-50 years of evolution and others have suggested similar figures.

We agree that ordinary rates of evolution would not allow RaTG13 to evolve into SARS-CoV-2 but we also believe that conditions inside the lungs of the miners were far from ordinary. Five major factors specific to the hospitalised miners favoured a very high rate of evolution inside them.

i) When viruses infect new species they typically undergo a period of very rapid evolution because the selection pressure on the invading pathogen is high. The phenomenon of rapid evolution in new hosts is well attested among corona- and other viruses (Makino et al., 1986; Baric et al., 1997; Dudas and Rambaut 2016; Forni et al., 2017).

ii) Judging by their clinical symptoms such as the CT scans, all the miner’s infections were primarily of the lungs. This localisation likely occurred initially because the miners were exerting themselves and therefore inhaling the disturbed bat guano deeply. As miners, they may already have had damaged lung tissues (patient 3 had suspected pneumoconiosis) and/or particulate matter was present that irritated the tissues and may have facilitated initial viral entry.

In contrast, standard coronavirus infections are confined to the throat and upper respiratory tract. They do not normally reach the lungs (Perlman and Netland, 2009). Lungs are far larger tissues by weight (kilos vs grammes) than the upper respiratory tract. There was therefore likely a much larger quantity of virus inside the miners than would be the case in an ordinary coronavirus infection.

Comparing a typical coronavirus respiratory tract infection with the extent of infected lungs in the miners from a purely mathematical point of view indicates the potential scale of this quantitative difference. The human aerodigestive tract is approximately 20cm in length and 5cm in circumference, i.e. approximately 100 cm2 in surface area. The surface area of a human lung ranges from 260,000-680,000 cm2(Hasleton, 1972). The amount of potentially infected tissue in an average lung is therefore approximately 4500-fold greater than that available to a normal coronavirus infection. The amount of virus present in the infected miners, sufficient to hospitalise all of them and kill half of them, was thus proportionately very large.

Evolutionary change is in large part a function of the population size. The lungs of the miners, we suggest, supported a very high viral load leading to proportionately rapid viral evolution.

Furthermore, according to the Master’s thesis, the immune systems of the miners were compromised and remained so even for those discharged. This weakness on the part of the miners may also have encouraged evolution of the virus.

iii) The length of infection experienced by the miners (especially patients 2, 3 and 4) far exceeded that of an ordinary coronavirus infection. From first becoming too sick to work in the mine, patient 2 survived 57 days until he died. Patient 3 survived 120 days after stopping work. Patient 4 survived 117 days and then was discharged as cured. Each had been exposed in the mine for 14 days prior to the onset of severe symptoms; thus each presumably had nascent infections for some time before calling in sick (See Table 2 of the thesis).

In contrast, in ordinary coronavirus infections the viral infection is cleared within about ten to fourteen days after being acquired (Tay et al., 2020). Thus, unlike most sufferers from coronavirus infection, the hospitalised miners had very long-term bouts of disease characterised by a continuous high load of virus. In the cases of patients 3 and 4 their illnesses lasted over 4 months.

iv) Coronaviruses are well known to recombine at very high rates: 10% of all progeny in a cell can be recombinants (Makino et al., 1986; Banner and Lai, 1991; Dudas and Rambaut, 2016). In normal virus evolution the mutation rate and the selection pressure are the main foci of attention. But in the case of a coronavirus adapting to a new host where many mutations distributed all over the genome are required to fully adapt to the new host, the recombination rate is likely to be highly influential in determining the overall speed of adaptation by the virus population (Baric et al., 1997).

Inside the miners a large tissue was simultaneously infected by a population of poorly-adapted viruses, with each therefore under pressure to adapt. Even if the starting population of virus lacked any diversity, many individual viruses would have acquired mutations independently but only recombination would have allowed these mutations to unite in the same genome. To recombine, viruses must be present in the same cell. In such a situation the particularities of lung tissues become potentially important because the existence of airways (bronchial tubes, etc.) allows partially-adapted viruses from independent viral populations to travel to distal parts of the lung (or even the other lung) and encounter other such partially-adapted viruses and populations. This movement around the lungs would likely have resulted in what amounted to a passaging effect without the need for a researcher to infect new tissues. Indeed, in the Master’s thesis the observation is several times made that areas of the lungs of a specific patient would appear to heal even while other parts of the lungs would become infected.

v) There were also a number of unusual things about the bat coronaviruses in the mine. They were abnormally abundant but also there were many different kinds, often causing co-infections of the bats (Ge et al., 2016). Viral co-infections are often more infectious or more pathogenic (Latham and Wilson, 2007).

As the WIV researchers remarked about the bats in the mine:

“we observed a high rate of co-infection with two coronavirus species and interspecies infection with the same coronavirus species within or across bat families. These phenomena may be owing to the diversity and high density of bat populations in the same cave, facilitating coronavirus intra- and interspecies transmissions, which may result in recombination and acceleration of coronavirus evolution.” (Ge et al., 2016).

The diversity of coronaviruses in the mine suggests that the miners were similarly exposed and that their illness may potentially have begun as co-infections.

Combining these observations, we propose that the miners’ lungs offered an unprecedented opportunity for accelerated evolution of a highly bat-adapted coronavirus into a highly human-adapted coronavirus and that decades of ordinary coronavirus evolution could easily have been condensed into months. However, we acknowledge that these conditions were unique.

-- A Proposed Origin for SARS-CoV-2 and the COVID-19 Pandemic, by Jonathan Latham, PhD and Allison Wilson, PhD

The most influential natural-origin paper, “The Proximal Origin of SARS-CoV-2,” by a group of biologists that included Kristian Andersen of Scripps Research, appeared online in a preliminary version in mid-February.
“We do not believe any type of laboratory-based scenario is plausible,” the scientists said. Why? Because molecular-modeling software predicted that if you wanted to optimize an existing bat virus so that it would replicate well in human cells, you would arrange things a different way than how the SARS-2 virus actually does it — even though the SARS-2 virus does an extraordinarily good job of replicating in human cells. The laboratory-based scenario was implausible, the paper said, because, although it was true that the virus could conceivably have developed its unusual genetic features in a laboratory, a stronger and “more parsimonious” explanation was that the features came about through some kind of natural mutation or recombination. “What we think,” explained one of the authors, Robert F. Garry of Tulane University, on YouTube, “is that this virus is a recombinant. It probably came from a bat virus, plus perhaps one of these viruses from the pangolin.” Journalists, for the most part, echoed the authoritative pronouncements of Daszak, Racaniello, Weiss, Andersen, and other prominent natural-originists. “The balance of the scientific evidence strongly supports the conclusion that the new coronavirus emerged from nature — be it the Wuhan market or somewhere else,” said the Washington Post’s “Fact Checker” column. “Dr. Fauci Again Dismisses Wuhan Lab As Source of Coronavirus,” said CBS News, posting a video interview of Anthony Fauci by National Geographic. “If you look at the evolution of the virus in bats, and what’s out there now,” Fauci said, “it’s very, very strongly leaning toward ‘This could not have been artificially or deliberately manipulated’ — the way the mutations have naturally evolved.”

-- Why US outsourced bat virus research to Wuhan: US-funded $3.7 million project approved by Trump's Covid-19 guru Dr Anthony Fauci in 2015 after US ban imposed on 'monster-germ' research, by Christina Lin

--Research on Highly Pathogenic H5N1 Influenza Virus: The Way Forward, by Anthony S. Fauci

U.S. intelligence, after originally asserting that the coronavirus had occurred naturally, conceded last month that the pandemic may have originated in a leak from the Wuhan lab.

-- Dr. Fauci Backed Controversial Wuhan Lab with U.S. Dollars for Risky Coronavirus Research, by Fred Guterl, Newsweek

Everyone took sides; everyone thought of the new disease as one more episode in an ongoing partisan struggle. Think of Mike Pompeo, that landmass of Cold War truculence; think of Donald Trump himself. They stood at their microphones saying, in a winking, I-know-something-you-don’t-know sort of way, that this disease escaped from a Chinese laboratory. Whatever they were saying must be wrong. It became impermissible, almost taboo, to admit that, of course, SARS-2 could have come from a lab accident. “The administration’s claim that the virus spread from a Wuhan lab has made the notion politically toxic, even among scientists who say it could have happened,” wrote science journalist Mara Hvistendahl in the Intercept.

