To the essential workers of 2020, in harm’s way to keep the economy running but without adequate protection and paid too little. And to future generations of Americans: learn the right lesson from our mistakes.

A companion archive holding thousands of images, videos, documents, stories, and other bonus content can be found at http://www.deepersickness.com.

In any event, the sloppy and fatuous nature of American good will can never be relied upon to deal with hard problems. These have been dealt with, when they have been dealt with at all, out of necessity—and in political terms, anyway, necessity means concessions made in order to stay on top.

—JAMES BALDWIN, Down at the Cross (1963)

INTRODUCTION

This journal recounts in detail the four pandemics—disease, disinformation, poverty, and violence—that charged through the United States like the proverbial horsemen of the apocalypse in the year 2020. During this calendar year, nearly four hundred thousand Americans died of COVID-19, the disease caused by a novel coronavirus. Beginning in April, the country erupted into protest, some opposing public health restrictions, others marching to stop the slaughter of Black men and women by white authorities. The experience changed how we learned, ate, shopped, worked, socialized, practiced medicine, grieved, celebrated, and died. We saw bright spots, moments of great heroism and sacrifice. And yet, in the United States, 2020 will long be known as a time of grief, frustration, confusion, loneliness, and even rage.

Could it have turned out differently?

Journalists and scholars are already uncovering the missteps made by those in power in early 2020 that failed to contain SARS-CoV-2 once it appeared in the US. In this book, in which we follow America as eyewitnesses to the tumult of the entire year, we are after a different question: Is there something in the character of the place, the bones of America, that made the layers of tragedy that unfolded in 2020 practically unavoidable?

As professional historians, we spend our lives trying to make sense of the past, in part so that we can better understand the present. For a full year, we turned our attention to daily events and the historical contexts of this year’s multiple pandemics in the hope of understanding both how we got here and how we might prevent ever returning. In January, Erik L. Peterson, a historian and philosopher of science and medicine, began following the outbreak of this new coronavirus, collecting primary sources for his course on the global history of epidemics at the University of Alabama. Independently, Margaret Peacock, an expert on propaganda, Russia, the Middle East, and the Cold War, decided to do the same for a course on the history of media and propaganda. An incidental conversation in the spring after our university moved courses online inspired us to merge projects.

We constructed this book as a journal, written mostly in real time as the year unspooled. Each day, we tracked hundreds of news stories, reports, tweets, posts, blogs, speeches, and videos from across the political spectrum, intent on capturing how people encountered these moments and what historical factors informed their understandings of the events unfolding around them. Of course, no one could describe a singular American experience of 2020. Instead, we set out to provide a wide range of glimpses into individual, subjective encounters with the chaos of this year by recruiting and interviewing a large and diverse group of people from different races, ethnicities, classes, political beliefs, and geographic regions willing to share their expertise and experiences. Dozens of scholars, politicians, activists, physicians, epidemiologists, attorneys, nurses, and public health experts helped us make meaning of the headlines. We also received invaluable insights from regular folks, who unpacked their unique perspectives and made this book the expansive, heart-wrenching project that it became.

This canvassing of 2020 required an effort larger than ourselves, and we are forever grateful for the work of so many. We acknowledge the ways this story is deeply subjective, shaped by our own expertise as historians and educators living and working far from the media hubs on both coasts. As such, we wrote this chronicle in the first person. When we need to speak about ourselves, it is with one collective I, with each entry reflecting a thorough braiding of each of our experiences and each of our years of training and research leading up to this moment.

One point we want to underscore in this book is how difficult it often was to understand what was happening around us during the pandemic. We want to show how mistaken we were at times, how distorted time felt, how surprisingly powerless and ignorant we all turned out to be, despite our best efforts to stay informed and empowered. We researched and wrote all day, every day, frenetically, yet lived in a state of focused confusion for most of that exhausting year. We had to, of course. Contrary to how most academic histories are composed, including our own work, there could be no outline, no thesis. We could not know which events would turn out to be mundane, which would become historic—they all felt like both, all the time. So, we took each day as it came, reading and watching and writing, as frantic days rolled one into another, crescendos piling on top of each other. Inevitably, we made mistakes. Rather than fixing them in the editing process, we preserved them here as a testament to the tumult of the year. We see value in them. For, while historians in the next decade or century will no doubt shed more dispassionate clarity on 2020, they will not be able to grasp the messy immediacy of documenting it while living it, that constant sense that the ground under us was quicksand.

