Borrell - The First Shots

Copyright 2021 by Brendan Borrell

All rights reserved

No part of this book may be used or reproduced in any manner whatsoever without written permission except in the case of brief quotations embodied in critical articles and reviews. For information, address HarperCollins Publishers, 195 Broadway, New York, NY 10007.

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Library of Congress Cataloging-in-Publication Data has been applied for.

ISBN 978-0-358-56984-8 (hardcover)

ISBN 978-0-358-56618-2 (ebook)

Cover design by Kerry Rubenstein

Cover illustration Ben Wiseman

Author photograph Ashley Barker

v2.1021

It is not the critic who counts; not the man who points out how the strong man stumbles or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again... who knows the great enthusiasms, the great devotions... who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.

THEODORE ROOSEVELT, APRIL 23, 1910,
A version of which is on the wall of Barney Grahams office at the Vaccine Research Center of the National Institutes of Health

Donald TrumpPresident

Michael PenceVice president

Mark MeadowsChief of staff to the president

Joseph GroganDirector, Domestic Policy Council

Deborah BirxCoordinator, White House Coronavirus Task Force

Jared KushnerSenior adviser to the president; Trumps son-in-law

Adam BoehlerCEO, U.S. International Development Finance Corporation; Kushners friend

HEADQUARTERS, WASHINGTON, DC

Alex AzarSecretary

Paul MangoDeputy chief of staff for policy

Brett GiroirAssistant secretary for health

Michael CaputoAssistant secretary for public affairs

Robert KadlecAssistant secretary, Office of the Assistant Secretary for Preparedness and Response (ASPR)

Michael CallahanSpecial adviser to the ASPR; staff physician, Massachusetts General Hospital

Rick BrightDirector, Biomedical Advanced Research and Development Authority (BARDA)

NATIONAL INSTITUTES OF HEALTH (NIH), BETHESDA, MARYLAND

Francis CollinsDirector

Anthony FauciDirector, National Institute of Allergy and Infectious Diseases (NIAID)

John MascolaDirector, Vaccine Research Center, NIAID

Barney GrahamDeputy director, Vaccine Research Center, NIAID

Kizzmekia CorbettResearch fellow, Vaccine Research Center, NIAID

Jason McLellanFormer research fellow; current associate professor, University of Texas at Austin

Larry CoreyCo-leader of the NIAID-funded COVID-19 Prevention Network; former president, Fred Hutchinson Cancer Research Center

CENTERS FOR DISEASE CONTROL AND PREVENTION (CDC), ATLANTA, GEORGIA

Robert RedfieldDirector

Anne SchuchatPrincipal deputy director

Nancy MessonnierDirector, National Center for Immunization and Respiratory Diseases

FOOD AND DRUG ADMINISTRATION (FDA), SILVER SPRING, MARYLAND

Stephen HahnCommissioner

Peter MarksDirector, Center for Biologics Evaluation and Research (CBER)

OPERATION WARP SPEED, WASHINGTON, DC

General Gustave PernaChief operating officer

Moncef SlaouiChief scientific adviser

James LawlerDirector, Clinical and Biodefense Research, University of Nebraska Medical Center

Matthew HepburnVaccine lead, Operation Warp Speed

Richard HatchettCEO, Coalition for Epidemic Preparedness Innovations

Carter MecherSenior medical adviser, Department of Veterans Affairs

MODERNA THERAPEUTICS

Stphane BancelCEO

Stephen HogePresident

Tal ZaksChief medical officer

Derrick RossiCofounder

PFIZER-BIONTECH

Albert BourlaCEO, Pfizer

Mikael DolstenChief medical officer, Pfizer

Katalin KarikSenior vice president for therapeutics, BioNTech

NOVAVAX

Stanley ErckPresident and CEO

Gregory GlennChief scientific officer

ASTRAZENECA

Menelas PangalosExecutive vice president, biopharmaceuticals R and D

Sarah GilbertProfessor, Jenner Institute, University of Oxford

JOHNSON AND JOHNSON

Alex GorskyCEO

SANOFI

Paul HudsonCEO

MERCK

Ken FrazierCEO

SHANGHAI PUBLIC HEALTH CLINICAL CENTER

PEOPLES REPUBLIC OF CHINA

1:30 P.M., FRIDAY, JANUARY 3, 2020

The specimen vial came sealed in a metal box. It had been sent here from the city of Wuhan, some five hundred miles inland, under desperate circumstances. On December 26, 2019, a man had shown up at Wuhans Central Hospital with a cough and a high fever. The patient was forty-one years old and worked at the Huanan Seafood Market, a bustling complex with over a thousand stalls. There, beneath the skyscrapers of that city of eleven million, were stacks of cages trucked in from the countryside containing animals like bamboo rats and raccoon dogs, an Asian fox relative with spectacled eyes. Some dealers even offered cobras, which are prized as both food and medicine. These captives were all waiting to be butchered and then thrown over a wood fire or boiled in a salty broth.

Winter in Wuhan meant foggy days, light rain, and temperatures in the fortiescold season. The market worker had been feeling ill for nearly a week. His cough progressed to a profound pain in his chest. Tests for bacterial pneumonia and flu came back negative. So, too, did tests for other common respiratory pathogens. After three days, he was rushed to the hospitals intensive care unit, gasping for air. Doctors put him under anesthesia and inserted the long, clear tube of a mechanical ventilator down his trachea. The breathing machine would perform the work that his lungs no longer could. A second tube snaked through his nose and into his stomach to provide sustenance. There was, for a short time, a third tube, this one fed down the trachea and into one of the most distant branches of his lungs. Through this tube, doctors squirted sterile saline and suctioned a foamy, pinkish fluid back into a vial. The lung-wash sample was preserved in alcohol, packed in the metal box with dry ice, and sent to the public health center on the outskirts of Shanghai where a microbiologist named Yong-Zhen Zhang was waiting.

As a child, Zhang had wanted to be a general leading soldiers into battle. Instead, he became a scientist committed to protecting the health of his countrymen and demonstrating Chinas scientific competency on the world stage. Back when he worked for the Chinese Center for Disease Control and Prevention in Beijing, it wasnt unusual for colleagues to get e-mails from him at three a.m. or for visitors to come by his office for morning tea and find him curled up on a small black leather couch where he had slept the night before.