IV. “Is It a Complete Coincidence?”

Even so, in January and February of 2020, there were thoughtful people who were speaking up, formulating their perplexities.

One person was Sam Husseini, an independent journalist. He went to a CDC press conference at the National Press Club on February 11, 2020. By then, 42,000 people had gotten sick in China and more than a thousand had died. But there were only 13 confirmed cases in the U.S. Halfway through the Q&A period, Husseini went to the microphone and asked the CDC’s representative, Anne Schuchat, where the virus had come from. His head was spinning, he told me later.

“Obviously the main concern is how to stop the virus,” Husseini said; nonetheless, he wanted to know more about its source. “Is it the CDC’s contention,” he asked, “that there’s absolutely no relation to the BSL-4 lab in Wuhan? It’s my understanding that this is the only place in China with a BSL-4 lab. We in the United States have, I think, two dozen or so, and there have been problems and incidents.” (A BSL-4 laboratory is a maximum-security biosafety-level-four facility, used to house research on the most dangerous known pathogens. New York has confirmed there are at least 11 BSL-4 facilities currently operating in the U.S.) Husseini hastened to say that he wasn’t implying that what happened in Wuhan was in any way intentional. “I’m just asking, Is it a complete coincidence that this outbreak happened in the one city in China with a BSL-4 lab?”

Schuchat thanked Husseini for his questions and comments. Everything she’d seen was quite consistent with a natural, zoonotic origin for the disease, she said.

That same month, a group of French scientists from Aix-Marseille University posted a paper describing their investigation of a small insertion in the genome of the new SARS-2 virus. The virus’s spike protein contained a sequence of amino acids that formed what Etienne Decroly and colleagues called a “peculiar furin-like cleavage site” — a chemically sensitive region on the lobster claw of the spike protein that would react in the presence of an enzyme called furin, which is a type of protein found everywhere within the human body, but especially in the lungs. When the spike senses human furin, it shudders, chemically speaking, and the enzyme opens the protein, commencing the tiny morbid ballet whereby the virus burns a hole in a host cell’s outer membrane and finds its way inside.

The code for this particular molecular feature — not found in SARS or any SARS-like bat viruses, but present in a slightly different form in the more lethal MERS virus — is easy to remember because it’s a roar: “R-R-A-R.” The letter code stands for amino acids: arginine, arginine, alanine, and arginine. Its presence, so Decroly and his colleagues observed, may heighten the “pathogenicity” — that is, the god-awfulness — of a disease.

Botao Xiao, a professor at the South China University of Technology, posted a short paper on a preprint server titled “The Possible Origins of 2019-nCoV Coronavirus.” Two laboratories, the Wuhan Center for Disease Control and Prevention (WHCDC) and the Wuhan Institute of Virology, were not far from the seafood market, which was where the disease was said to have originated, Xiao wrote — in fact, the WHCDC was only a few hundred yards away from the market — whereas the horseshoe bats that hosted the disease were hundreds of miles to the south. (No bats were sold in the market, he pointed out.) It was unlikely, he wrote, that a bat would have flown to a densely populated metropolitan area of 15 million people. “The killer coronavirus probably originated from a laboratory in Wuhan,” Xiao believed. He urged the relocation of “biohazardous laboratories” away from densely populated places. His article disappeared from the server.

-- The Possible Origins of 2019-nCoV Coronavirus, by Botao Xiao, and Lei Xiao

And late in the month, a professor at National Taiwan University, Fang Chi-tai, gave a lecture on the coronavirus in which he described the anomalous R-R-A-R furin cleavage site. The virus was “unlikely to have four amino acids added all at once,” Fang said — natural mutations were smaller and more haphazard, he argued. “From an academic point of view, it is indeed possible that the amino acids were added to COVID-19 in the lab by humans.” When the Taiwan News published an article about Fang’s talk, Fang disavowed his own comments, and the video copy of the talk disappeared from the website of the Taiwan Public Health Association. “It has been taken down for a certain reason,” the association explained. “Thank you for your understanding.”

V. “A Serious Shortage of Appropriately Trained Technicians”

In the spring, I did some reading on coronavirus history. Beginning in the 1970s, dogs, cows, and pigs were diagnosed with coronavirus infections; dog shows were canceled in 1978 after 25 collies died in Louisville, Kentucky. New varieties of coronaviruses didn’t start killing humans, though, until 2003 — that’s when restaurant chefs, food handlers, and people who lived near a live-animal market got sick in Guangzhou, in southern China, where the shredded meat of a short-legged raccoonlike creature, the palm civet, was served in a regional dish called “dragon-tiger-phoenix soup.” The new disease, SARS, spread alarmingly in hospitals, and it reached 30 countries and territories. More than 800 people died; the civet-borne virus was eventually traced to horseshoe bats.

Later, smaller outbreaks of SARS in Taiwan, Singapore, and China’s National Institute of Virology in Beijing were all caused by laboratory accidents. Of the Beijing Virology Institute, the World Health Organization’s safety investigators wrote, in May 2004, that they had “serious concerns about biosafety procedures.” By one account, a SARS storage room in the Beijing lab was so crowded that the refrigerator holding live virus was moved out to the hallway. “Scientists still do not fully understand exactly where or how SARS emerged 18 months ago,” wrote Washington Post reporter David Brown in June 2004. “But it is clear now that the most threatening source of the deadly virus today may be places they know intimately — their own laboratories.”

I’m just asking, Is it a complete coincidence that this outbreak happened in the one city in China with a BSL-4 lab?

MERS arose in 2012, possibly spread by camels that had contracted the disease from bats or bat guano, then passed it to human drinkers of raw camel milk and butchers of camel meat. It was an acute sickness, with a high fatality rate, mostly confined to Saudi Arabia. Like SARS, MERS ebbed quickly — it all but disappeared outside the Middle East, except for an outbreak in 2015 at the Samsung Medical Center in South Korea, where a single case of MERS led to more than 180 infections, many involving hospital workers.

In January 2015, the brand-new BSL-4 lab in Wuhan, built by a French contractor, celebrated its opening, but full safety certification came slowly. According to State Department cables from 2018 leaked to the Washington Post, the new BSL-4 lab had some start-up problems, including “a serious shortage of appropriately trained technicians and investigators needed to safely operate this high-containment laboratory.” The staff had gotten some training at a BSL-4 lab in Galveston, Texas, but they were doing potentially dangerous work with SARS-like viruses, the memo said, and they needed more help from the U.S.

Two years before the novel coronavirus pandemic upended the world, U.S. Embassy officials visited a Chinese research facility in the city of Wuhan several times and sent two official warnings back to Washington about inadequate safety at the lab, which was conducting risky studies on coronaviruses from bats...

What the U.S. officials learned during their visits concerned them so much that they dispatched two diplomatic cables categorized as Sensitive But Unclassified back to Washington. The cables warned about safety and management weaknesses at the WIV lab and proposed more attention and help. The first cable, which I obtained, also warns that the lab’s work on bat coronaviruses and their potential human transmission represented a risk of a new SARS-like pandemic.

“During interactions with scientists at the WIV laboratory, they noted the new lab has a serious shortage of appropriately trained technicians and investigators needed to safely operate this high-containment laboratory,” states the Jan. 19, 2018, cable, which was drafted by two officials from the embassy’s environment, science and health sections who met with the WIV scientists. (The State Department declined to comment on this and other details of the story.)

The Chinese researchers at WIV were receiving assistance from the Galveston National Laboratory at the University of Texas Medical Branch and other U.S. organizations, but the Chinese requested additional help. The cables argued that the United States should give the Wuhan lab further support, mainly because its research on bat coronaviruses was important but also dangerous.

As the cable noted, the U.S. visitors met with Shi Zhengli, the head of the research project, who had been publishing studies related to bat coronaviruses for many years. In November 2017, just before the U.S. officials’ visit, Shi’s team had published research showing that horseshoe bats they had collected from a cave in Yunnan province were very likely from the same bat population that spawned the SARS coronavirus in 2003.