We constructed an expansive digital museum as a companion to the book at deepersickness.com. It displays the thousands of sources we curated over the year, the hundreds of pages of additional content we wrote that did not fit into the printed book, a collection of eyewitness narratives from contributors recounting their experiences with this year, and an exhibit space highlighting original research on 2020 from scholars and students around the country. We encourage you to engage with our voluminous research and add your stories to the historical record. We created this digital museum for three reasons. First, we wanted to preserve the anxieties, sorrows, pains, fears, angers, boredom, and even unexpected joys of this experience, including as many voices as we can. We collected many and hope to collect more. These stories take up more space than a printed book allows, but they are invaluable, nonetheless, and worth saving. Second, we built this site to preserve our sources before they disappear. Too many of the internet-based materials we used to construct the project are ephemeral. We like to imagine that our modern data is saved forever somewhere in the cloud, but tweets, Facebook/Instagram posts, even news stories, disappear like individual raindrops into a river. On deepersickness.com, we have saved as much as we could. Third, we preserved our sources for readers to view because the recounting of history is a perennial battlefield. How we remember the past shapes everything we do. It defines us in the present and shapes what choices we will make in the future. Inevitably, some readers will disagree with our analyses of these events. In hindsight, we might disagree with ourselves in 2020 as well. Please, readers, examine the sources for yourselves. Preserving sources from 2020 makes it more difficult for people in the future to ignore or gloss over certain realities about this experience. Americans, as we found, too often substitute folklore for history.

As we heard story after story of grief and loss, the question Was the tragedy of 2020 inevitable, and, if so, why? kept reoccurring. Tracing day after day, certain preexisting conditions that shaped this year came into focus—the way a physician armed with a family medical history might see a chronic illness behind a patient’s present symptoms.

Three historical factors, in particular, made America sicker than we should have been in 2020: (a) entrenched racial hierarchies; (b) an economic structure dependent on individual accumulation of wealth and widespread consumption of ephemeral goods and entertainment; (c) distraction, cognitive dissonance, and an intentional historical amnesia that prevented the majority of comfortable, well-intentioned, middle-class, white Americans like ourselves from doing anything about the first two issues.

These factors channeled seventy-four million people—nearly 47 percent of all votes cast—to nearly reelect a narcissistic, predatory charlatan who accumulated immense power by repeating age-old, bigoted, malevolent, and dishonest tropes. Millions more disregarded health and safety guidelines, refusing to wear masks or avoid gatherings in poorly ventilated spaces or with large numbers of people, resulting in higher rates of disease and death in the United States than in most other countries. These factors justified ongoing official and vigilante violence toward Black citizens, whether they were jogging, bird-watching in a park, sitting in their cars, sleeping in their homes, or protesting peacefully in the streets. And in the background, these factors drove many millions of people into increasing states of socioeconomic precarity.

The American 2020 experience was so bad not because coronavirus itself was worse here, but because disease is social and cultural as well as biological. And the causes of that social and cultural disease are historical. In other words, the country’s underlying disorders limited the possible outcomes of the American pandemic year. Despite our prolific technology and our deep-seated belief in progress, we Americans have not broadly diagnosed, let alone treated, the moral failings of our past. Instead, too much of white America remains willfully ignorant, manufacturing and adhering to a false past, preserved in the monuments that adorn our cities and public buildings, constructed in order to distract from the most deeply unequal, unpatriotic, and immoral portions of our present existences. This is among the worst of our preexisting conditions, our deeper sickness.

Through the year, we heard another question echoed time and again: Will 2020 be recognized as a turning point—a 1968, for instance? The answer depends not just on our politicians but on Americans in 2021 and 2031 and 2121. Apocalypse is not just another word for cataclysm; it originally meant a revealing of what lies beneath. True to that original meaning, the apocalypse of 2020 revealed the deep, historical deformities in the American body politic. If we allow our amazement that heavily funded biotech corporations were able to create a coronavirus vaccine in record-breaking time to distract us from addressing our deeper sickness, then 2020 will not be a turning point in anything but the most superficial, historically uninteresting way.