“Most importantly,” the cable states, “the researchers also showed that various SARS-like coronaviruses can interact with ACE2, the human receptor identified for SARS-coronavirus. This finding strongly suggests that SARS-like coronaviruses from bats can be transmitted to humans to cause SARS-like diseases. From a public health perspective, this makes the continued surveillance of SARS-like coronaviruses in bats and study of the animal-human interface critical to future emerging coronavirus outbreak prediction and prevention.”

The research was designed to prevent the next SARS-like pandemic by anticipating how it might emerge. But even in 2015, other scientists questioned whether Shi’s team was taking unnecessary risks. In October 2014, the U.S. government had imposed a moratorium on funding of any research that makes a virus more deadly or contagious, known as “gain-of-function” experiments...

“The cable tells us that there have long been concerns about the possibility of the threat to public health that came from this lab’s research, if it was not being adequately conducted and protected,” he said.

There are similar concerns about the nearby Wuhan Center for Disease Control and Prevention lab, which operates at biosecurity level 2, a level significantly less secure than the level-4 standard claimed by the Wuhan Insititute of Virology lab, Xiao said. That’s important because the Chinese government still refuses to answer basic questions about the origin of the novel coronavirus while suppressing any attempts to examine whether either lab was involved.

Sources familiar with the cables said they were meant to sound an alarm about the grave safety concerns at the WIV lab, especially regarding its work with bat coronaviruses. The embassy officials were calling for more U.S. attention to this lab and more support for it, to help it fix its problems.

“The cable was a warning shot,” one U.S. official said. “They were begging people to pay attention to what was going on.”

No extra assistance to the labs was provided by the U.S. government in response to these cables. The cables began to circulate again inside the administration over the past two months as officials debated whether the lab could be the origin of the pandemic and what the implications would be for the U.S. pandemic response and relations with China.

Inside the Trump administration, many national security officials have long suspected either the WIV or the Wuhan Center for Disease Control and Prevention lab was the source of the novel coronavirus outbreak. According to the New York Times, the intelligence community has provided no evidence to confirm this. But one senior administration official told me that the cables provide one more piece of evidence to support the possibility that the pandemic is the result of a lab accident in Wuhan.

“The idea that it was just a totally natural occurrence is circumstantial. The evidence it leaked from the lab is circumstantial. Right now, the ledger on the side of it leaking from the lab is packed with bullet points and there’s almost nothing on the other side,” the official said.

-- State Department cables warned of safety issues at Wuhan lab studying bat coronaviruses, by Josh Rogin, The Washington Post, April 14, 2020

In November or December of 2019, the novel coronavirus began to spread. Chinese scientists initially named it “Wuhan seafood market pneumonia virus,” but soon that idea went away. The market, closed and decontaminated by Chinese officials on January 1, 2020, was an amplifying hub, not the source of the outbreak, according to several studies by Chinese scientists. Forty-five percent of the earliest SARS-2 patients had no link with the market.

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Part 2 of 2

VI. Emergence

Now let’s take a step back. AIDS, fatal and terrifying and politically charged, brought on a new era in government-guided vaccine research, under the guidance of Anthony Fauci. A virologist at Rockefeller University, Stephen S. Morse, began giving talks on “emerging viruses” — other plagues that might be in the process of coming out of nature’s woodwork.

-- Emerging Viruses: AIDS & Ebola: Nature, Accident or Intentional?, by Leonard G. Horowitz, DMD, MA, MPH

In 1992, Richard Preston wrote a horrific account of one emergent virus, Ebola, in The New Yorker, which became a best-selling book in 1994; Laurie Garrett’s The Coming Plague: Newly Emerging Diseases in a World Out of Balance appeared that same year and was also a best seller. The idea seemed to be everywhere: We were on the verge of a wave of zoonotic, emergent plagues.

-- Crisis in the Hot Zone: Lessons from an outbreak of Ebola, by Richard Preston

This new, useful term, emerging, began to glow in the research papers of some coronavirologists, who were out of the spotlight, working on common colds and livestock diseases. The term was useful because it was fluid. An emerging disease could be real and terrifying, as AIDS was — something that had just arrived on the medical scene and was confounding our efforts to combat it — or it could be a disease that hadn’t arrived, and might never arrive, but could be shown in a laboratory to be waiting in the wings, just a few mutations away from a human epidemic. It was real and unreal at the same time — a quality that was helpful when applying for research grants.


Where Did It Come From? This chart measures the genetic similarity of known viruses to the novel coronavirus (which appears in yellow). By far the closest is the bat virus RaTG13, which appears in blue, and which was recovered in 2013 and brought to the Wuhan Institute of Virology. The first SARS, marked in red, is a much more distant relative. Graphic: Zhou, P., Yang, XL., Wang, XG. et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 579, 270–273 (2020)

Take, for instance, this paper from 1995: “High Recombination and Mutation Rates in Mouse Hepatitis Viruses Suggest That Coronaviruses May Be Potentially Important Emerging Viruses.” It was written by Dr. Ralph Baric and his bench scientist, Boyd Yount, at the University of North Carolina. Baric, a gravelly voiced former swim champion, described in this early paper how his lab was able to train a coronavirus, MHV, which causes hepatitis in mice, to jump species, so that it could reliably infect BHK (baby-hamster kidney) cell cultures. They did it using serial passaging: repeatedly dosing a mixed solution of mouse cells and hamster cells with mouse-hepatitis virus, while each time decreasing the number of mouse cells and upping the concentration of hamster cells. At first, predictably, the mouse-hepatitis virus couldn’t do much with the hamster cells, which were left almost free of infection, floating in their world of fetal-calf serum. But by the end of the experiment, after dozens of passages through cell cultures, the virus had mutated: It had mastered the trick of parasitizing an unfamiliar rodent. A scourge of mice was transformed into a scourge of hamsters. And there was more: “It is clear that MHV can rapidly alter its species specificity and infect rats and primates,” Baric said. “The resulting virus variants are associated with demyelinating diseases in these alternative species.” (A demyelinating disease is a disease that damages nerve sheaths.) With steady prodding from laboratory science, along with some rhetorical exaggeration, a lowly mouse ailment was morphed into an emergent threat that might potentially cause nerve damage in primates. That is, nerve damage in us.

A few years later, in a further round of “interspecies transfer” experimentation, Baric’s scientists introduced their mouse coronavirus into flasks that held a suspension of African-green-monkey cells, human cells, and pig-testicle cells. Then, in 2002, they announced something even more impressive: They’d found a way to create a full-length infectious clone of the entire mouse-hepatitis genome. Their “infectious construct” replicated itself just like the real thing, they wrote.

Not only that, but they’d figured out how to perform their assembly seamlessly, without any signs of human handiwork. Nobody would know if the virus had been fabricated in a laboratory or grown in nature. Baric called this the “no-see’m method,” and he asserted that it had “broad and largely unappreciated molecular biology applications.” The method was named, he wrote, after a “very small biting insect that is occasionally found on North Carolina beaches.”

In 2006, Baric, Yount, and two other scientists were granted a patent for their invisible method of fabricating a full-length infectious clone using the seamless, no-see’m method. But this time, it wasn’t a clone of the mouse-hepatitis virus — it was a clone of the entire deadly human SARS virus, the one that had emerged from Chinese bats, via civets, in 2002. The Baric Lab came to be known by some scientists as “the Wild Wild West.” In 2007, Baric said that we had entered “the golden age of coronavirus genetics.”

“I would be afraid to look in their freezers,” one virologist told me.

Baric and Shi Zhengli of the Wuhan Institute of Virology, the two top experts on the genetic interplay between bat and human coronaviruses, began collaborating in 2015.