A DEEPER SICKNESS

WEDNESDAY, JANUARY 1, 2020

Sharon Sanders of Winter Haven, Florida, has been tracking global disease outbreaks on her site, FluTrackers.com, since 2006. It was the first public forum to note the H1N1 influenza (swine flu) pandemic when it appeared in North America. I came across the site in 2013 after it was the first Western media outlet to report on the H7N9 avian influenza (bird flu) outbreak in China. The very next year, they broke the story about eight hemorrhagic fever deaths in Guinea that eventually became the terrifying 2014 Ebola virus outbreak. Sanders has mobilized health experts and volunteers from around the world to translate esoteric news on disease from Arabic, Chinese, Dutch, French, German, Hindi, Indonesian, Spanish, Vietnamese, and several other languages.

What Sanders saw last night concerned her. In the 2013 H7N9 avian flu pandemic, she tells me, the earliest reports were that one to four people had the virus.¹ Now, she is seeing two brief media reports out of China identifying twenty-seven people sick with an unknown respiratory infection connected to an open-air market in Wuhan. Twenty-seven—a high number for a first report! She thought about calling Michael Coston, a colleague who runs the Avian Flu Diary blog, but it was the middle of the night. "In fourteen years, I have never called him late at night." Still, long ago, they had agreed that if it was "very significant," they would be in touch, no matter the time. So she called him.

Coston confirmed her concerns. It fit the profile of a viral outbreak. Sanders posted the stories to FluTrackers.com and slept for a few hours. Part of her worry came from knowing that news of this sort normally doesn’t pass through the Chinese government internet firewall. A single outbreak of any disease involving twenty-seven humans that was being widely broadcast means something serious is going on, she says. Overnight, others posted additional info out of China.² The Wuhan city government claims there has been no human-to-human transmission of this new virus.

This morning, Sanders checked again. Nothing on the American news sites. Nothing from the Centers for Disease Control and Prevention (CDC).

FRIDAY, JANUARY 10, 2020

Anthony Fauci, an American immunologist and director of the National Institute of Allergy and Infectious Diseases (NIAID), reports that the United States has reached peak levels of influenza a month early.³ There have been four hundred confirmed flu deaths, with larger-than-usual numbers of children being hospitalized.⁴ It could be a bad year.

Meanwhile, the World Health Organization (WHO) announces a disease cluster with an unspecified illness in Hubei Province, exactly as Sanders and others at FluTrackers.com are reporting. The CDC issues a Level 1 advisory, meaning Americans should avoid live animal markets overseas and stay home if they feel sick.⁵ Cases in China have grown to fifty-nine, including some in Hong Kong, which is worrying because Hong Kong is a good distance from Hubei Province.⁶ China’s medical and scientific community now suggest there could be human-to-human transmission.

Posts to FluTrackers.com show a run on face masks in China. Ever since the SARS (severe acute respiratory syndrome) outbreak two decades ago, it has become customary in China to wear face masks during disease outbreaks. In 2002, SARS started as a mystery pneumonia from the interior of China. By the spring of 2003, SARS was on every front page in the world—the next calamity after the 9/11/2001 terrorist attacks and the anthrax scare that followed.⁷ At the time, the Chinese government clamped down on news about the outbreak, jeopardizing lives. The virus killed fewer than one thousand people globally, and fear of SARS faded.⁸ When MERS (Middle East respiratory syndrome) appeared ten years later, there was even less concern in Western countries, though it was a deadlier coronavirus.

It might feel like a SARS moment for disease trackers like Sanders, but WHO takes a wait and see approach. We in the United States, at least, are in no danger.⁹

The real worry is that we are on the brink of war with Iran. Last week, the US government killed Iranian major general Qasem Soleimani in Baghdad, which infuriated the Iranians. People are protesting in the streets both here and in Iran. Just two days ago, Iranian ballistic missiles hit the Al Asad Air Base in Iraq, possibly injuring American soldiers. Now we hold our breath to see if tensions will escalate.

TUESDAY, JANUARY 14, 2020

WHO reports the sickness in China is a new kind of coronavirus, much like SARS or MERS. Disease trackers around the world might be unnerved by this. I’ve seen the American media report on it, yet the rest of the American public isn’t giving it much attention.

That’s no surprise. Adam Smith, the economist and moral philosopher, wrote long ago about how easy it is to detach ourselves from disasters in faraway places that are beyond many Westerners’ imaginations.¹⁰ Even in the Information Age when you can communicate with someone in China in seconds, the actual people there are abstract, too far away, and far too easy to stereotype. The reports say that this new coronavirus came from a wet market. It is a strange term, but it just means a place where animals are often butchered and sold. Many Americans have never heard of a wet market and have no idea how it could help spread a virus. It is too remote to matter.