VII. “I Had Not Slept a Wink”


Virologist Shi Zhengli at the Wuhan Institute of Virology in 2017. Photo: Feature China / Barcroft Studios / Future Publishing / Getty Images

Early in the pandemic, Scientific American profiled Shi Zhengli, known in China as the “bat woman.” Shi trapped hundreds of bats in nets at the mouths of caves in southern China, sampled their saliva and their blood, swabbed their anuses, and gathered up their fecal pellets. Several times, she visited and sampled bats in a mine in Mojiang, in southern China, where, in 2012, six men set to work shoveling bat guano were sickened by a severe lung disease, three of them fatally. Shi’s team took the samples back to Wuhan and analyzed whatever fragments of bat virus she could find. In some cases, when she found a sequence that seemed particularly significant, she experimented with it in order to understand how it might potentially infect humans. Some of her work was funded by the National Institutes of Health and some of it by the U.S. Defense Threat Reduction Agency of the Department of Defense via Peter Daszak’s EcoHealth Alliance.

As Shi explained to Scientific American, late in December 2019, she heard from the director of the Wuhan Institute that there was an outbreak of a new disease in the city. Medical samples taken from hospital patients arrived at her lab for analysis. Shi determined that the new virus was related to SARS but even more closely related to a bat disease that her own team had found on a virus-hunting trip: the now-famous RaTG13. Shi was surprised that the outbreak was local, she said: “I had never expected this kind of thing to happen in Wuhan, in central China.” The bat hiding places that she’d been visiting were, after all, as far away as Orlando, Florida, is from New York City. Could this new virus, she wondered, have come from her own laboratory? She checked her records and found no exact matches. “That really took a load off my mind,” she said. “I had not slept a wink for days.”

If one of the first thoughts that goes through the head of a lab director at the Wuhan Institute of Virology is that the new coronavirus could have come from her lab, then we are obliged to entertain the scientific possibility that it could indeed have come from her lab. Right then, there should have been a comprehensive, pockets-inside-out, fully public investigation of the Virology Institute, along with the other important virus labs in Wuhan, including the one close by the seafood market, headquarters of the Wuhan CDC. There should have been interviews with scientists, interviews with biosafety teams, close parsings of laboratory notebooks, freezer and plumbing and decontamination systems checks — everything. It didn’t happen. The Wuhan Institute of Virology closed down its databases of viral genomes, and the Chinese Ministry of Education sent out a directive: “Any paper that traces the origin of the virus must be strictly and tightly managed.”

Shi made some WeChat posts early in 2020. “The novel 2019 coronavirus is nature punishing the human race for keeping uncivilized living habits,” she wrote. “I, Shi Zhengli, swear on my life that it has nothing to do with our laboratory.” She advised those who believed rumors, and gave credence to unreliable scientific papers, to “shut their stinking mouths.”

[A]after seeing the devastation of Hurricane Harvey, conservative Christian pastor John McTernan had noted that “God is systematically destroying America” out of anger over “the homosexual agenda.”

-- Christian faith doesn’t just say disasters are God’s retribution, by Mathew Schmalz

VIII. “‘Bug to Drug’ in 24 Hours”

It wasn’t only AIDS that changed the way the NIH funded research. The War on Terror also influenced which diseases got the most attention. In the late ’90s, under Bill Clinton and then George W. Bush, biodefense specialists became interested — again — in anthrax. The Defense Threat Reduction Agency built a small anthrax factory in Nevada, using simulants, to demonstrate how easy it would be for a terrorist to build a small anthrax factory. And in the first year of the Bush presidency, the Defense Intelligence Agency wrote up plans to create a vaccine-resistant form of anthrax using state-of-the-art gene-splicery. A front-page article describing these initiatives, “U.S. Germ Warfare Research Pushes Treaty Limits,” appeared in the New York Times on September 4, 2001, one week before 9/11. “Pentagon Says Projects Are Defense, Is Pressing Ahead,” was the subtitle.

After the 9/11 attacks, and the mysterious anthrax mailings that began a week later (which said, “TAKE PENACILIN [sic] NOW / DEATH TO AMERICA / DEATH TO ISRAEL / ALLAH IS GREAT”), the desire for biopreparedness became all consuming. Now there were emerging biothreats from humans as well as from the evolving natural world. Fauci’s anti-terror budget went from $53 million in 2001 to $1.7 billion in 2003. Setting aside his work toward an AIDS vaccine, which was taking longer than he’d foreseen, Fauci said he would be going all out to defend against a suite of known Cold War agents, all of which had been bred and perfected in American weapons programs many years before — brucellosis, anthrax, tularemia, and plague, for instance. “We are making this the highest priority,” Fauci said. “We are really marshaling all available resources.”

I would be afraid to look in their freezers.

Vaccine development had to progress much faster, Fauci believed; he wanted to set up “vaccine systems” and “vaccine platforms,” which could be quickly tailored to defend against a particular emergent strain some terrorist with an advanced biochemistry degree might have thrown together in a laboratory. “Our goal within the next 20 years is ‘bug to drug’ in 24 hours,” Fauci said. “This would specifically meet the challenge of genetically engineered bioagents.” The first Project BioShield contract Fauci awarded was to VaxGen, a California pharmaceutical company, for $878 million worth of shots of anthrax vaccine.

By 2005, so much money was going toward biothreat reduction and preparedness that more than 750 scientists sent a protest letter to the NIH. Their claim was that grants to study canonical biowar diseases — anthrax, plague, brucellosis, and tularemia, all exceptionally rare in the U.S. — had increased by a factor of 15 since 2001, whereas funds for the study of widespread “normal” diseases, of high public-health importance, had decreased.

Fauci was firm in his reply: “The United States through its leaders made the decision that this money was going to be spent on biodefense,” he said. “We disagree with the notion that biodefense concerns are of ‘low public-health significance.’ ”

In 2010, by one count, there were 249 BSL-3 laboratories and seven BSL-4 laboratories in the U.S., and more than 11,000 scientists and staffers were authorized to handle the ultralethal germs on the government’s select pathogen list. And yet the sole bioterrorist in living memory who actually killed American citizens, according to the FBI — the man who sent the anthrax letters — turned out to be one of the government’s own researchers. Bruce Ivins, an eccentric, suicidal laboratory scientist from Ohio who worked in vaccine development at Fort Detrick, allegedly wanted to boost the fear level so as to persuade the government to buy more of the patented, genetically engineered anthrax VaxGen vaccine, of which he was a co-inventor.(See David Willman’s fascinating biography of Ivins, Mirage Man.) Fauci’s staff at NIH funded Ivins’s vaccine laboratory and gave $100 million to VaxGen to accelerate vaccine production. (The NIH’s $878 million contract with VaxGen, however, was quietly canceled in 2006; Ivins, who was never charged, killed himself in 2008.)

“The whole incident amounted to a snake eating its own tail,” wrote Wendy Orent in an August 2008 piece titled “Our Own Worst Bioenemy” in the Los Angeles Times. “No ingenious biowarrior from Al Qaeda sent the lethal envelopes through the U.S. postal system. An American scientist did.” What confirmed Ivins’s guilt, according to the FBI, was that there was a genetic match between the anthrax used in the killings and the strain held at Fort Detrick.

Bruce Edwards Ivins (/ˈaɪvɪnz/; April 22, 1946 – July 29, 2008) was an American microbiologist, vaccinologist, senior biodefense researcher at the United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Maryland, and the suspected perpetrator of the 2001 anthrax attacks. Ivins died on July 29, 2008, of an overdose of acetaminophen (Tylenol) in an apparent suicide after learning that criminal charges were likely to be filed against him by the Federal Bureau of Investigation (FBI) for an alleged criminal connection to the attacks.

At a news conference at the United States Department of Justice (DOJ) on August 6, 2008, FBI and DOJ officials formally announced that the Government had concluded that Ivins was likely solely responsible for "the deaths of five persons, and the injury of dozens of others, resulting from the mailings of several anonymous letters to members of Congress and members of the media in September and October 2001, which letters contained Bacillus anthracis, commonly referred to as anthrax." On February 19, 2010, the FBI released a 92-page summary of evidence against Ivins and announced that it had concluded its investigation. The FBI conclusions have been contested by many, including senior microbiologists, the widow of one of the victims, and several prominent American politicians. Senator Patrick Leahy (D-VT), who was among the targets in the attack, Senator Chuck Grassley (R-IA), Senator Arlen Specter (R-PA), Representative Rush Holt (D-NJ), and Representative Jerrold Nadler (D-NY) all argued that Ivins was not solely responsible for the attacks. No formal charges were ever filed against Ivins for the crime, and no direct evidence of his involvement has been uncovered.

The FBI subsequently requested a panel from the National Academy of Sciences (NAS) to review its scientific work on the case. On May 15, 2011, the panel released its findings, which "conclude[d] that the bureau overstated the strength of genetic analysis linking the mailed anthrax to a supply kept by Bruce E. Ivins." The NAS committee stated that its primary finding was that "it is not possible to reach a definitive conclusion about the origins of the B. anthracis in the mailings based on the available scientific evidence alone.

-- Bruce Edwards Ivins, by Wikipedia

IX. “Weapons of Mass Disruption”

After SARS appeared in 2003, Ralph Baric’s laboratory moved up the NIH funding ladder. SARS was a “dual use” organism — a security threat and a zoonotic threat at the same time. In 2006, Baric wrote a long, fairly creepy paper on the threat of “weaponizable” viruses. Synthetic biology had made possible new kinds of viral “weapons of mass disruption,” he wrote, involving, for example, “rapid production of numerous candidate bioweapons that can be simultaneously released,” a scattershot terror tactic Baric called [url]the “‘survival of the fittest’ approach[/url].”

Synthetic genomes can be devised fairly rapidly using a variety of bioinformatics tools and purchased fairly cheaply ($1.10/base at current rates), allowing for rapid production of numerous candidate bioweapons that can be simultaneously released (e.g., survival of the fittest approach) or lab tested and then the best candidate used for nefarious purposes. The latter approach assumes that an organization has funded the development of a secure facility, has provided trained personnel and is willing to test the agents and/or passage them in humans, as animal models may be unreliable predictors of human pathogenesis. Assuming the technology continues to advance and spread globally, synthetic biology will allow for rapid synthesis of large designer genomes (e.g., ~30 Kb genome in less than a couple of weeks); larger genomes become technically more demanding. It seems likely that a standard approach could be designed for recovering each synthetic virus, further minimizing the need for highly trained personnel.

-- Synthetic Viral Genomics: Risks and Benefits for Science and Society, by Ralph S. Baric

Lanz von Liebenfels and his mentor Guido von List can be viewed as archetypal Social Darwinists and the Third Reich as Social Darwinism carried to its logical conclusion. Similar to the rationale behind the race eugenics programs in the United States (which also influenced American immigration policies, both of which the Nazis regarded with admiration and approval), it was an ideology of the survival of the fittest, and the enslavement and destruction of the weakest, from Jews to women, from the mentally and physically handicapped to the aged, from Slavs and Gypsies to Communists.

-- Unholy Alliance: A History of Nazi Involvement With the Occult, by Peter Levenda

Baric hoped to find a SARS vaccine, but he couldn’t; he kept looking for it, year after year, supported by the NIH, long after the disease itself had been contained. It wasn’t really gone, Baric believed. Like other epidemics that pop up and then disappear, as he told a university audience some years later, “they don’t go extinct. They are waiting to return.” What do you do if you run a well-funded laboratory, an NIH “center of excellence,” and your emergent virus is no longer actually making people sick? You start squeezing it and twisting it into different shapes. Making it stand on its hind legs and quack like a duck, or a bat. Or breathe like a person.

Baric’s safety record is good — although there was a minor mouse-bite incident in 2016, uncovered by ProPublica — and his motives are beyond reproach: “Safe, universal, vaccine platforms are needed that can be tailored to new pathogens as they emerge, quickly tested for safety, and then strategically used to control new disease outbreaks in human populations,” he wrote in a paper on public health. But the pioneering work he did over the past 15 years — generating tiny eager single-stranded flask monsters and pitting them against human cells, or bat cells, or gene-spliced somewhat-human cells, or monkey cells, or humanized mice — was not without risk, and it may have led others astray.

In 2006, for instance, Baric and his colleagues, hoping to come up with a “vaccine strategy” for SARS, produced noninfectious virus replicon particles (or VRPs) using the Venezuelan-equine-encephalitis virus (another American germ-warfare agent), which they fitted with various SARS spike proteins. Then, wearing Tyvek suits and two pairs of gloves each, and working in a biological safety cabinet in a BSL-3-certified laboratory, they cloned and grew recombinant versions of the original SARS virus in an incubator in a medium that held African-green-monkey cells. When they had grown enough virus, the scientists swapped out one kind of spike protein for a carefully chosen mutant, and they challenged their prototype vaccine with it in mice.

The scientists also tried their infectious SARS clones in something called an air-liquid interface, using a relatively new type of cell culture developed by Raymond Pickles of the University of North Carolina’s Cystic Fibrosis Center. Pickles had perfected a method of emulating the traits of human airway tissue by cultivating cells taken from lung-disease patients — nurturing the culture over four to six weeks in such a way that the cells differentiated and developed a crop of tiny moving hairs, or cilia, on top and goblet cells within that produced real human mucus. In fact, before infecting these HAE (human airway epithelial) cells with a virus, the lab worker must sometimes rinse off some of the accumulated mucus, as if helping the lab-grown tissue to clear its throat. So Baric was exposing and adapting his engineered viruses to an extraordinarily true-to-life environment — the juicy, sticky, hairy inner surface of our breathing apparatus.

SARS-2 seems almost perfectly calibrated to grab and ransack our breathing cells and choke the life out of them. “By the time SARS-CoV-2 was first detected in late 2019, it was already pre-adapted to human transmission,” Alina Chan and her co-authors have written, whereas SARS, when it first appeared in 2003, underwent “numerous adaptive mutations” before settling down. Perhaps viral nature hit a bull’s-eye of airborne infectivity, with almost no mutational drift, no period of accommodation and adjustment, or perhaps some lab worker somewhere, inspired by Baric’s work with human airway tissue, took a spike protein that was specially groomed to colonize and thrive deep in the ciliated, mucosal tunnels of our inner core and cloned it onto some existing viral bat backbone. It could have happened in Wuhan, but — because anyone can now “print out” a fully infectious clone of any sequenced disease — it could also have happened at Fort Detrick, or in Texas, or in Italy, or in Rotterdam, or in Wisconsin, or in some other citadel of coronaviral inquiry. No conspiracy — just scientific ambition, and the urge to take exciting risks and make new things, and the fear of terrorism, and the fear of getting sick. Plus a whole lot of government money.

X. “Risky Areas for Spillover”

Project Bioshield began to fade by the end of the Bush administration, although the expensive high-containment laboratories, controversial preservers and incubators of past and future epidemics, remain. By 2010, some BioShield projects had dissolved into Obama’s Predict program, which paid for laboratories and staff in 60 “risky areas for spillover” around the world. Jonna Mazet, a veterinary scientist from the University of California, Davis, was in charge of Predict, which was a component of USAID’s “Emerging Pandemic Threats” program. Her far-flung teams collected samples from 164,000 animals and humans and claimed to have found “almost 1,200 potentially zoonotic viruses, among them 160 novel coronaviruses, including multiple SARS- and MERS-like coronaviruses.” The fruits of Predict’s exotic harvest were studied and circulated in laboratories worldwide, and their genetic sequences became part of GenBank, the NIH’s genome database, where any curious RNA wrangler anywhere could quickly synthesize snippets of code and test out a new disease on human cells.

Baric, Jonna Mazet, and Peter Daszak of EcoHealth worked together for years — and Daszak also routed Predict money to Shi Zhengli’s bat-surveillance team in Wuhan through his nonprofit, mingling it with NIH money and money from the U.S. Defense Threat Reduction Agency. In 2013, Mazet announced that Shi Zhengli’s virus hunters, with Predict’s support, had, for the first time, isolated and cultured a live SARS-like virus from bats and demonstrated that this virus could bind to the human ACE2, or “angiotensin-converting enzyme 2,” receptor, which Baric’s laboratory had determined to be the sine qua non of human infectivity. “This work shows that these viruses can directly infect humans and validates our assumption that we should be searching for viruses of pandemic potential before they spill over to people,” Mazet said.