I have resolved to document this pandemic if it comes to the United States. As historians have long noted, disease outbreaks reveal the fault lines and weaknesses of a society. We are living on the eve of a polarizing presidential election, amidst rising income inequality, housing insecurity, underfunded education systems, continued race violence, and brutal school shootings. We inhabit a world where one’s media popularity often matters more than one’s commitment to speak the truth. How would we handle such a crisis if it came to our shores? Would the constant movement of populations around the globe enable a disease that started in China to spread to my front door? Could the American healthcare system, which is based on a structure of profit-driven, acute care, respond adequately to keep me safe? Given our nation’s long history of violence, nativism, and racism, and given how divided we are on matters ranging from environmental protection to immigration to notions of freedom and liberty, would we be able to put aside our political differences and join forces in the face of a national crisis to protect ourselves and one another? What are the odds that our acrimonious, outrage-driven, twenty-four-hour media landscape would politicize a pandemic and prevent collective mobilization? Hopefully, we can avoid these questions. Hopefully, the virus stays in China.

WEDNESDAY, JANUARY 22, 2020

The CDC reports the new coronavirus is already in the United States. Two days ago, a man in his thirties checked himself into a clinic in Snohomish County, Washington, with body aches and labored breathing. The office staff gave him a mask to wear and left him waiting for twenty minutes in the front room—standard procedure. Four days earlier, on January 16, he had flown home from visiting his family in Wuhan. He had not been to the Huanan Seafood Market, where Chinese authorities suspect the new coronavirus originated, nor had he spoken to anyone who was sick during his travels. He hadn’t felt ill until the day before going to the clinic. Healthcare workers in Snohomish County sent him home to quarantine while awaiting the test results. Later, officials in hazmat suits showed up at his house and whisked him off to an airborne-isolation unit at Providence Regional Medical Center in Everett, Washington.

This man’s illness is pretty terrifying, given that Chinese scientists have confirmed rumors that the virus can spread through human-to-human contact. Sanders suspected this when she wrote on January 20 that healthcare workers in China were getting sick: Always a bad sign. And she noted that videos from China show unconscious people lying on the streets and sidewalks, healthcare workers in full protective gear, packed hospital waiting rooms, bodies being stacked in vans outside a hospital. It looks much grimmer than most American reporting reveals.

In response to the outbreak in China, the CDC and Customs and Border Protection (CBP) of the Department of Homeland Security (DHS) decided five days ago to assign about a hundred government employees to LAX, SFO, and JFK—the three airports that handle most of the flights from Wuhan. Around two hundred million passengers travel through these three airports each year. What are one hundred government workers tracking self-reported illness going to be able to do? And what about entry from other Chinese cities?

Thankfully, today the CDC says they plan to step up screening, though it’s not clear what that means. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases (NCIRD), maintains the risk to Americans remains low. But the novel coronavirus is certainly spreading outside Wuhan.¹¹ The CDC has begun contact tracing from the sick man in Washington State to anyone he may have interacted with during the four-day span between arriving from China and seeking medical attention.¹²

For what it’s worth, President Trump, who is awaiting his impeachment trial in the Senate, seems unconcerned. Asked in an interview today if there is reason to worry about the pandemic, he said, It’s one person coming in from China, and we have it under control. It’s going to be just fine. President Xi’s China, he intimates, is going to stop it. Indeed, the Chinese government is taking unprecedented measures, shutting down airports and train stations in central China during the busiest travel time of the year. Just yesterday, January 21, China quarantined the eleven million inhabitants of the city of Wuhan in Hubei Province.¹³ The Chinese government has initiated street spraying. I sympathize with the people of Wuhan, and I’m really glad not to be there right now. It is hard to imagine what the lockdown of a whole city would look like. WHO still does not consider this a public health emergency. Only seventeen people have died from the virus, after all. Sanders and the folks at FluTrackers.com, on the other hand, say that spraying means this new coronavirus is worryingly contagious.