Daszak, for his part, seems to have viewed his bat quests as part of an epic, quasi-religious death match. In a paper from 2008, Daszak and a co-author described Bruegel’s painting The Fall of the Rebel Angels and compared it to the contemporary human biological condition. The fallen angels could be seen as pathogenic organisms that had descended “through an evolutionary (not spiritual) pathway that takes them to a netherworld where they can feed only on our genes, our cells, our flesh,” Daszak wrote. “Will we succumb to the multitudinous horde? Are we to be cast downward into chthonic chaos represented here by the heaped up gibbering phantasmagory against which we rail and struggle?”

XI. “Lab-Made?”

There are, in fact, some helpful points of agreement between zoonoticists — those who believe in a natural origin of the SARS-2 virus — and those who believe that it probably came from a laboratory. Both sides agree, when pressed, that a lab origin can’t be conclusively ruled out and a natural origin can’t be ruled out either — because nature, after all, is capable of improbable, teleological-seeming achievements. Both sides also agree, for the most part, that the spillover event that began the human outbreak probably happened only once, or a few times, quite recently, and not many times over a longer period. They agree that bat virus RaTG13 (named for the Rinolophus affinus bat, from Tongguan, in 2013) is the closest match to the human virus that has yet been found, and that although the two viruses are very similar, the spike protein of the bat virus lacks the features the human spike protein possesses that enable it to work efficiently with human tissue.

Zoonoticists hold that SARS-2’s crucial features — the furin cleavage site and the ACE2 receptor — are the result of a recombinant event involving a bat coronavirus (perhaps RaTG13 or a virus closely related to it) and another, unknown virus. Early on, researchers proposed that it could be a snake sold at the seafood market — a Chinese cobra or a banded krait —but no: Snakes don’t typically carry coronaviruses. Then there was a thought that the disease came from sick smuggled pangolins, because there existed a certain pangolin coronavirus that was, inexplicably, almost identical in its spike protein to the human coronavirus — but then, no: There turned out to be questions about the reliability of the genetic information in that diseased-pangolin data set, on top of which there were no pangolins for sale at the Wuhan market. Then a group from China’s government veterinary laboratory at Harbin tried infecting beagles, pigs, chickens, ducks, ferrets, and cats with SARS-2 to see if they could be carriers. (Cats and ferrets got sick; pigs, ducks, and most dogs did not.)

In September, some scientists at the University of Michigan, led by Yang Zhang, reported that they had created a “computational pipeline” to screen nearly a hundred possible intermediate hosts, including the Sumatran orangutan, the Western gorilla, the Olive baboon, the crab-eating macaque, and the bonobo. All these primates were “permissive” to the SARS-2 coronavirus and should undergo “further experimentational investigation,” the scientists proposed.

Despite this wide-ranging effort, there is at the moment no animal host that zoonoticists can point to as the missing link. There’s also no single, agreed-upon hypothesis to explain how the disease may have traveled from the bat reservoirs of Yunnan all the way to Wuhan, seven hours by train, without leaving any sick people behind and without infecting anyone along the way.

The zoonoticists say that we shouldn’t find it troubling that virologists have been inserting and deleting furin cleavage sites and ACE2-receptor-binding domains in experimental viral spike proteins for years: The fact that virologists have been doing these things in laboratories, in advance of the pandemic, is to be taken as a sign of their prescience, not of their folly. But I keep returning to the basic, puzzling fact: This patchwork pathogen, which allegedly has evolved without human meddling, first came to notice in the only city in the world with a laboratory that was paid for years by the U.S. government to perform experiments on certain obscure and heretofore unpublicized strains of bat viruses — which bat viruses then turned out to be, out of all the organisms on the planet, the ones that are most closely related to the disease. What are the odds?

In July, I discovered a number of volunteer analysts who were doing a new kind of forensic, samizdat science, hunched over the letter code of the SARS-2 genome like scholars deciphering the cuneiform impressions in Linear B tablets. There were the anonymous authors of Project Evidence, on GitHub, who “disavow all racism and violent attacks, including those which are aimed at Asian or Chinese people,” and there was Yuri Deigin, a biotech entrepreneur from Canada, who wrote a massive, lucid paper on Medium, “Lab-Made?,” which illumined the mysteries of the spike protein. Jonathan Latham of the Bioscience Resource Project, with his co-author Allison Wilson, wrote two important papers: one a calm, unsparing overview of laboratory accidents and rash research and the other a close look at the small outbreak of an unexplained viral pneumonia in a bat-infested copper mine in 2012. I corresponded with Alina Chan (now the subject of a nicely turned piece in Boston magazine by Rowan Jacobsen) and with the pseudonymous Billy Bostickson, a tireless researcher whose Twitter photo is a cartoon of an injured experimental monkey, and Monali Rahalkar, of the Agharkar Research Institute in Pune, India, who wrote a paper with her husband, Rahul Bahulikar, that also sheds light on the story of the bat-guano-shoveling men whose virus was remarkably like SARS-2, except that it was not nearly as catching. I talked to Rossana Segreto, a molecular biologist at the University of Innsbruck, whose paper, “Is Considering a Genetic-Manipulation Origin for SARS-CoV-2 a Conspiracy Theory That Must Be Censored?,” co-authored with Yuri Deigin, was finally published in November under a milder title; it argued that SARS-2’s most notable features, the furin site and the human ACE2-binding domain, were unlikely to have arisen simultaneously and “might be the result of lab manipulation techniques such as site directed mutagenesis.” Segreto is also the person who first established that a bat-virus fragment named BtCoV/4991, identified in 2013, was 100 percent identical to the closest known cousin to SARS-CoV-2, the bat virus RaTG13, thereby proving that the virus closest to the SARS-2-pandemic virus was linked back not to a bat cave but to a mine shaft, and that this same virus had been stored and worked on in the Wuhan Institute for years. This made possible the first big investigative piece on SARS-2’s origins, in the Times of London, in July: “Nobody can deny the bravery of scientists who risked their lives harvesting the highly infectious virus,” the Times authors write. “But did their courageous detective work lead inadvertently to a global disaster?”

XII. “A New, Non-Natural Risk”

In 2011, a tall, confident Dutch scientist, Ron Fouchier, using grant money from Fauci’s group at NIH, created a mutant form of highly pathogenic avian influenza, H5N1, and passaged it ten times through ferrets in order to prove that he could “force” (his word) this potentially fatal disease to infect mammals, including humans, “via aerosols or respiratory droplets.” Fouchier said his findings indicated that these avian influenza viruses, thus forced, “pose a risk of becoming pandemic in humans.”

This experiment was too much for some scientists: Why, out of a desire to prove that something extremely infectious could happen, would you make it happen? And why would the U.S. government feel compelled to pay for it to happen? Late in 2011, Marc Lipsitch of the Harvard School of Public Health got together with several other dismayed onlookers to ring the gong for caution. On January 8, 2012, the New York Times published a scorcher of an editorial, “An Engineered Doomsday.” “We cannot say there would be no benefits at all from studying the virus,” the Times said. “But the consequences, should the virus escape, are too devastating to risk.”

These gain-of-function experiments were an important part of the NIH’s approach to vaccine development, and Anthony Fauci was reluctant to stop funding them. He and Francis Collins, director of the National Institutes of Health, along with Gary Nabel, NIAID director of vaccine research, published an opinion piece in the Washington Post in which they contended that the ferret flu experiments, and others like them, were “a risk worth taking.” “Important information and insights can come from generating a potentially dangerous virus in the laboratory,” they wrote; the work can “help delineate the principles of virus transmission between species.” The work was safe because the viruses were stored in a high-security lab, they believed, and the work was necessary because nature was always coming up with new threats. “Nature is the worst bioterrorist,” Fauci told a reporter. “We know that through history.”

Soon afterward, there followed some distressing screwups in secure federal laboratories involving live anthrax, live smallpox, and live avian influenza. These got attention in the science press. Then Lipsitch’s activists (calling themselves the Cambridge Working Group) sent around a strong statement on the perils of research with “Potential Pandemic Pathogens,” signed by more than a hundred scientists. The work might “trigger outbreaks that would be difficult or impossible to control,” the signers said. Fauci reconsidered, and the White House in 2014 announced that there would be a “pause” in the funding of new influenza, SARS, and MERS gain-of-function research.

Baric, in North Carolina, was not happy. He had a number of gain-of-function experiments with pathogenic viruses in progress. “It took me ten seconds to realize that most of them were going to be affected,” he told NPR. Baric and a former colleague from Vanderbilt University wrote a long letter to an NIH review board expressing their “profound concerns.” “This decision will significantly inhibit our capacity to respond quickly and effectively to future outbreaks of SARS-like or MERS-like coronaviruses, which continue to circulate in bat populations and camels,” they wrote. The funding ban was itself dangerous, they argued. “Emerging coronaviruses in nature do not observe a mandated pause.”

Hoping to smooth over controversy by showing due diligence, the National Science Advisory Board for Biosecurity, founded in the BioShield era under President Bush, paid a consulting firm, Gryphon Scientific, to write a report on gain-of-function research, which by now was simply referred to as GoF. In chapter six of this thousand-page dissertation, published in April 2016, the consultants take up the question of coronaviruses. “Increasing the transmissibility of the coronaviruses could significantly increase the chance of a global pandemic due to a laboratory accident,” they wrote.

The Cambridge Working Group continued to write letters of protest and plead for restraint and sanity. Steven Salzberg, a professor of biomedical engineering at Johns Hopkins, said, “We have enough problems simply keeping up with the current flu outbreaks — and now with Ebola — without scientists creating incredibly deadly new viruses that might accidentally escape their labs.” David Relman of Stanford Medical School said, “It is unethical to place so many members of the public at risk and then consult only scientists — or, even worse, just a small subset of scientists — and exclude others from the decision-making and oversight process.” Richard Ebright wrote that creating and evaluating new threats very seldom increases security: “Doing so in biology — where the number of potential threats is nearly infinite, and where the asymmetry between the ease of creating threats and the difficulty of addressing threats is nearly absolute — is especially counterproductive.” Lynn Klotz wrote, “Awful as a pandemic brought on by the escape of a variant H5N1 virus might be, it is SARS that now presents the greatest risk. The worry is less about recurrence of a natural SARS outbreak than of yet another escape from a laboratory researching it to help protect against a natural outbreak.” Marc Lipsitch argued that gain-of-function experiments can mislead, “resulting in worse not better decisions,” and that the entire gain-of-function debate as overseen by the NIH was heavily weighted in favor of scientific insiders and “distinctly unwelcoming of public participation.”

Nariyoshi Shinomiya, a professor of physiology and nano-medicine at the National Defense Medical College in Japan, offered this warning: “Similar to nuclear or chemical weapons there is no going back once we get a thing in our hands.”

But in the end, Baric was allowed to proceed with his experiments, and the research papers that resulted, showered with money, became a sort of Anarchist’s Cookbook for the rest of the scientific world. In November 2015, Baric and colleagues published a collaboration paper with Shi Zhengli titled “A SARS-like Cluster of Circulating Bat Coronaviruses Shows Potential for Human Emergence.” Into a human SARS virus that they had adapted so that it would work in mice, Baric and Shi et al. inserted the spike protein of a bat virus, SHC014, discovered by Shi in southern China. They dabbed the mice nasally with virus and waited, looking for signs of sickness: “hunching, ruffled fur.” They also infected human airway cells with the mouse-adapted bat-spike-in-a-human-virus backbone. In both mice and human airway cells, the chimeric virus caused a “robust infection.”

This proved, Baric and Shi believed, that you did not need civets or other intermediate hosts in order for bats to cause an epidemic in humans and that therefore all the SARS-like viruses circulating in bat populations “may pose a future threat.” Peter Daszak, who had used Predict funds to pay Shi for her work on the paper, was impressed by this conclusion; the findings, he said, “move this virus from a candidate emerging pathogen to a clear and present danger.”

Richard Ebright was trenchantly unenthusiastic. “The only impact of this work,” he said, “is the creation, in a lab, of a new, non-natural risk.”

Early in 2016, Baric and Shi again collaborated. Shi sent Baric a fresh bat virus spike protein, and Baric inserted it into the backbone of a human SARS virus and then used that infectious clone to attack human airway cells. “The virus readily and efficiently replicated in cultured human airway tissues, suggesting an ability to potentially jump directly to humans,” reported the UNC’s website. This time, they also used the bat-human hybrid virus to infect transgenic humanized mice that grew human ACE2 protein. The mice, young and old, lost weight and died, proving, again, that this particular bat virus was potentially “poised to emerge in human populations.” It was “an ongoing threat,” Baric wrote. But was it? Civets and camels that are exposed to a lot of bat-guano dust may be an ongoing threat and a manageable one. But the bats themselves just want to hang in their caves and not be bothered by frowning sightseers in spacesuits who want to poke Q-tips in their bottoms. This 2016 “poised for human emergence” paper was supported by eight different NIH grants. In 2015, Baric’s lab received $8.3 million from the NIH; in 2016, it received $10.5 million.

Gain-of-function research came roaring back under Trump and Fauci. “The National Institutes of Health will again fund research that makes viruses more dangerous,” said an article in Nature in December 2017. Carrie Wolinetz of the NIH’s office of science policy defended the decision. “These experiments will help us get ahead of viruses that are already out there and pose a real and present danger to human health,” she told The Lancet. The NIH, Wolinetz said, was committed to a leadership role with gain-of-function research internationally. “If we are pursuing this research in an active way, we will be much better positioned to develop protection and countermeasures should something bad happen in another country.”

A reporter asked Marc Lipsitch what he thought of the resumption of NIH funding. Gain-of-function experiments “have done almost nothing to improve our preparedness for pandemics,” he said, “yet they risked creating an accidental pandemic.”

XIII. “Proximity Is a Problem”

In April, four months into the coronavirus emergency, a deputy director at the NIH wrote an email to EcoHealth Alliance. “You are instructed to cease providing any funds to Wuhan Institute of Virology,” it said. In response, Daszak and the chief scientific officer of New England Biolabs (a company that sells seamless gene-splicing products to laboratories, among other things) got 77 Nobel Prize winners to sign a statement saying that the cancellation deprived the “nation and the world of highly regarded science that could help control one of the greatest health crises in modern history and those that may arise in the future.” Later, as a condition of further funding, the NIH wrote to say it wanted Daszak to arrange an outside inspection of the Wuhan lab and to procure from Wuhan’s scientists a sample of whatever they’d used to sequence the SARS-2 virus. Daszak was outraged (“I am not trained as a private detective”), and again he fought back. He was reluctant to give up his own secrets, too. “Conspiracy-theory outlets and politically motivated organizations have made Freedom of Information Act requests on our grants and all of our letters and emails to the NIH,” he told Nature. “We don’t think it’s fair that we should have to reveal everything we do.”

But Daszak has survived — even prospered. Recently, The Lancet made him the lead investigator in its inquiry into the origins of the pandemic, and the World Health Organization named him to its ten-person origins investigation. (“We’re still close enough to the origin to really find out more details about where it has come from,” Daszak told Nature.)

The NIH has also set up an ambitious new international program, called CREID, which stands for Centers for Research in Emerging Infectious Diseases, and it has put Daszak’s EcoHealth in charge of trapping animals and looking for obscure bat viruses in Singapore, Malaysia, and Thailand. Baric is one of Daszak’s partners in CREID. The virus hunting and collecting, which Richard Ebright likens to “looking for a gas leak with a lighted match,” will continue and widen with U.S. funding. “We’re going to work in remote parts of Malaysia and Thailand to get to the front line of where the next pandemic is going to start,” Daszak told NPR.

In May, an interviewer from the People’s Pharmacy website asked Baric if he had any thoughts on whether the coronavirus began with a natural bat-to-human transfer. “Or was there something a little bit more, perhaps, insidious involved?”