The viral pneumonia from Wuhan is regularly reported in the American news now, but only gets a fleeting mention. The cases are relatively low still. Researchers at Imperial College London insist these low numbers are deceptive; their models suggest there could be triple the publicized number currently infected.¹⁴

FRIDAY, JANUARY 24, 2020

China has locked down a second city in Hubei Province, Huanggang, with a population of eight million. The nearby city of Ezhou shuts down its train stations. These restrictions take place during Chunyun, the forty-day period when people in China go home to celebrate the Lunar New Year with their extended families—truly the busiest travel season on Earth each year. A shutdown of these proportions will be exceedingly difficult for families and, by extension, the Chinese economy. Japan, Taiwan, Macau, Vietnam, South Korea, Thailand, and Singapore also report cases. Nevertheless, Trump tweets, It will all work out well.¹⁵

The US reports its second case of the new virus today: a Chicago woman in her sixties who recently flew home from China.¹⁶ She saw her physician for respiratory issues. The doctor immediately admitted her to a Chicago-area hospital and placed her in isolation before her test came back positive. (Her blood sample had to be sent to the CDC in Atlanta, since the US hasn’t approved a test for distribution.)

Scientists measure the spread of a virus by its reproductive ratio—R0; R-naught as the British say it—an estimate of how many people are likely to be infected by a single individual. If one person infects two people, then the R0 is 2.0. If the R0 is larger than 1.0, the virus will spread rapidly. Even a low-virulence disease can be scary if it spreads quickly. Influenza plus pneumonia has a lethality rate of around 0.1 percent. So, if this new coronavirus has a R0 over 1.0 for very long—and kills like the flu plus pneumonia—China, and maybe all of east Asia, could be looking at many thousands of deaths before it’s contained.

These are scary numbers, but the odds seem good this time won’t be as bad as the SARS epidemic two decades ago, when 774 people died.¹⁷ Health experts are already running tests and conducting contact tracing for this new virus. In addition, significant scientific and technological advances have taken place since the 2002–03 outbreak. Genetic sequencing is inexpensive and easy now. Chinese scientists sequenced the genome of this new virus two weeks ago and shared it with the world.¹⁸ American scientists did their own sequencing this week.¹⁹ In contrast, when SARS appeared in Canada seventeen years ago, scientists operated more or less in the dark.

According to Michael B. A. Oldstone, professor of immunology and microbiology at Scripps Research in La Jolla, California, scientists know this virus relatively well. They are called coronaviruses because they have crowns around the outside that act as grappling hooks, allowing coronaviruses to cling to the cells of their hosts’ respiratory systems.²⁰ Eventually, dead cells broken up by the virus clog the lungs, and if your body can’t clean up the damage fast enough, you can suffer from respiratory distress and even suffocate to death. Thankfully, these coronaviruses usually are not lethal, Oldstone tells me. The common cold is probably due to a coronavirus, but so are the original SARS and MERS, both of which are much deadlier. And, he cautions, even less deadly viruses can be terribly destructive if they transmit effectively.

This wouldn’t be much of a concern, except they are saying now that the virus has been with us for a while. The amount of genetic change shown between the original samples of the virus and more recent ones reveals to virologists like Andrew Rambaut at the University of Edinburgh that this new coronavirus has been circulating for about two months.²¹ Trump promises that Xi’s government is on top of it. But the worry in the scientific and medical community is the virus has a high transmission rate and has already traveled much farther than our government is admitting.

MONDAY, JANUARY 27, 2020

The basketball legend Kobe Bryant died in a tragic helicopter accident yesterday. Some corners of the internet say he was assassinated. But this is a hoax—a conspiracy theory pushed by one self-described psychologist.²² There is an epidemic of false information, hoaxes, and conspiracies like this one on nearly any topic on any given day.

Take the hoaxes surrounding the new virus, for instance. Though many Americans learned about this novel coronavirus only a few days ago, one conspiracy theory—that Bill and Melinda Gates took out a patent on a coronavirus vaccine in 2015—has been retweeted at least fifteen thousand times.²³ A YouTube video promoting this hoax has over 2.6 million views.

Many conspiracy theories are openly partisan, insisting that members of the so-called Deep State are colluding with Democratic politicians. Others traffic in racism and xenophobia. One story claimed that 2.8 million people in China are infected and 112,000 have died, while the Chinese government manipulates WHO and the international news media to promulgate a lower count.²⁴ These numbers are preposterous, unlikely to happen in a country with modern healthcare. Hoaxers attach images of rioting people on the streets of Beijing to their posts, reinforcing barbaric stereotypes. These right-wing conspiracy theorists neglect to mention that, at least for now, Trump’s message is that China has this new coronavirus under control.