“Well, of course the answers to those questions are in China,” Baric replied. “Exactly how they work in that facility is something that would be very difficult for a Westerner to know,” he said. “The main problems that the Institute of Virology has is that the outbreak occurred in close proximity to that Institute. That Institute has in essence the best collection of virologists in the world that have gone out and sought out, and isolated, and sampled bat species throughout Southeast Asia. So they have a very large collection of viruses in their laboratory. And so it’s — you know — proximity is a problem. It’s a problem.”

Over the course of the fall, and especially after the election muffled Donald Trump’s influence over the country’s public-health apparatus, that proximity problem — and the uncomfortable questions of origins it raised — began to grow somewhat more discussable. The BBC, Le Monde, and Italy’s RAI have all recently taken seriously the scientific possibility of a lab leak. In late October, the World Health Organization convened the first meeting of its second inquiry into the origins of the disease. The WHO’s effort is perhaps the world’s best chance to satisfy its curiosity about goings-on at the Wuhan Institute of Virology and at the Wuhan CDC’s virus lab near the Wuhan seafood market. But, as the New York Times has reported, the WHO’s information gathering has been hindered by Chinese secretiveness since February, when an initial investigative team sent to Beijing was told its members’ access to scientists would be restricted and that it couldn’t visit the seafood market, then considered a hub of the pandemic.

When a BBC video team tried to inspect the Yunnan mine shaft, they found the road to the mine blocked by a strategically parked truck that had “broken down” shortly before they arrived. Reporter John Sudworth asked Daszak, one of the ten members of the second WHO investigative team, whether he would push for access to the Wuhan Institute of Virology. “That’s not my job to do that,” Daszak replied.

In November, David Relman, the Stanford microbiologist, one of the most thoughtful of the voices warning against gain-of-function research, published a paper in Proceedings of the National Academy of Sciences on the urgent need to unravel the origins of COVID-19. “If SARS-CoV-2 escaped from a lab to cause the pandemic,” he wrote, “it will become critical to understand the chain of events and prevent this from happening again.” Conflicts of interest by researchers and administrators will need to be addressed, Relman wrote; to reach the truth, the investigation must be transparent, international, and, as much as possible, unpolitical. “A more complete understanding of the origins of COVID-19 clearly serves the interests of every person in every country on this planet.”

“The world is sitting on a precedent-setting decision right now,” wrote Alina Chan on December 8. “It is unclear if SARS2 is 100 percent natural or emerged due to lab/research activities. If we walk away from this, demonstrating that we cannot effectively investigate its origins, it will pave the way for future COVIDS.”

Just before this issue of New York went to press, I reached Ralph Baric by phone and asked him where he now believed SARS-2 came from. (Anthony Fauci, Shi Zhengli, and Peter Daszak didn’t respond to emails, and Kristian Andersen said he was busy with other things.) Baric said he still thought the virus came from bats in southern China, perhaps directly, or possibly via an intermediate host, although the smuggled pangolins, in his view, were a red herring. The disease evolved in humans over time without being noticed, he suspected, becoming gradually more infectious, and eventually a person carried it to Wuhan “and the pandemic took off.” Then he said, “Can you rule out a laboratory escape? The answer in this case is probably not.”

XIV. Transmission

So how did we actually get this disease?

Here’s what I think happened. In April 2012, in a copper mine in Mojiang, China, three men were given an awful job — they were told to shovel bat guano out of a mine shaft. They went to work and shoveled guano for seven hours a day in the confined, insufficiently ventilated space of the mine shaft, and by the end of the week, they were sick with a viral pneumonia of unknown etiology. Three more, younger shovelers were hired to replace the ones who were out sick.

The viral load in their lungs was so huge, because of all the guano dust, that their lungs became a kind of accelerated laboratory passaging experiment, as Jonathan Latham and Allison Wilson have written, forcing the virus to switch its allegiance from bats to humans. SARS experts were consulted, and the disease was judged to be SARS-like but not SARS. It was something new. (Shi Zhengli told Scientific American that the guano shovelers had died of a fungal disease, but, as Monali Rahalkar pointed out, they were treated with antivirals, and their symptoms were consistent with viral pneumonia with attendant secondary fungal infections.)

Although it was a severe disease, and in the end three of the shovelers died, there was no resultant epidemic. It was actually a case of industrial overexposure to an infectious substance — what we might call a massive OSHA violation. The bat disease that the men encountered wasn’t necessarily all that dangerous except in an environment of immunosuppressive overload.

Peter Daszak and Shi Zhengli were interested, of course, because this unidentified coronavirus disease involved bats and people. Of the fragmentary bits of virus Shi retrieved from the mine shaft, one was SARS-like, and Shi sequenced it and called it BtCoV/4991 and published a paper about it. Several times — in 2016 and 2018 and 2019 — this most interesting sample, a portion of what we now know as RaTG13, was taken out of the freezers in Shi’s lab and worked on in undisclosed ways. (Peter Daszak claims that these samples have disintegrated and can’t be validated or studied.) Samples of the nameless human disease also traveled back to the Wuhan Institute of Virology — few specifics about these valuable specimens have been released by Chinese sources, however.

This is the period in the story that demands a very close investigation, when chimeric assemblages may have been created and serially passaged, using BtCoV/4991, a.k.a. RaTG13, and other bat viruses, perhaps along with forms of the human virus. It’s when Shi and Baric both published papers that were about what happened when you hot-swapped mutant spike proteins between bat viruses and human viruses.

The link, via the renamed sample BtCoV/4991, to the copper mine is of exceptional importance because of the one huge difference between the unnamed guano shovelers’ virus and the SARS-2 virus that is now ravaging, for example, California: transmissibility. Airborne human-to-human transmissibility — the kind of thing that gain-of-functioneers like Ron Fouchier and Ralph Baric were aiming at, in order to demonstrate what Baric called “lurking threats” — is COVID-19’s crucial distinguishing feature. If six men had gotten extremely sick with COVID-19 back in 2012 in southern China, doctors and nurses in the hospital where they lay dying would likely have gotten sick as well. There might have been hundreds or thousands of cases. Instead, only the shovelers themselves, who had breathed a heavy concentration of guano dust for days, got it.

The existence of bat virus RaTG13 is therefore not necessarily evidence of a natural bat origin. In fact, it seems to me to imply the opposite: New functional components may have been overlaid onto or inserted into the RaTG13 genome, new Tinkertoy intermolecular manipulations, especially to its spike protein, which have the effect of making it unprecedentedly infectious in human airways.

This is where the uniquely peculiar furin insert and/or the human-tuned ACE2-receptor-binding domain may come in — although it’s also possible that either of these elements could have evolved as part of some multistep zoonotic process. But in the climate of gonzo laboratory experimentation, at a time when all sorts of tweaked variants and amped-up substitutions were being tested on cell cultures and in the lungs of humanized mice and other experimental animals, isn’t it possible that somebody in Wuhan took the virus that had been isolated from human samples, or the RaTG13 bat virus sequence, or both (or other viruses from that same mine shaft that Shi Zhengli has recently mentioned in passing), and used them to create a challenge disease for vaccine research — a chopped-and-channeled version of RaTG13 or the miners’ virus that included elements that would make it thrive and even rampage in people? And then what if, during an experiment one afternoon, this new, virulent, human-infecting, furin-ready virus got out?

For more than 15 years, coronavirologists strove to prove that the threat of SARS was ever present and must be defended against, and they proved it by showing how they could doctor the viruses they stored in order to force them to jump species and go directly from bats to humans. More and more bat viruses came in from the field teams, and they were sequenced and synthesized and “rewired,” to use a term that Baric likes. In this international potluck supper of genetic cookery, hundreds of new variant diseases were invented and stored. And then one day, perhaps, somebody messed up. It’s at least a reasonable, “parsimonious” explanation of what might have happened.

This may be the great scientific meta-experiment of the 21st century. Could a world full of scientists do all kinds of reckless recombinant things with viral diseases for many years and successfully avoid a serious outbreak? The hypothesis was that, yes, it was doable. The risk was worth taking. There would be no pandemic.

I hope the vaccine works.

*This article appears in the January 4, 2021, issue of New York Magazine. Subscribe Now!