In the past, news funneled through print media, radio, television, and film. Much of it, funded by big corporations or governments, was subject to some editorial oversight. Now, the truth has become a commodity whose manufacture is determined by the market. Any person can post an idea or a video that can go viral—absolutely no pun intended—regardless of its veracity. Now more than ever, market-driven truth, hacked together on the internet, drives the news that major broadcasters tell. A massive 2018 study showed that false news spreads much more rapidly than truth in our social media-saturated society.²⁵ And some of it, via Fox News, reaches the president, who repeats, amplifies, and legitimates the falsehoods.

WEDNESDAY, JANUARY 29, 2020

In his timeless book, A Journal of the Plague Year, Daniel Defoe recounts the fear that struck people before the pestilence spread through London in 1665. Frightened Londoners thronged out of the town . . . Indeed, nothing was to be seen but wagons and carts, with goods, women, servants, children . . . all hurrying away.²⁶ Today, like so many times before in human history, people are running from plague.

Two hundred and ten worried US foreign service workers and their families left Wuhan and landed this morning in California.²⁷ The National Center for Emerging and Zoonotic Infectious Diseases, a division of the CDC, screened them—although this screening can’t have been very telling, since it takes days for tests from the CDC in Atlanta to come back with results. Workers with the Administration for Children and Families (ACF), a division of Health and Human Services (HHS), will help them settle into the base today. From there, they can decide whether to remain in quarantine for three days or to travel to their homes across the country, where they will self-monitor for an additional fourteen days. Compared to the reportedly strict lockdown of Wuhan and the Hubei region, it is a modest intervention.

Meanwhile, Mike Ryan, executive director of the WHO Health Emergencies Programme, takes the podium at a hurried press conference in Geneva. Fifteen countries now have infected citizens. They have to stop transmission, he says emphatically. He believes chains of transmission can still be interrupted, but there is worry in his voice.²⁸ Coronavirus is spreading fast.

There is a lot we know. Right now, WHO reports 6,065 cases and around 250 deaths globally. Only a handful of infected people reside in the United States. We know it is another viral respiratory disease caused by a SARS coronavirus. Its most obvious symptoms include fever and a dry, persistent cough. We also know who it endangers the most. An article published in the Journal of Medical Virology charts the first seventeen deaths from Wuhan.²⁹ More males died from this disease than females—average age, seventy-five. Most people in this group lived only fourteen days from the time they reported their first symptoms. Two weeks from coughing to dead. Eleven showed comorbidities like diabetes, heart disease, cirrhosis of the liver, and hypertension.

Most of these comorbidities are associated with modern, stereotypically Western lifestyles. That’s another reason for those of us in Europe and North America to hope the fifteen countries where the virus has been detected are able to contain it.

THURSDAY, JANUARY 30, 2020

Some health officials argue that yesterday’s evacuations from China are an overreaction. It doesn’t make sense, protests Paul Offit, a prominent pediatrician and flu vaccine promotor at the Perelman School of Medicine at University of Pennsylvania, during a CDC telebriefing.³⁰ Influenza kills thirty thousand Americans a year, he says, yet we don’t put an entire plane full of passengers into quarantine in California for that. We have detained people in the March Air Reserve Base, and there are zero Americans dead, Offit complains. He echoes the president, who again insists everything is okay, that the Chinese government has the virus under control.

Nevertheless, today, Trump asks HHS to launch the White House Coronavirus Task Force (CTF). Alex Azar Jr., the Trump-appointed head of HHS, will lead it. Azar signals HHS will soon declare this a public health emergency and confirms the suspicions first aired last Friday that Chinese scientists uncovered direct person-to-person spread.³¹

Creating a vaccine will be the only real solution. Companies like Johnson & Johnson have already started working on such a vaccine for the Chinese market. Vaccines for viruses are difficult to develop, though. We take them for granted now, but each vaccine represents many years, often decades, of research. Funding is often a problem in vaccine development. Back in 2016, researchers at the Center for Vaccine Development in Texas reported being unable to attract investors to finance work on the first SARS coronavirus.³² Vaccine developers must avoid antibody-dependent enhancement, which occurs when a vaccine makes it easier for an infection to invade the host cell.³³ Even when safe and effective vaccines have been readily available for decades, increasing numbers of anti-vaxxers are encouraging completely unnecessary deaths. A